A review of the charts of 473 children (between 2 and 18 years old) who were seen for a well-child checkup at three general pediatric clinics showed that only 29% (27) of the 93 whom researchers identified as overweight were, in fact, given that diagnosis. In addition, the clinics correctly identified only one of 82 children "at risk" of overweight.* Clinicians were more likely to make the diagnosis in children who were older than 7.5 years, and there was a tendency for the identified overweight child to be female. Approximately 85% of children who were given a diagnosis of overweight were offered a treatment plan.
Investigators attribute the underdiagnosis of overweight to a failure to plot the body mass index (BMI) percentile for age and gender on growth charts. In fact, not one of the reviewed charts had a calculated and recorded BMI. Instead, the charts contained weight-for-age and height-for-age information (Louthan MV et al: Clin Pediatr 2005;44:57).
*Investigators based their diagnoses on criteria of the Centers for Disease Control and Prevention [CDC], which classify a child with a body mass index (BMI) between the 85th and 95th percentiles for age and gender as "at risk of overweight" and a child with a BMI greater than or equal to the 95th percentile as "overweight."