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Defining overweight and obesity in children

Obesity means having too much body fat. It is not the same as overweight, which means weighing too much. Obesity is becoming much more common in childhood. Most often, it begins between the ages of 5 and 6 years and in adolescence.

Child health experts recommend that children be screened for obesity at age 2 years. If needed, they should be referred to weight management programs.

Measuring Body Fat

Your child's mass index (BMI) is calculated using height and weight. A health care provider can use BMI to estimate how much body fat your child has.

Measuring body fat and diagnosing obesity in children is different than measuring these in adults. In children:

  • The amount of body fat changes with age. Because of this, a BMI is harder to interpret during puberty and periods of rapid growth.
  • Girls and boys have different amounts of body fat.

A BMI level that says a child is obese at one age may be normal for a child at a different age. To determine if a child is overweight or obese, experts compare BMI levels of children at the same age to each other. They use a special chart to decide whether a child's weight is healthy or not.

  • If a child's BMI is higher than 85% (85 out of 100) of other children their age and sex, they are considered at risk of being overweight.
  • If a child's BMI is higher than 95% (95 out of 100) of other children their age and sex, they are considered overweight or obese.

References

Gahagan S. Overweight and obesity. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 47.

O'Connor EA, Evans CV, Burda BU, Walsh ES, Eder M, Lozano P. Screening for obesity and intervention for weight management in children and adolescents: evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2017;317(23):2427-2444. PMID: 28632873 www.ncbi.nlm.nih.gov/pubmed/28632873.

Review Date 8/5/2018

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.