Is A Fat Child Overweight, Obese, At Risk, Or What?

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Main Category: Pediatrics / Children's Health
Also Included In: Obesity / Weight Loss / Fitness;  Sports Medicine / Fitness;  Nutrition / Diet
Article Date: 03 Jul 2006 - 10:00 PDT


How should a doctor define a child who is overweight? Should that child be told he/she is fat, overweight, obese, at risk of overweight, or what? This is the theme of a discussion by a committee convened by AMA (American Medical Association), the Centers for Disease Control and Prevention (CDC) and some other experts.

The idea is to use terms that are clearer when referring to a child's bodyweight.

As far as the CDC is concerned children are never called 'obese' - regardless of how heavy they are. The CDC says those who seem to be overweight be called 'at risk of overweight'. Obese children should be called 'overweight', says the CDC. How do they define these terms?

-- At risk of overweight
This means the child's BMI (body mass index) is in the 85th - 94th percentile for their sex and age. In other words, a child who is 'at risk of overweight' is fatter than 85%-94% of all other kids of his/her age and sex.

-- Overweight
This means the child's BMI is in the 95%-100% percentile for age and sex. In other words, the child is fatter than at least 95% of all other children of his/her age and sex.

The committee suggest that terms used for children should be the same as the terms used for adults. An obese child should be termed in the same way as an obese adult is, an overweight child should be termed in the same way as an obese adult is. The final recommendations of the committee will be issued in September, 2006. After that, government bodies and medical organisations can decide whether they agree or not.

Should a doctor tell a fat child he/she is obese or overweight?

If a doctor tells a child he/she is obese or overweight there is a risk of upsetting the child and/or the family. By saying nothing the health care professional is not doing what is best for the child, and the family. Should a doctor address a serious issue head on, or avoid it? Child and teen obesity in the USA has become a serious public health issue. Obese and many overweight children, if they do not take action to bring their weight down, face a very high risk of serious illness early into their adulthood.

If a child came into a doctor's practice with a serious illness the doctor would tell him/her and the family straight away. If a fourteen year old child came in smoking a cigarette wouldn't the doctor explain the health risks and urge him/her to stop? Surely, obesity and overweight is no different. The risk of serious illness as a result of childhood obesity/overweight is there. A very high percentage of obese and overweight children eventually become overweight or obese adults.

The problem with the current terms used by the CDD is that they allow the patient to live in denial - the problem is not dealt with head on - it is avoided. If obesity and overweight were used for children in the same way they are used for adults all it would do is bring the USA in line with the rest of the world. Why should the USA, whose child obesity rates are far higher than they are in Europe or Japan, have to skim around the theme? What matters more, political correctness or the future health of America's children?

US pediatricians and nurses have written in to Medical News Today saying they find the whole terminology thing confusing. An obese child is 'overweight' and an overweight child is 'at risk of overweight'. If health care professionals find it baffling what chance have the children and their families.

I asked my two kids a simple question this morning 'If a child is at risk of overweight is he/she fat?' They both said no, not yet. The term is so inaccurate.

17% of US children are 'overweight' - in other words, obese. 34% are 'at risk of overweight' - in other words, overweight. However, the way these present figures come about are from calculations that date back to the 1960s when very few kids were fat. It is possible that children are taller than 40 years ago. Wouldn't it be better to just have two terms for everyone, children and adults - obese and overweight? Wouldn't it be better to work out average child heights today according to sex and age and draw up a new chart - but leave political correctness out of the equation?

Written by: Christian Nordqvist
Editor: Medical News Today
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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