Clinical Assessment of Pediatric Obesity: OMA Clinical Practice Statement

Dr. Shivani Sidana, Associate Professor, Department of Endocrinology and Metabolism, AIIMS, Bathinda 

Assessment of pediatric obesity is age dependent and relies on standardized growth charts and BMI-based classifications to accurately identify overweight, obesity, and severe obesity in children and adolescents.

The Obesity Medical Association (OMA) Clinical Practice Statement provides evidence-based guidance for the assessment and initial clinical evaluation of pediatric patients with obesity. The recommendations are intended for children and adolescents with a body mass index (BMI) at or higher than the 95th percentile, particularly those experiencing adverse health consequences related to excess body mass.

For children younger than 2 years, weight status is assessed using weight-for-length percentiles derived from the World Health Organization (WHO) or Centers for Disease Control and Prevention (CDC) growth charts. These charts account for age-related growth patterns and differences in feeding practices.

For children and adolescents aged 2–20 years, body mass index (BMI) percentile is the primary tool for classifying weight status. Overweight is considered when BMI is between the 85th and 94th percentiles, while obesity isconsidered when BMI is at or above the 95th percentile.

In individuals with BMI values exceeding the 95th percentile, obesity severity is further classified using the percent of the 95th percentile into Class 1, Class 2, and Class 3. Any BMI at or above 120% of the 95th percentile is considered severe obesity.

BMI standard deviation scores may be used to adjust for age and sex, but are not recommended for monitoring change in children and adolescents with severe obesity because of score compression at higher BMI levels. For these patients, changes in the percent of the 95th percentile are preferred.

In older adolescents, an absolute BMI threshold of 35 kg/m² may be used to identify severe obesity, particularly in boys aged approximately 18 years and girls aged approximately 16 years.

(Source: Cuda SE, Censani M. Assessment, differential diagnosis, and initial clinical evaluation of the pediatric patient with obesity: an Obesity Medical Association (OMA) Clinical Practice Statement 2022. Obesity Pillars. 2022 Mar 1;1:100010. )