Evaluation of Children and Adolescents with Obesity

Childhood overweight and obesity in Indian children and adolescents is a relatively new but widespread epidemic. Hence, it is necessary to evaluate and identify these children to prevent long-term complications. The most important evaluation to identify and assess obesity-related risks in these children involves anthropometric assessment and using appropriate growth charts. Overweight and obesity are defined using weight-for-length or -height parameters (World Health Organization 2006 charts) in Indian children less than 5 y and body mass index (Indian Academy of Pediatric 2015 charts) in Indian children aged 5-18 y. Waist circumference is another important predictor of pediatric obesity-related comorbidities and is also a component to define metabolic syndrome. Tall and obese children usually have primary obesity, and short and obese children require further evaluation for endocrine disease or syndromic causes. The presence of developmental delay, hearing or vision impairment, genital and digit abnormalities or dysmorphism should warrant a genetic evaluation. It is important to document social and dietary history as well as time spent in physical activity and usage of electronic screen. Finally, comorbidities associated with childhood obesity are common, which can result in long-term complications; hence, these comorbidities should be screened and managed to prevent long-term cardiometabolic risks.