Assessment of the obese child or adolescent

The evaluation of a child or adolescent for obesity begins with weight and height measurements to calculate body mass index percentile. A thorough medical evaluation should be done to screen for obesity-associated medical conditions, including hypertension, dyslipidemia, fatty liver disease, prediabetes and diabetes, obstructive sleep apnea, polycystic ovary syndrome, and orthopedic conditions. Most of the obesity comorbidities known in adults also occur during childhood, and early recognition is an opportunity to protect long-term health. Obese youth seem to be at higher risk for serious mental health conditions, including depression, anxiety, and eating disorders. In addition, these children are vulnerable to psychological stress from teasing and from low self-esteem. Because intervention is primarily behavior based, evaluation of obese children and adolescents must include current, potentially modifiable lifestyle behaviors as well as an assessment of the strengths and barriers of the home and community environment.