Identifying obesity/overweight status in children and adolescents; A cross-sectional medical record review of physicians’ weight screening practice in outpatient clinics, Saudi Arabia

Abstract

Background BMI is a feasible and recommended measure for overweight and obesity screening in children and adolescents. The study aimed to determine how often physicians correctly identified obesity/ overweight status in children and adolescents by using BMI percentile charts. Methods This retrospective cross-sectional study reviewed the paper medical records of children and adolescents (6–14 years) who visited family medicine and pediatric outpatient clinics (Jan-June 2012) in a medical city in Riyadh. Investigators calculated BMI percentiles (using height, weight, age and gender data retrieved from the records) in order to identify patient weight status. Physician documentation of obesity/overweight diagnoses in patient problem lists were cross checked against their BMI percentile to assess the accuracy of physicians’ identification of weight status. The recommended management plan for identified patients was also recorded. Results A total of 481 charts were reviewed, 213 (44%) children were seen by family medicine physicians and 268 (56%) by pediatricians. The sample was equally distributed by gender. Height was undocumented for 13% (71) of visiting patients. Eighteen percent of patients (86) were classified as overweight (35)/obese (51) according to age and sex adjusted BMI percentile. Physicians’ correctly identified and documented weight status in 20% of overweight/obese patients: 17 out of 86 subjects. Weight status identification was higher among pediatricians—25% as compared to family medicine physicians—10% [p = 0.08]. Dietary referral was the most common management plan for the identified children. Physicians were more likely to identify obese children {≥95 th } compared to overweight {≥85 th - 95 th } children. Subjects whose BMI for age classified them into the highest BMI percentile category {≥95 th } were more likely to be correctly identified (29%) compared to those classified within {≥85 th - 95 th } category—6% [p = 0.007]. Conclusion Physician identification of obesity/ overweight status for children and adolescents was low, irrespective of their specialty, and despite the condition being prevalent in the sample. Future research that concentrates on interventions that may improve documentation of obesity/overweight diagnoses and parameters needed for BMI indices would be beneficial.

Allometric multi-scaling of weight-for-height relation in children and adolescents: Revisiting the theoretical basis of body mass index of thinness and obesity assessment

“…The body mass index (BMI), defined as weight in kilograms divided by height in meters squared, has been widely used to assess both body thinness and fat in all age groups, including children and adolescents [1][2][3][4]. In practice, the World Health Organization (WHO), medical doctors, nutritionists, and elementary schools use BMI to screen for thinness, underweight, overweight, and obesity [5,6].…”

Smartphone-based application to control and prevent overweight and obesity in children: design and evaluation

“…Therefore, with increasing obesity rates and related health problems, finding ways to help people lose excess weight is crucial, because overweight and obesity in children are associated with many adverse physical and psychological consequences [ 13 ]. This is despite the fact that overweight and obesity can be identified, prevented, and treated, and its early diagnosis can lead to timely intervention [ 14 ]. In this regard, Information and Communication Technology (ICT) can play a major role by providing easier and more affordable access to health and treatment services [ 15 ].…”

Diagnóstico y clasificación del sobrepeso y la obesidad: comparación de criterios

“…La prevalencia de sobrepeso y obesidad infantil está incrementando en los últimos años, convirtiéndose en la enfermedad crónica no transmisible y prevenible más prevalente del mundo. Además, se considera uno de los principales problemas de salud pública (Sarmiento et al 2016;Chacín et al 2019;Garrido-Miguel et al 2019;Nasim et al 2019). Esta patología se define, según la Organización Mundial de la Salud (OMS), como una acumulación anormal o excesiva de grasa que puede ser perjudicial para la salud.…”

“…Serrano, 2015 como diabetes tipo 2, hipertensión arterial, accidentes vasculares, coronariopatías, hiperinsulinemia, alteraciones en el perfil lipídico y aumento de la mortalidad (Bartrina et al 2005;Flores-Huerta et al 2008;Mönckeberg and Muzzo 2015). También pueden sufrir problemas psicológicos como baja autoestima, depresión y aislamiento social (Bermejo Sarmiento et al 2016;Nasim et al 2019;OMS 2019).…”