An initial visit should be used to take a detailed history and physical examination in order to triage the child into one of three categories:
1. Children with the most common type of obesity - that which is due to lifestyle factors. These children may benefit from repeated brief goal setting to address their weight problem without further onward referral.
2. Children who need onward referral to a specialist including children with a suspected syndrome or an organic disorder (< 2% of children).
3. Those with suspected co-morbidities of obesity who will require additional tests (laboratory testing, fitness testing, sleep studies, orthopaedic review). If such complications are present, referral to a specialist should be strongly considered.
In addition, to measuring a child’s growth and plotting this on a child growth chart (see below), it is important to rule out an underlying organic disorder and to screen for co-morbidities.
Please remember also to ask parents or young people about the psychological factors that can influence or result from weight gain (e.g. emotional eating, low mood, social withdrawal or bullying).
For guidance on the best way to measure height and weight in children please see the videos from the College of Paediatrics and Child Health (UK) below.
How to measure weight in children
who do not want to be weighed.
How to measure weight in infants and children.
How to measure a child’s height.