Obesity, Overweight, and Dyslipidemia in Children and Adolescents

Table of Contents

1. OBESITY, OVERWEIGHT, AND DYSLIPIDEMIA IN CHILDREN AND ADOLESCENTS
2. DEFINITIONS
3. BODY MASS INDEX (BMI)
4. EPIDEMIOLOGY
5. ETIOLOGY
6. ASSESSMENT
   1. History
   2. Physical exam
   3. Other Screening Tools
7. CO-MORBIDITIES
8. HYPERLIPIDEMIA
9. DIET AND EXERCISE RECOMMENDATIONS
10. PHARMACOLOGIC INTERVENTIONS
11. REFERRING TO SUBSPECIALISTS
12. TAKE HOME POINTS
13. RESOURCES & REFERENCES
14. ABOUT THE MODULE

Other Screening Tools

Currently, there are no widely accepted guidelines for screening for co-morbidities of overweight and obesity among pediatric practitioners. However, an expert committee recommends getting the following screening labs (Barlow, 2007):

• BMI 85th to <95 ^th percentile for age and gender with no risk factors
  • fasting lipid profile

• BMI 85th to <95 ^th percentile for age and gender with risk factors in the history or physical exam
  • AST, ALT, fasting glucose levels and fasting lipid panel

• BMI > 95 ^th percentile for age and gender, regardless of risk factors
  • AST, ALT, fasting glucose levels and fasting lipid panel

Risk Factors:

1. Personal history of cigarette smoking
2. Personal history of diabetes mellitus
3. Personal history of hypertension
4. Family history of
   1. diabetes mellitus type 2
   2. dyslipidemia
   3. premature heart disease (MI, CVA)
   4. hypertension
   5. obesity

Also consider testing patients based on specific complaints or risk factors that might support a particular diagnosis of diabetes or NASH/NAFLD:

1. Glucose: polyuria; polydipsia; polyphagia; weight loss or gain; black, Hispanic or Native American background; PCOS; acanthosis nigricans
2. AST/ALT: abdominal pain (especially RUQ); FH of liver disease