What is the standard clinical measure used to screen for overweight and obesity in children and adolescents?

• A. BMI percentile adjusted for age and sex.
• B. Weight-for-age percentile
• C. Height-for-age percentile
• D. BMI z-score

Answer: (A)

In children, screening for overweight and obesity is done using BMI adjusted for age and sex, plotted as a percentile on growth charts. This approach accounts for the way body composition changes as kids grow and for differences between boys and girls. By comparing a child’s BMI to peers of the same age and sex, clinicians can categorize weight status in a way that’s meaningful for growth and development. In practice, the 85th to 94th percentile is often used to flag overweight, and the 95th percentile or higher indicates obesity.

Weight-for-age percentile doesn’t reflect height and can be misleading as children grow taller or shorter at different rates. Height-for-age percentile tracks linear growth and doesn’t assess adiposity. BMI z-score is a related metric that expresses how many standard deviations a child’s BMI is from the reference median and is more common in research or specific clinical scenarios. For routine screening, BMI percentile adjusted for age and sex is the standard measure.