The new children’s BMI scale rises to 60 as childhood obesity increases

In the last few decades, severe childhood obesity in America has nearly quadrupled, experts said.

WASHINGTON — U.S. health officials have revamped a tool to track rising cases of severe childhood obesity that had previously disappeared from the charts.

Updated growth charts released Thursday by the Centers for Disease Control and Prevention now extend to a body mass index of 60 — up from previous charts that stopped at a BMI of 37, with additional categories to track obesity Children aged 2 to 19 years.

In the last few decades, severe childhood obesity in America has nearly quadrupled, experts said.

“A decade ago, we realized that we were kind of beating our growth charts,” said Dr. Tom Inge, who directs the weight loss surgery program at Lurie Children’s Hospital of Chicago.

The CDC charts are the most widely used tool in the US to track children’s growth and development. Parents are used to discussing the progress of their children’s growth from the time they are babies, noted Dr. Alyson Goodman of the CDC. The new charts will be “extremely helpful” in forging better conversations between parents and healthcare providers, she said.

“They use these charts as a visual aid,” Goodman said.

The old charts have been used since 2000. They were based on data from US surveys conducted from 1963 to 1994, when far fewer children were obese, let alone severely obese, said Cynthia Ogden, a CDC epidemiologist. Today, about 4.5 million children – about 6% – fall into this category

Growth charts show developmental patterns by age, expressed in BMI, a calculation of height and weight, and also in curves called percentiles. Unlike adults, children are not classified as obese or severely obese based on a strict BMI cut-off, Inge noted. Instead, children are described as obese based on percentiles — where they fall compared to other children their age.

A child is considered obese when they reach the 95th percentile on the growth charts and are severely obese at 120% of that mark—or have a BMI of 35 or greater. according to CDC. For example, a 17-year-old boy who is 5 feet, 8 inches tall and weighs 250 pounds would have a BMI of 38 and would be described as severely obese.

The old charts didn’t include kids like Bryan Alcala of Aurora, Illinois, who first sought help in 2019 as a high school freshman measuring 5 feet, 5 inches and weighing about 300 pounds.

“That’s when it kind of got out of hand,” recalls Alcala, who gained extra pounds after developing a rare bone disease as a child that limited his activity.

Kids like Alcala, with BMIs of 45, 50 or higher, topped the CDC charts, making it difficult to assess their status or properly represent their progress, which often delayed treatment, Inge said.

“It’s like driving a car at night, with no headlights and no dashboard,” said Inge. “You don’t know where they stand in relation to their peers.”

Alcala, now 17, had weight-loss surgery in April and lost 115 pounds, with ten more to come.

“Everything is going well now,” he says.

However, an expert questioning the use of BMI to assess adults said doctors need to be careful when using the new charts with children. They should focus on behaviors that lead to weight gain and be careful not to stigmatize children and families, said Dr. Tracy Richmond, associate professor of pediatrics at Harvard Medical School.

“I find it problematic to use it as a visual tool for families,” Richmond said. “The family and the child already know that they live in one big body. We clinicians will not provide any new information with it.”

But Erika Alcala, Bryan’s mother, said she was glad the new growth charts would include children like her son.

“Until you see it on paper and in front of you, you don’t know,” she said. The new children’s BMI scale rises to 60 as childhood obesity increases

Laura Coffey

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