Overweight Children

Question 1

What does a BMI centile chart show?

Answer 1

The expected distribution of BMI values based on a child’s age and sex

Question 2

What axes are used on the BMI centile chart used to assess weight in children?

Answer 2

BMI by age in years

Question 3

At what centile is a child considered at high risk of being…
-Overweight
-Obese
?

Answer 3

> = 85th centile: high risk of overweight

> = 95th centile: high risk of obesity

Question 4

At what centile is a child considered...
-Overweight
-Obese
-Severely obese
?

Answer 4

> = 91st centile: overweight

> = 98th centile: clinically obese

> = 99.6th centile: severely obese

Question 5

Why can BMI not be calculated accurately in children <2 y/o?

Answer 5

Children <2 y/o cannot have their height accurately measured

Question 6

How is an approximate BMI centile given for children <2 y/o?

Answer 6

By plotting weight and length on a BMI conversion chart

Question 7

Use of waist circumference as a diagnostic measurement is not recommended in children. T/F?

Answer 7

True

Question 8

Children of black ethnicity are less likely to be overweight. T/F?

Answer 8

False

Black ethnicity is a risk factor for childhood obesity

Question 9

Breastfeeding for >= X months is protective against childhood obesity

Answer 9

> = 4 months

Question 10

Name 2 genetic causes of severe obesity

Answer 10

• Prader-Willi syndrome
• Bardet-Biedl syndrome

(both have hyperphagia as a symptom)

Question 11

When is an obese child referred for paediatric review?

Answer 11

• Serious obesity-related morbidity that requires weight loss e.g., sleep apnoea, benign intracranial hypertension
• Suspected underlying medical cause of obesity e.g., endocrine
• <2 y/o who are severely obese (BMI >=99.6th centile)

Question 12

Why is weight maintenance the goal of treatment for overweight and obese children?

Answer 12

Because height will be increasing as children are constantly growing

Height gain and weight maintenance will reduce BMI

Question 13

At what age should children start following the Eatwell Guide?

Answer 13

> 5 years

Question 14

At what age should children start following the Eatwell Guide?

Answer 14

> 5 years

Question 15

For how many minutes per day should a child aged…
- <5 y/o (but able to walk)
- 5-18 y/o
… be physically active?

Answer 15

< 5 y/o: >= 180 minutes per day

5-18 y/o: >= 60 minutes per day

Question 16

Parental/family involvement in diet/activity/behavioural management programmes has been shown to significantly reduce BMI. T/F?

Answer 16

True

Question 17

When may drugs be used to help manage weight in children? Which drug is used?

Answer 17

Orlistat can be prescribed to adolescents (>12 y/o) with:

• Extreme obesity (BMI >=3.5 SD’s above the median)
• Severe obesity (BMI >=99.6th centile) with comorbidities

Question 18

How does Orlistat work?

Answer 18

Inhibits gastric and pancreatic lipase to reduce absorption of dietary fat by ~30%

Question 19

Is bariatric surgery ever considered in overweight children?

Answer 19

May be considered in post-pubertal adolescents with very severe to extreme obesity and severe comorbidities

Question 20

Define ‘weight bias’

Answer 20

Weight bias = negative attitudes and beliefs held about people who are overweight or obese. This can be about others or oneself

Question 21

Define ‘weight stigma’

Answer 21

Weight stigma = actions, such as exclusion, which are taken against people who are obese

Question 22

Children living in areas of highest deprivation have the largest percentage of overweight and underweight children. T/F?

Answer 22

False

% of overweight children increases as level of deprivation increases

% of underweight children is steady across the deprivation quintiles