Pediatricians Not Tracking Kids' BMI

Surveys find most failing to measure patients' body weight

By Randy Dotinga
HealthDay Reporter

TUESDAY, May 8 (HealthDay News) -- Despite recommendations that came out years ago, two new studies suggest that many pediatricians are failing to properly track the body weight of their young patients.

Ideally, pediatricians take note of a child's height and weight and then perform a calculation to get a number that reveals whether the child has a weight problem, said Dr. Jennifer Hillman of Cincinnati Children's Hospital Medical Center, lead author of one of the studies.

But Hillman and her colleagues found that 42 Cincinnati pediatricians correctly measured and tracked the body-mass index (BMI) of only 5.5 percent of the 500 children studied.

Obesity is a growing problem in children, Hillman said, causing "secondary complications like diabetes and high blood pressure and cardiac problems. We're seeing those things earlier and earlier."

The results of the 2004 study were released Monday at the Pediatric Academic Societies' annual meeting, in Toronto.

BMI, a number derived from a person's height and weight, measures whether someone is underweight, of normal weight or overweight.

Why not just eyeball a kid?

That doesn't work, according to Hillman. When kids are between toddler-age and adolescence, she said, "it's very difficult to look at a child and actually know by appearance" whether they're at risk for being underweight or overweight.

But even just the BMI doesn't present the entire picture for kids, as it does in adults. The growth of children throws off the BMI, so pediatricians who track it look at charts that tell them the proper BMI for children of specific ages and genders.

The American Academy of Pediatrics has recommended since 2003 that pediatricians track BMI; federal growth charts have included BMI since 2000.

Why isn't there more consideration of BMI?

"One reason may be a lack of knowledge about the recommendations, about what the BMI means in children and how to use it," Hillman said. "We also wonder if there's some resistance in terms of how it takes a lot of extra time to explain this to families, and there's resistance from the family's perspective about a diagnosis of obesity and overweight."

A second study to be presented at the pediatric meeting found that a higher number -- 52 percent -- of 1,662 pediatricians surveyed in 2006 report assessing the BMI of patients over the age of 2.

That survey found that 92 percent of pediatricians felt comfortable talking to patients about weight issues, but only 38 percent thought such counseling would be effective. About two-thirds said they didn't have enough time to talk about the topic of weight.

Ninety-six percent of pediatricians want to do more about obesity, but "the barriers to being able to do this are both time and the doctor's expertise," in addition to health insurance companies that probably don't pay for weight and nutrition management, said study author Dr. Jonathan Klein, an associate professor of pediatrics at the University of Rochester.

What to do?

Parents "need to start prompting their physicians about BMI and learning about it," said Hillman. "That will push pediatricians to become more savvy and address the issue. It may also send a message to physicians that there may not be as much resistance as we think. Most parents just want their kids to be healthy, even if that means talking about something that's particularly sensitive."

More information

Learn more about BMI and kids from the U.S. Centers for Disease Control and Prevention.

SOURCES: Jennifer Hillman, M.D., clinical fellow in adolescent medicine, Cincinnati Children's Hospital Medical Center; Jonathan Klein, M.D., associate professor, pediatrics, University of Rochester, New York; May 7, 2007, presentation, Pediatric Academic Societies meeting, Toronto