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  • Pediatric Original Article
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Introducing excess body weight in childhood and adolescence and comparison with body mass index and waist-to-height ratio

International Journal of Obesity volume 39, pages 52–60 (2015)Cite this article

Subjects

Abstract

Background:

Weight status in children and adolescents is commonly defined using age- and gender-corrected standard deviation scores for body mass index (BMI-SDS, also called z-scores). Values are not reliable for the extremely obese however. Moreover, paediatricians and parents may have difficulties understanding z-scores, and while percentiles are easier to gauge, the very obese have values above the 99th percentile, making distinction difficult. The notion of excess body weight (EBW) is increasingly applied in adult patients, mainly in the context of bariatric surgery. However, a clear definition is not available to date for the paediatric population.

Methods:

A simple definition of EBW for children and adolescents is introduced, with median weight as a function of height, age and gender (characterized by an asterisk): EBW (%)=100x(weight−median weight*)/median weight*. EBW is compared with BMI-SDS and waist-to-height ratio (WHtR). Using two data sources (APV registry and German Health Interview and Examination Survey for Children and Adolescents (KiGGS)) including more than 14 000 children, the relationships between these anthropometric and various metabolic parameters are analysed for a group of overweight/obese children who have sought obesity therapy (APV), for the general paediatric population and for the subset of overweight/obese children from the general population (KiGGS).

Results:

The three anthropometric parameters are strongly correlated, with the linear correlation coefficients exceeding 0.8 in the general population and 0.75 in those seeking obesity therapy. Moreover, their relationship to metabolic parameters is quite similar regarding correlations and area under the curve from receiver operating characteristic analyses.

Conclusions:

EBW has similar predictive value for metabolic or cardiovascular comorbidities compared with BMI and WHtR. As it is reliable at the extreme end of the obesity spectrum, easily communicable and simple to use in daily practice, it would make a very useful addition to existing tools for working with obese children and adolescents. Its usefulness in assessing weight change needs to be studied however.

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Acknowledgements

We express our gratitude to all health professionals of the APV Study Group taking care of overweight and obese children and contributing to the APV database. Part of the work was supported by the Federal Ministry of Education and Research, Germany (Integrated Research and Treatment Center IFB ‘Adiposity Diseases’, FKZ: 01E01001; Competence Network Obesity, FKZ 01GI1130).

Author information

Authors and Affiliations

  1. Clinical Trial Centre Leipzig, University of Leipzig,

    D Petroff

  2. Leipzig, Germany

    D Petroff

  3. Leipzig University Medical Center, IFB Adiposity Diseases, Leipzig, Germany,

    D Petroff & S Blüher

  4. Institute of Human Genetics, Jena University Hospital, Friedrich-Schiller-University, Jena, Germany

    K Kromeyer-Hauschild

  5. Department of Pediatric Endocrinology and Diabetology, Charité Universitätsmedizin, Berlin, Germany

    S Wiegand

  6. Children’s Hospital of Eastern Switzerland, St Gallen, Switzerland

    D l'Allemand-Jander

  7. Pediatric Endocrinology and Diabetology, University Children’s Hospital, University of Tuebingen,

    G Binder

  8. Tuebingen, Germany

    G Binder

  9. Pediatric Endocrinology and Diabetology, Centre for Child and Adolescent Health, University of Freiburg, Freiburg, Germany,

    K-O Schwab

  10. Clinic for Rehabilitation of Children and Adolescents, Sylt, Germany

    R Stachow

  11. Department of Women and Child Health, University Hospital of Leipzig,

    W Kiess

  12. Leipzig, Germany

    W Kiess

  13. Children’s Hospital Wilhelmsstift, Hamburg, Germany

    E Hammer

  14. SANA Hospital Lichtenberg, Berlin, Germany

    S Sturm

  15. Institute of Epidemiology and Medical Biometry, University of Ulm,

    R W Holl

  16. Ulm, Germany

    R W Holl

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  1. D Petroff
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Correspondence to D Petroff.

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Petroff, D., Kromeyer-Hauschild, K., Wiegand, S. et al. Introducing excess body weight in childhood and adolescence and comparison with body mass index and waist-to-height ratio. Int J Obes 39, 52–60 (2015). https://doi.org/10.1038/ijo.2014.170

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  • DOI: https://doi.org/10.1038/ijo.2014.170

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