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This version was published on October 1, 2007
Clinical Pediatrics, Vol. 46, No. 8, 689-697 (2007)
DOI: 10.1177/0009922807300744
© 2007 SAGE Publications

Use of Enhanced Body Mass Index Charts During the Pediatric Health Supervision Visit Increases Physician Recognition of Overweight Patients

Michael J. Gilbert, MD

University of Washington, Department of Pediatrics, Seattle, ichael.Gilbert{at}SeattleChildrens.org

Michael F. Fleming, MD, MPH

University of Wisconsin-Madison, Department of Family Medicine

The American Academy of Pediatrics recommends counseling about obesity-specific topics and measuring body mass index (BMI) at all health supervision visits. The authors compared the rates of overweight diagnosis and physician counseling at 2 clinics, one using color-coded BMI charts. The authors interviewed patients and reviewed their charts for differences in diagnosis and counseling rates. They also retrospectively compared age- and physician-matched charts pre- and postintervention, reviewing them for diagnosis of overweight. Intervention patients were more likely to have their BMI discussed (53/77 vs 3/70, P < .0001) and be identified as overweight both prospectively (8/10 vs 1/8, P = .015) and in the authors' matched chart review (8/10 vs 1/10, P = .005). Discussion rates of obesity-related topics such as nutrition, physical activity, and media time did not differ. BMI charts increase overweight patient identification by pediatricians. Further research is needed on the benefits of earlier overweight identification and best counseling methods for promoting healthy weight.

Key Words: obesity • children • body mass index • prevention • anticipatory guidance


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