>95th centile NCHS

Rule out underlying causes*
e.g., Hypothyroidism (1-2/1000 children),
Prader Willi (1/25000 population),
Cushings syndrome

Developmental Delay,
Short Stature,
Dysmorphism,
Abnormal genitalia

All are relatively rare conditions
and have distinctive clinical
features.
*May require referral to 
Endocrinologist

>95th centile NCHS

Look out for severe complications* 
(See Table 1)

Blurred optic disks, Breathing
difficulties , Painful walking,
Abdominal pain

Rare, but some severe
complications are potentially
fatal.
*Appropriate reference to experts

>75th centile, NCHS &
Family history of obesity
/related morbidities

Screen for co morbidities
Such as Hypertension (25% obese children)
Dyslipidemias             (20% obese children)
Polycystic ovaries       (20% obese children)
Childhood Type II Diabetes Mellitus
Insulin Resistance Syndrome

Blood pressure
Lipid Profile
Blood sugar levels
Fasting insulin
USG

Comorbidities are very
common (upto 30%)

Further investigation and
referral according to findings

All overweight and obese
children

 Assess for Psychological disorders
e.g., Depression, Binge eating, Bulimea

Counsellors

Could be cause or effect of
obesity