What is BMI?
Body Mass Index (BMI) is a number calculated from a child's weight and
height. BMI is a reliable indicator of body fatness for most children and
teens. BMI does not measure body fat directly, but research has shown that
BMI correlates to direct measures of body fat, such as underwater weighing
and dual energy x-ray absorptiometry (DXA).1 BMI can be
considered an alternative for direct measures of body fat. Additionally,
BMI is an inexpensive and easy-to-perform method of screening for weight
categories that may lead to health problems.
For children and teens, BMI is age- and sex-specific and is often referred
to as BMI-for-age.
What is a BMI percentile?
After BMI is calculated for children and teens, the BMI number is plotted
on the CDC BMI-for-age growth charts (for either girls or boys) to obtain a
percentile ranking. Percentiles are the most commonly used indicator to
assess the size and growth patterns of individual children in the United
States. The percentile indicates the relative position of the child's BMI
number among children of the same sex and age. The growth charts show the
weight status categories used with children and teens (underweight, healthy
weight, overweight, and obese).
BMI-for-age weight status categories and the corresponding percentiles are
shown in the following table.
| Weight Status Category |
Percentile Range |
| Underweight |
Less than the 5th percentile |
| Healthy weight |
5th percentile to less than the 85th percentile |
| Overweight |
85th to less than the 95th percentile |
| Obese |
Equal to or greater than the 95th percentile |
How is BMI used with children and teens?
BMI is used as a screening tool to identify possible weight problems for
children. CDC and the American Academy of Pediatrics (AAP) recommend the
use of BMI to screen for overweight and obesity in children beginning at 2
years old.
For children, BMI is used to screen for obesity, overweight, healthy
weight, or underweight. However, BMI is not a diagnostic tool. For example,
a child may have a high BMI for age and sex, but to determine if excess fat
is a problem, a health care provider would need to perform further
assessments. These assessments might include skinfold thickness
measurements, evaluations of diet, physical activity, family history, and
other appropriate health screenings.
How is BMI calculated and interpreted for children and teens?
Calculating and interpreting BMI using the BMI Percentile Calculator
involves the following steps:
- Before calculating BMI, obtain accurate height and weight
measurements.
- Calculate the BMI and percentile using the Child and Teen BMI
Calculator. The BMI number is calculated using standard formulas.
- Review the calculated BMI-for-age percentile and results. The
BMI-for-age percentile is used to interpret the BMI number because BMI is
both age-and sex-specific for children and teens. These criteria are
different from those used to interpret BMI for adults — which do not take
into account age or sex. Age and sex are considered for children and
teens for two reasons:
The amount of body fat changes with age. (BMI for children and teens
is often referred to as BMI-for-age.)
The amount of body fat differs between girls and boys.
The CDC
BMI-for-age growth charts for girls and boys take into account
these differences and allow translation of a BMI number into a
percentile for a child's or teen's sex and age.
- Find the weight status category for the calculated BMI-for-age
percentile as shown in the following table. These categories are based on
expert committee recommendations.
| Weight Status Category |
Percentile Range |
| Underweight |
Less than the 5th percentile |
| Healthy weight |
5th percentile to less than the 85th percentile |
| Overweight |
85th to less than the 95th percentile |
| Obese |
Equal to or greater than the 95th percentile |
See the following example of how some sample BMI numbers would be
interpreted for a 10-year-old boy.
The CDC BMI-for-age growth charts are available at: CDC Growth Charts: United States.
Is BMI interpreted the same way for children and teens as it is for
adults?
Although the BMI number is calculated the same way for children and
adults, the criteria used to interpret the meaning of the BMI number for
children and teens are different from those used for adults. For children
and teens, BMI age- and sex-specific percentiles are used for two
reasons:
- The amount of body fat changes with age.
- The amount of body fat differs between girls and boys.
The CDC BMI-for-age growth charts take into account these differences and
allow translation of a BMI number into a percentile for a child's sex and
age.
For adults, on the other hand, BMI is interpreted through categories that
do not take into account sex or age.
Why can't healthy weight ranges be provided for children and teens?
Healthy weight ranges cannot be provided for children and teens for the
following reasons:
- Healthy weight ranges change with each month of age for each sex.
- Healthy weight ranges change as height increases.
How can I tell if my child is overweight or obese?
CDC and the American Academy of Pediatrics (AAP) recommend the use of Body
Mass Index (BMI) to screen for overweight and obesity in children and teens
aged 2 through 19 years. Although BMI is used to screen for overweight and
obesity in children and teens, BMI is not a diagnostic tool.
For example, a child who is relatively heavy may have a high BMI for his
or her age. To determine whether the child has excess fat, further
assessment would be needed. Further assessment might include skinfold
thickness measurements. To determine a counseling strategy, assessments of
diet, health, and physical activity are needed.
Can I determine if my child or teen is obese by using an adult BMI
calculator?
No. The adult calculator provides only the BMI number and not the BMI age-
and sex-specific percentile that is used to interpret BMI and determine the
weight category for children and teens. It is not appropriate to use the
BMI categories for adults to interpret BMI numbers for children and
teens.
My two children have the same BMI values, but one is considered obese and
the other is not. Why is that?
The interpretation of BMI-for-age varies by age and sex so if the children
are not exactly the same age and of the same sex, the BMI numbers have
different meanings. Calculating BMI-for-age for children of different ages
and sexes may yield the same numeric result, but that number will fall at a
different percentile for each child for one or both of the following
reasons:
- The normal BMI-related changes that take place as children age and as
growth occurs.
- The normal BMI-related differences between sexes.
See the following graphic for an example for a 10-year-old boy and a
15-year-old boy who both have a BMI-for-age of 23. (Note that two children
of different ages are plotted on the same growth chart to illustrate a
point. Normally the measurement for only one child is plotted on a growth
chart.)
References
1Mei Z, Grummer-Strawn LM, Pietrobelli A, Goulding A, Goran MI,
Dietz WH. Validity of body mass index compared with other body-composition
screening indexes for the assessment of body fatness in children and
adolescents. American Journal of Clinical Nutrition
2002;7597–985.
2Freedman DS, Dietz WH, Srinivasan SR, Berenson GS. The
relation of overweight to cardiovascular risk factors among children and
adolescents: The Bogalusa Heart Study. Pediatrics
1999;103:1175–1182.
3Must A and Anderson SE. Effects of obesity on morbidity in
children and adolescents. Nutrition in Clinical Care
2003;6(1):4–12.
4Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH.
Predicting obesity in young adulthood from childhood and parental obesity.
New England Journal of Medicine 1997;37(13):869–873.
5Ferraro KF, Thorpe RJ Jr, Wilkinson JA. The life course of
severe obesity: does childhood overweight matter? Journal of
Gerontology: Social Sciences 2003;58B(2):S110–S119.
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Centers for Disease Control and Prevention content is free and public domain.