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Using body mass index Z-score among severely obese adolescents: a cautionary note.
Int J Pediatr Obes 2009; 4(4):405-10IJ

Abstract

Over 17% of US children aged 12-19 years are obese, leading to new issues in differentiating weight status among severely obese adolescents. Using the CDC 2000 growth curves and published equations, this study highlights the pitfalls of using body mass index (BMI) Z-score as an outcome measure in clinical research involving severely obese adolescents. Above BMIs of 40, which are typical for adolescent treatment programs, a wide range of BMI translates to a very narrow range of BMI Z-scores, and BMI Z-scores exhibit an upper limit similar to BMI percentiles. At this level, the correspondence between BMI and BMI Z-score differs by age, sex and starting BMI. Thus, a stable high BMI during adolescence results in increasing BMI Z-scores for boys and decreasing BMI Z-scores in girls. A new supplemental BMI reference may be needed specifically for severely obese adolescents to improve measurement and evaluation of treatment success in this group.

Authors+Show Affiliations

Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229-3039, USA. Jessica.woo@cchmc.org

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19922058

Citation

Woo, Jessica G.. "Using Body Mass Index Z-score Among Severely Obese Adolescents: a Cautionary Note." International Journal of Pediatric Obesity : IJPO : an Official Journal of the International Association for the Study of Obesity, vol. 4, no. 4, 2009, pp. 405-10.
Woo JG. Using body mass index Z-score among severely obese adolescents: a cautionary note. Int J Pediatr Obes. 2009;4(4):405-10.
Woo, J. G. (2009). Using body mass index Z-score among severely obese adolescents: a cautionary note. International Journal of Pediatric Obesity : IJPO : an Official Journal of the International Association for the Study of Obesity, 4(4), pp. 405-10. doi:10.3109/17477160902957133.
Woo JG. Using Body Mass Index Z-score Among Severely Obese Adolescents: a Cautionary Note. Int J Pediatr Obes. 2009;4(4):405-10. PubMed PMID: 19922058.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Using body mass index Z-score among severely obese adolescents: a cautionary note. A1 - Woo,Jessica G, PY - 2009/11/20/entrez PY - 2009/11/20/pubmed PY - 2010/1/29/medline SP - 405 EP - 10 JF - International journal of pediatric obesity : IJPO : an official journal of the International Association for the Study of Obesity JO - Int J Pediatr Obes VL - 4 IS - 4 N2 - Over 17% of US children aged 12-19 years are obese, leading to new issues in differentiating weight status among severely obese adolescents. Using the CDC 2000 growth curves and published equations, this study highlights the pitfalls of using body mass index (BMI) Z-score as an outcome measure in clinical research involving severely obese adolescents. Above BMIs of 40, which are typical for adolescent treatment programs, a wide range of BMI translates to a very narrow range of BMI Z-scores, and BMI Z-scores exhibit an upper limit similar to BMI percentiles. At this level, the correspondence between BMI and BMI Z-score differs by age, sex and starting BMI. Thus, a stable high BMI during adolescence results in increasing BMI Z-scores for boys and decreasing BMI Z-scores in girls. A new supplemental BMI reference may be needed specifically for severely obese adolescents to improve measurement and evaluation of treatment success in this group. SN - 1747-7174 UR - https://www.unboundmedicine.com/medline/citation/19922058/Using_body_mass_index_Z_score_among_severely_obese_adolescents:_a_cautionary_note_ L2 - https://doi.org/10.3109/17477160902957133 DB - PRIME DP - Unbound Medicine ER -