Background:
Childhood obesity confers a substantial risk of adult obesity, lifelong health risks, and social and economic disadvantages. BMI has been the standard as a reliable indicator of overweight and obese children. In 2005, the Institute of Medicine defined a BMI% > 95% for age as obese and BMI% > 85% as overweight. Obesity appears to be undercoded in hospital data given the much higher prevalence in the general population.
Methods:
We conducted a record review to estimate the prevalence of obese and overweight children, 6 months–18 years, who were hospitalized during a 15‐month period at our urban community hospital. The chart review looked for BMI, diagnosis, and comorbidities from the text of the visit.
Results:
A total of 785 children met the inclusion criteria. Thirteen percent had a BMI% of 85%–94%, and 29% had a BMI% > 95% for a total percentage of children with a BMI% > 85% of 42%. Obesity was recognized as a diagnosis or problem in only 23% of the obese patients. When comparing the admitting diagnoses of obese/overweight and non‐obese/overweight children, there was a discrepancy in admitting diagnosis. In the obese subgroup, psychiatric illness was the most common diagnosis (24%), and in the non– obese/overweight subgroup, psychiatric illnesses was fourth (6.7%). This difference was significant (P < 0.0001). There were no differences in respiratory illnesses, skin and soft‐tissue infections, or diabetes.
Conclusions:
The prevalence of childhood obesity has risen remarkably in the last 3 decades, with urban areas especially affected. Our chart surveillance reveals a rate of overweight and obesity of more than 40%. Unfortunately, this was grossly underrecognized and underdiagnosed, representing an important missed opportunity to intervene. Of note, psychiatric diagnoses were significantly more common among the overweight/obese.
Author Disclosure:
M. Medows, none; B. Bedri, none; K. Dudycz‐Sulicz, none; R. Pandey, none; D. A. Rauch, none.