BMI Calculation and Centile Assessment
This 2-year-2-month-old girl has a BMI of 22.8 kg/m², which places her above the 97th percentile (approximately 98th-99th percentile), indicating obesity that requires immediate clinical evaluation and intervention. 1
BMI Calculation
- Height: 87 cm = 0.87 meters
- Weight: 17.2 kg
- BMI = 17.2 ÷ (0.87)² = 22.8 kg/m² 1
Growth Chart Selection and Interpretation
For this child at 26 months of age, CDC growth charts should be used, as WHO charts are recommended only for children under 24 months. 1, 2
- The CDC recommends transitioning from WHO to CDC growth charts at 24 months of age 1
- CDC charts extend through age 19 years, providing continuity for long-term monitoring 1, 2
Centile Classification
This child's BMI of 22.8 kg/m² significantly exceeds the obesity threshold for her age group:
- Children aged 2-18 years with BMI ≥95th percentile are classified as obese 1
- Values at or above the 97.7th percentile (labeled as 98th percentile on growth charts) indicate potential adverse health conditions requiring evaluation 1, 2
- For a 2-year-old girl, a BMI of 22.8 kg/m² is substantially elevated, placing her well above the 95th percentile threshold 1
Clinical Significance and Required Actions
This degree of obesity at age 2 years carries significant health risks and mandates comprehensive evaluation:
- Immediate assessment for obesity-related complications including metabolic abnormalities, cardiovascular risk factors, and potential underlying endocrine disorders 1, 2
- Screen for contributing factors: dietary patterns, physical activity levels, sleep habits, family history, and medications 1
- Evaluate for genetic syndromes or endocrine disorders (thyroid dysfunction, Cushing syndrome) that may contribute to excessive weight gain 2
- Assess family growth patterns and parental BMI, as maternal obesity is associated with childhood obesity risk 3
Monitoring Strategy
Serial measurements every 2-4 months initially are essential to track BMI trajectory and response to interventions:
- Plot all measurements on CDC growth charts to visualize trends over time 2
- Growth velocity and trajectory are more informative than single measurements 2
- A BMI consistently tracking above the 95th percentile or crossing upward through percentile lines indicates progressive obesity requiring intensified intervention 2, 3
Common Pitfalls to Avoid
- Do not delay evaluation until the child is older, as early childhood obesity strongly predicts adolescent and adult obesity with associated metabolic complications 3
- Do not use WHO charts for this age (26 months), as CDC charts are the appropriate standard 1, 2
- Do not reassure parents based on the child appearing "healthy" or "just chubby," as a BMI above the 97th percentile represents clinically significant obesity 1