Growth and BMI Assessment for 16-Year-Old Female
This 16-year-old girl with weight 46.9kg and height 137.5cm has a BMI of 24.8 kg/m², placing her at approximately the 75th-85th BMI centile, with height below the 2nd centile (<0.4th centile) and weight around the 9th-25th centile for age, indicating severe short stature with disproportionately higher weight relative to height. 1
BMI Calculation and Interpretation
BMI = 46.9 kg ÷ (1.375 m)² = 24.8 kg/m²
- For a 16-year-old female, a BMI of 24.8 kg/m² falls between the 75th and 85th centile on UK WHO growth charts, indicating she is approaching the overweight category (≥85th centile represents mild-to-moderate overweight). 2
- This BMI places her in a category requiring monitoring, as adolescents between the 75th-85th percentiles for BMI are at increased risk of progressing to obesity. 2
Height Assessment
- Height of 137.5cm at age 16 years is severely below the 2nd centile (approximately <0.4th centile), indicating significant short stature that warrants immediate evaluation for underlying causes. 1, 3
- Values below 2 standard deviations (2.3rd percentile) are recommended thresholds for identifying children whose growth might indicate adverse health conditions including chronic malnutrition, underlying medical conditions, or genetic factors. 3
- This degree of short stature requires comprehensive evaluation including assessment for genetic conditions (Turner syndrome), endocrine disorders (growth hormone deficiency, hypothyroidism), chronic diseases, and nutritional deficiencies. 3
Weight Assessment
- Weight of 46.9kg at age 16 years falls approximately between the 9th and 25th centile for age, which would be appropriate if her height were normal. 1
- However, the critical finding is the discrepancy between height centile (<2nd) and weight centile (9th-25th), indicating disproportionate weight relative to her short stature. 1, 4
Clinical Significance and Recommendations
This patient requires urgent referral to pediatric endocrinology for evaluation of severe short stature, as the height below the 2nd centile at age 16 (near completion of growth) suggests a significant underlying condition. 3
Immediate Actions Required:
- Comprehensive medical evaluation to investigate causes of severe short stature, including screening for Turner syndrome, growth hormone deficiency, celiac disease, inflammatory bowel disease, and other chronic conditions affecting growth. 3
- Family growth pattern assessment to determine if short stature reflects genetic potential versus pathologic growth failure. 3
- Nutritional counseling is warranted given the BMI approaching the overweight threshold (75th-85th centile), particularly important as her short stature means even modest weight gain significantly impacts BMI. 2
Monitoring Strategy:
- Serial measurements every 3-6 months to track BMI trajectory, as adolescents with BMI in the 75th-85th percentile range are at substantially increased risk (up to 20 times more likely) of becoming overweight adults. 1, 3
- Growth velocity assessment through serial measurements provides more valuable information than single measurements for determining if intervention is needed. 1
Key Clinical Pitfall:
The most critical error would be focusing solely on the BMI (which appears relatively normal at 75th-85th centile) while missing the severe short stature (<2nd centile) that makes this weight disproportionately high and indicates serious underlying pathology requiring immediate investigation. 1, 3