Related Experiment Video
Updated: Aug 14, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
IOTF thresholds for overweight and obesity and their relation to metabolic risk in children (EarlyBird 20)
L D Voss1, B S Metcalf, A N Jeffery
1Department of Endocrinology and Metabolism, Peninsula Medical School, Plymouth, UK. l.voss@phnt.swest.nhs.uk
Insights
Paediatric overweight and obesity cutoffs lack health risk evidence, potentially misidentifying metabolic risks in young children. These Body Mass Index (BMI) thresholds should be used cautiously to avoid stigmatizing children.
Area of Science:
- Pediatrics
- Metabolic Health
- Obesity Research
Background:
- International guidelines propose paediatric Body Mass Index (BMI) cutoffs for overweight and obesity from age 2.
- These cutoffs are based on adult thresholds but lack specific health risk validation in children.
Purpose of the Study:
- To evaluate the rationale behind the International Obesity TaskForce's paediatric BMI cutoffs.
- To assess the utility of paediatric BMI categories as markers for metabolic risk in young children.
Main Methods:
- Analysis of data from the EarlyBird Study.
- Examination of Body Mass Index (BMI) categories in relation to insulin resistance and metabolic risk markers.
Main Results:
- Paediatric BMI categories for overweight and obesity are poor indicators of insulin resistance in young children.
- Body Mass Index (BMI) is known to have poor tracking from early childhood to adulthood, with less known about metabolic risk tracking.
Conclusions:
- The rationale for current paediatric overweight and obesity thresholds, based on adult data, is questioned due to lack of direct health risk evidence.
- Caution is advised when applying these thresholds to very young children, as they may inaccurately label children and lead to unnecessary stigma.
Abstract:
The International Obesity TaskForce has published paediatric cutoffs from the age of 2 years for overweight and obesity, based on adult thresholds. We question their rationale. The adult cutoffs were based on known health risk; the children's were not. Data from the EarlyBird Study show that BMI category for overweight and obesity in young children are poor markers of insulin resistance and, by implication, of metabolic risk and diabetes. Moreover, BMI is known to track poorly from early childhood to adulthood. We know even less about the tracking of insulin resistance and other indices of metabolic risk from the earliest years. Until we understand more about which children acquire such risk factors, any such thresholds for overweight and obesity should be used with caution in the very young, as they may unnecessarily stigmatise the heavier child.
Related Concept Videos
01:24Obesity
01:26Type II Diabetes I: Introduction