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Multidisciplinary Approach to Obesity Management: A Case Report
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A Comprehensive Analysis of Overweight, Obesity, and Failure to Thrive in Pediatric Inpatients: Prevalence,

Ibrahim A Al Alwan1,2,3, Elaf A AlShammari1,2,3, Ahmed A AlAbdulkarim1,3

  • 1Department of Pediatrics, Ministry of the National Guard - Health Affairs, Riyadh, Saudi Arabia.

Saudi Medical Journal
|June 4, 2026
PubMed

Insights

Pediatric weight abnormalities are common in hospitals, with failure to thrive (FTT) diagnosed more often than overweight or obesity. Inpatient care needs improvement for accurate diagnosis and management of pediatric weight disorders.

Area of Science:

  • Pediatric Endocrinology
  • Clinical Nutrition
  • Hospital Medicine

Background:

  • Pediatric weight abnormalities, including failure to thrive (FTT), overweight, and obesity, present significant challenges in healthcare settings.
  • Accurate diagnosis and effective inpatient management are crucial for addressing these conditions and preventing long-term health consequences.
  • Existing literature suggests potential gaps in the recognition and management of these conditions within hospital environments.

Purpose of the Study:

  • To evaluate the prevalence of pediatric weight abnormalities among inpatients.
  • To assess the diagnostic accuracy for FTT, overweight, and obesity in a hospital setting.
  • To examine the inpatient management strategies employed for these conditions.

Main Methods:

  • Retrospective cohort study analyzing medical records of pediatric inpatients aged 2-14 years.
  • Data collection included anthropometrics, dietary history, physical activity, diagnostic workup, and treatment plans.
  • Weight abnormalities classified using BMI percentiles (overweight/obesity) and weight-for-age/growth percentiles (FTT).

Main Results:

  • 9.6% of admissions had weight abnormalities: 60.3% FTT, 24.2% obese, 15.5% overweight.
  • Diagnostic accuracy was higher for FTT (38%) compared to obesity (28%) and overweight (13%).
  • Documentation of dietary intake, physical activity, and screen time was notably poor; logistic regression indicated age and dietary history documentation influenced accuracy.

Conclusions:

  • Underdiagnosis of overweight and obesity is prevalent, alongside suboptimal documentation practices in pediatric inpatient care.
  • While FTT receives more clinical attention, overweight and obesity are frequently underrecognized despite standard measurements.
  • Inconsistent inpatient management highlights the need for improved protocols for pediatric weight disorders.
Abstract

Keywords:
FTTObesityOverweight

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