TABLE 7

Medical Screening According to BMI Category

BMI PercentileRecent HistoryMedication UseReview of SymptomsFamily History (First- and Second-Degree Relatives)Physical ExaminationLaboratory Tests
5th–84thBMI percentile changeMedications that may affect weight gain (eg, neuropsychiatric medications)Obesity, type 2 diabetes, hypertension, lipid level abnormalities, heart diseaseBlood pressure (correct cuff)
85th–94thBMI percentile changeMedications that may affect weight gain (eg, neuropsychiatric medications)Snoring/sleep, abdominal pain, menstrual irregularities, hip, knee, or leg pain, polyuria, thirst, depressionObesity, type 2 diabetes, hypertension, lipid level abnormalities, heart diseaseBlood pressure (correct cuff), acanthosis nigricans, tonsils, goiter, tender abdomen, liver, bowing of legs, limited hip range of motion, optic discs if headaches, acne and hirsutismFasting lipid profile; if age 10 y and other risk factors, fasting glucose level biannually; ALT and AST levels biannually
95th–99thBMI percentile changeMedications that may affect weight gain (eg, neuropsychiatric medications)Snoring/sleep, abdominal pain, menstrual irregularities, hip, knee, or leg pain, urination, thirst, depressionObesity, type 2 diabetes, hypertension, lipid level abnormalities, heart diseaseBlood pressure (correct cuff), acanthosis nigricans, tonsils, goiter, tender abdomen, liver, bowing of legs, limited hip range of motion, optic discs if headaches, acne and hirsutismFasting lipid profile; if age 10 y and other risk factors, fasting glucose level biannually; ALT and AST levels biannually
>99thBMI changeMedications that may affect weight gain (eg, neuropsychiatric medications)Snoring/sleep, abdominal pain, menstrual irregularities, hip, knee, or leg pain, urination, thirst, depressionObesity, type 2 diabetes, hypertension, lipid levels abnormalities, heart diseaseBlood pressure (correct cuff), acanthosis nigricans, tonsils, goiter, tender abdomen, liver, bowing of legs, limp, limited hip range of motion, optic discs if headaches, acne and hirsutism, skin inflammationFasting lipid profile; if age 10 y and other risk factors, fasting glucose level biannually; ALT and AST levels biannually