TABLE 8

Weight Goals and Intervention Stages, According to Age and BMI Categories

AgeBMI CategoryWeight Goal to Improve BMI PercentileaInitial Intervention StageHighest Intervention Stage
<2 yWeight for heightNAPrevention counselingPrevention counseling
2–5 y5th–84th percentile or 85th–94th percentile with no health risksWeight velocity maintenancePrevention counselingPrevention counseling
85th–94th percentile with health risksWeight maintenance or slow weight gainPrevention Plus (stage 1)SWM (stage 2)
≥95th percentileWeight maintenance (weight loss of up to 1 lb/mo may be acceptable if BMI is >21 or 22 kg/m2)Prevention Plus (stage 1)CMI (stage 3)
6–11 y5th–84th percentile or 85th–94th percentile with no health risksWeight velocity maintenancePrevention counselingPrevention counseling
85th–94th percentile with health risksWeight maintenancePrevention Plus (stage 1)SWM (stage 2)
95th–99th percentileGradual weight loss (1 lb/mo or 0.5 kg/mo)Prevention Plus (stage 1)CMI (stage 3)
>99th percentileWeight loss (maximum is 2 lb/wk)Prevention Plus (stage 1) or stage 2 or 3 if family is motivatedTCI (stage 4), if appropriate
12–18 y5th–84th percentile or 85th–94th percentile with no health risksWeight velocity maintenance; after linear growth is complete, weight maintenancePrevention counselingPrevention counseling
85th–94th percentile with health risksWeight maintenance or gradual weight lossPrevention Plus (stage 1)SWM (stage 2)
95th–99th percentileWeight loss (maximum is 2 lb/wk)Prevention Plus (stage 1)TCI (stage 4), if appropriate
>99th percentileWeight loss (maximum is 2 lb/wk)Prevention Plus (stage 1) or stage 2 or 3 if patient and family are motivatedTCI (stage 4), if appropriate
  • SWM indicates structured weight management; CMI, comprehensive multidisciplinary intervention; TCI, tertiary care intervention; NA, not applicable.

  • a If a child has obesity-related health risks, then the target outcome is a downward shift of the child's BMI curve. Serial weights, with the goals described here, are more easily assessed over weeks and months. In growing children, weight maintenance or even slow weight gain results in lower BMI.