Study: BMI tests underestimate obesity in teens with disabilities

A study of tests used to assess obesity in adolescents with physical disabilities demonstrated new approaches based on BMI and other measures are needed, according to a press release from Wolters Kluwer Health.

Brooks C. Wingo, PhD, an assistant professor of occupational therapy at the University of Alabama at Birmingham, and colleagues found standard assessments tend to underestimate the effect of obesity on children and adolescents with mobility limitations, according the release. The researchers suggested new cutoff points to identify disabled teens who could need diagnosis and treatment to prevent health and functional problems stemming from excess body weight.

Wingo and colleagues studied 29 adolescents averaging 16 years of age who had spinal cord injury or other types of physical disability requiring use of a wheelchair. The researchers assessed a variety of clinical indicators of body weight, including BMI; width of a skinfold pinched in the upper arm; and circumferences of waist, arm and leg. Dual-energy X-ray absorptiometry (DXA) was used to measure body fat, and obesity was defined as 30% or greater body fat for boys and 35% or greater for girls.

The use of combined measures showed 35% of boys and 58% of girls studied were obese; however, with the use of BMI measurement alone, only 6% of boys and 42% of girls would have been classified as obese.

The researchers concluded the use of BMI was the best-performing measure, but only when the cutoff point for obesity was adjusted to account for age. Wingo and colleagues used a cutoff point of 20 for boys and 19 for girls, rather than the standard cutoff point of 30 or higher.

The researchers call for the development of disability-specific cutoff points, which could enable clinicians to better identify children at risk of adiposity-related diseases. They also stated these cutoff points would allow the development of preventative strategies to improve quality of life for children with disabilities.

Reference: Wingo B, et al. Am J Phys Med. 2015;doi:10.1097/PHM.0000000000000323.

Disclosure: Please see the full study for a list of all authors’ relevant financial disclosures.

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