Body mass index charts: Useful yet underused

Objectives: To determine how frequently pediatricians use body mass index (BMI) and whether pediatricians are more likely to regard a child as "too fat" and manifest greater concern about health sequelae when presented with BMI versus height and weight charting. Study design: North Carolina Pediatrics Society members completed a self-administered, quasi-experimental mail survey, using two different case vignette versions. They were given a clinical vignette but systematically received either the same hypothetical overweight child's height and weight data, percentile, and charts (Ht and Wt Group) or her BMI, percentile, and chart (BMI Group). They rated levels of fatness and concern by using Likert scales and the frequency of use of methods to determine overweight. Results: Adjusted response rate was 71% (N = 356). The BMI Group rated the hypothetical child with a higher mean on a scale of fatness (P < .0001) and reported higher levels of concern about all consequences (all P values ≤.01) than those in the Ht and Wt Group. Only 11% of respondents reported "always," and 31% reported "never," using BMI. Conclusions: BMI charting prompted greater recognition of a weight problem than height and weight charting, yet BMI is inconsistently used. Interventions to help pediatricians adopt this tool may be warranted.