BMI Counseling Toolkit

BMI Counseling Toolkit

A growing concern among experts is that for the first time in US history, this generation will live shorter, unhealthier lives than their parents due to the obesity epidemic.

Obesity affects about 12.7 million US children and adolescents. Despite recent declines in the prevalence among preschool-aged children, obesity among children is still too high, hovering around 17% for ages 2 – 19.¹

In a recent study examining trends in obesity prevalence among US children and adolescents, findings reveal an increase in extreme obesity²:

  • Children ages 6 – 11 years (3.6 percent in 1988-1994 to 4.3 percent in 2013-2014)
  • Adolescents ages 12 – 19 years (2.6 percent in 1988-1994 to 9.1 percent in 2013-2014)

This toolkit offers busy pediatricians, school nurses and practice group personnel resources for addressing children and adolescents who screen overweight and obese to reduce unhealthy weight and increase healthy eating and active living behaviors for youth and their families.

What is BMI?

Body Mass Index (BMI) is a useful screening tool that can serve as a measure of body fat and uncover potential weight and health-related issues. Children and adolescents who screen as overweight or obese are at greater risk for developing serious health diseases and conditions like diabetes, high blood pressure, heart disease, bone and joint problems and sleep apnea.

Students in Pennsylvania get screened for BMI as part of annual state-mandated health screenings in schools. Although BMI screening and notification programs hold promise of addressing a serious issue, a gap exists in follow-up measures for children who screen overweight and obese.

Parents value weight-focused guidance from a trusted medical professional. Research has shown that patients who were counseled in a primary care setting about the benefits of healthy eating and physical activity often took positive action. Patients lost weight and exercised more than peers who did not receive counseling.³ Parents are more likely to identify their child’s correct body image and address unhealthy behaviors after conversations with their

BMI Screening Letter

Studies show that school-based interventions have been unsuccessful in reducing childhood obesity prevalence, potentially due to the lack of follow-up with appropriate nutritional education programming. In order to help fill this gap, the Highmark Foundation partnered with Penn State PRO Wellness to develop and test an effective BMI screening letter that leads parents to tools and resources for making healthy lifestyle changes for their families.

View BMI Letter

BMI Calculator for Children

Use a BMI calculator for children and young adults ages 2-19 to calculate the corresponding BMI-for-age percentile on a BMI-for-age growth chart. Visit the Centers for Disease Control and Prevention (CDC) website for more information.

Visit CDC Site

BMI-for-Age Growth Charts

BMI for children and young adults ages 2-20 is referred to as BMI-for-age. Because body fat changes as you grow, BMI-for-age is plotted on separate growth charts to determine a BMI percentile ranking.

A BMI percentile is an indication of how a child’s measurements compare to others of the same age and gender. A child whose BMI is at the 50th percentile is close to the average of the population. A child above the 95th percentile is considered obese because 95 percent of the population weighs less than he or she does. A child below the 5th percentile is considered underweight because 95 percent of the population weighs more. You may receive these charts at your child’s yearly checkup.

BMI-for-age Girls 

BMI-for-age Boys 



  1. Prevention CfDCa. Childhood Obesity Facts | Overweight & Obesity | CDC2016.
  2. Ogden CL, National Center for Health Statistics UCfDCaP, Hyattsville, Maryland, Carroll MD, et al. Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988-1994 Through 2013-2014. JAMA. 2016;315:2292-2299.
  3. NIH. Talking with Patients about Weight Loss:  Tips for Primary Care Providers 2016.
  4. Hernandez RG, Cheng TL, Serwint JR. Parents’ Healthy Weight Perceptions and Preferences Regarding Obesity Counseling in Preschoolers: Pediatricians Matter. 2010.