Obesity was introduced into the International Classification of Diseases (ICD-9 code

278.0) in the 1950s. However, in the twenty-first century it has already reached epidemic
proportions and it will be the leading cause of death and disability in this century
worldwide, thus threatening to reverse many of the health gains achieved in recent
decades. Surprisingly, obesity is often neglected, being frequently not even thought of as
a serious, life-threatening chronic disease.
The widely used clinical term obesity derives from the Latin ob, for on account of ,
and esum, meaning having eaten. Strictly speaking, obesity is not defined as an excess of
body weight but of body fat, to the extent that health may be adversely affected. Despite
this important difference, medical criteria for the diagnosis of overweight and obesity do
not rely on the measurement of adiposity. By convention set out in international
guidelines, overweight and obesity are arbitrarily defined on the basis of the body mass
index (BMI) or Quetelets index (Table 4.1). The index is calculated by dividing the
individuals weight (expressed in kilograms) by the square of his or her height (expressed
in metres). A graded classification is valuable in diagnosing individuals, establishing
meaningful comparisons of weight status within and between populations, identifying
intervention priorities, and providing a firm basis for evaluating treatments and
interventions. Although BMI is widely used as a simple surrogate measure of body fat and
has been shown to correlate closely with adiposity, it does not provide an exact
description of body composition. The principal limitation of BMI as a measure of body fat
is that it does not distinguish fat mass from fat-free mass.
 The classification of overweight and obesity in children and adolescents is especially
complicated by their continually changing height and body composition. During these
developmental periods, the changes often take place at different rates and times in
diverse populations, making agreement over the diagnosis of overweight and obesity in
children and adolescents difficult to establish. Pediatricians in the USA have classically
used the 85th and 95th centiles of BMI for age and sex based on US nationally
representative survey data as cut-off points to identify overweight and obesity. However,
by choosing percentile values, any public health analyses and comparison purposes are
minimised due to the fact that cut-off points vary between populations and over time. A
standard definition for child overweight and obesity cut-off points for BMI based on
international data and linked to the widely accepted adult cut-off points of 25 and
30kg/m2 has been established, which is more practical and allows comparisons.

Comprehension Questions
1. What is the main idea of the text above?
2. What is the topic of the first paragraph?
3. What is the topic sentence of the last paragraph?
4. What is obesity?
5. Is obesity a disease? Why?
6. What is the the main limitation of the body mass index (BMI) to categorize the body
fat?
7. If I am 1.65 m and 80 kg, am I categorised as obesity?
8. What makes the classification of overweight and obesity in children and adolescents
hard to be done?
9. How then the Pediatricians overcome the problem stated on number 8?
10. Calculate your body mass index. Are you normal?