Criteria for medical intervention in obese children: A new definition of 'Obesity disease' in Japanese children

The Committee of the Japan Society for the Study of Obesity reported the new criteria for ' obesity disease' for Japanese adults in 2000. We defined the criteria for the diagnosis of obesity in children with medical problems, corresponding to the ' obesity disease' criteria in adults. Obesity in childhood was defined as follows: percentage of overweight ( POW) and body fat exceeded the criteria. ' Obesity disease in childhood' was defined as obesity associated with health or medical problems, and with indications for medical intervention. Medical problems with indications for immediate intervention were grouped as A problems, which consisted of ( i) hypertension; ( ii) sleep apnea or hypoventilation; ( iii) Type 2 diabetes mellitus or impaired glucose tolerance; and ( iv) increased waist circumference or accumulation of visceral adipose tissue. Metabolic derangements or equivalent associated with obesity were grouped as B problems: ( i) liver dysfunction; ( ii) hyperinsulinemia; ( iii) hypercholesterolemia; ( iv) hypertriglyceridemia; ( v) low serum high-density lipoprotein cholesterol; ( vi) acanthosis nigricans, and ( vii) hyperuricemia. Obese children over 5 years of age with following conditions were diagnosed as ' obesity disease in childhood': ( i) any ' A problem', ( ii) POW greater than or equal to 50% and any ' B problem', or ( 3) POW < 50% and more than one ' B problem' or equivalent. We decided to take physicosocial problems related to obesity into consideration as the criteria. The resultant criteria are proposed by the Committee for Research of Appropriate Body Build in Children.*