Dear Colleague Letter - Revisions to NYSDOH BMI Percentile Growth Charts

September 2009

Dear Colleague:

Revised sex-specific Body Mass Index (BMI)-for-age percentile growth charts are now available from the New York State Department of Health. To order pads of the growth charts, please visit the following link and click on "Ordering Materials" to download the order form:

The BMI-for-age percentile growth charts have been updated to include a new weight status category labeled "severely obese" for youths with a BMI at or above the 99th percentile. The prevalence of youth with severe obesity is increasing, and these children are at high risk for biochemical abnormalities and multiple cardiovascular disease risk factors.

According to the Expert Committee Recommendations for the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity, all youth ages two years and older should be assessed annually using sex-specific BMI-for-age percentiles as part of routine pediatric health supervision.

For older adolescents whose BMI exceeds the adult criteria for overweight or obesity, the adult cut-points should be used. The growth charts have been revised accordingly. Thus, overweight is defined by a BMI at or above the 85th percentile and below the 95th percentile or a BMI at or above 25 kg/m2 and below 30 kg/m2. Obese is defined by a BMI at or above the 95th percentile and below the 99th percentile or a BMI at or above 30 kg/m2 and below 35 kg/m2. Severely obese is defined by a BMI at or above the 99th percentile or a BMI at or above 35 kg/m2.

For screening purposes, youth whose BMI or percentile values place their weight status in the overweight, obese or severely obese categories should be assessed further. This would include a focused review of systems and focused family history, examination of the patient's BMI trajectory, assessment of dietary, physical activity and television/media use habits, and measurement and review of appropriate laboratory tests.

I encourage you to share these growth charts with other members of your health care team to ensure that all patient care staff are aware of the recommendations and apply this information to their routine pediatric practice as an important step toward prevention and early identification of overweight and obesity in youth.


Barbara A. Dennison, M.D.
Director, Policy and Research Translation Unit
Division of Chronic Disease and Injury Prevention