Table 1.
Key elements on assessment of history and physical examination in children and adolescents with obesity.
| History |
| General history |
| ‐Gestation and birth weight |
| ‐History of gestational diabetes |
| ‐Past medical history (history of developmental delay, visual, or hearing impairment might be hints of an underlying genetic obesity syndrome) and history of drug use |
| Growth history |
| ‐Onset of obesity and potential triggering factors identified by parents or child |
| ‐Previous growth parameters, height velocity, and pubertal history |
| Complication screening |
| ‐Specific symptoms |
| Polyuria, polydipsia, and nocturia |
| Hip and knee pain |
| Snoring, daytime lethargy, and early morning headache |
| Headache and visual disturbance (potential pseudotumor cerebri) |
| Acne, hirsutism, and menstrual history (for girls) |
| ‐Psychological effects of obesity |
| ‐Exercise tolerance |
| Family history |
| ‐Family members with the following conditions: |
| Obesity, type 2 diabetes or gestational diabetes, hypertension, fatty liver, dyslipidemia, and other cardiovascular diseases |
| Polycystic ovarian syndrome |
| ‐Home and neighborhood environment |
| ‐Parents' occupation and supervision |
| ‐Household members and relationship |
| ‐Family attitude and commitment toward obesity treatment |
| Lifestyle factors |
| ‐Diet |
| Breakfast consumption |
| Sugary beverage consumption and eating habits, for example, snacking, fast food intake, binge eating |
| 3‐day food diary |
| ‐Physical activity |
| Sports participation |
| 7‐day exercise diary |
| ‐Sedentary behavior |
| Screen time |
| Usual schedule for homework, tutorial classes, and other nonexercise extracurricular activities |
| ‐Sleep routine |
| Physical exam |
| General |
| ‐Anthropometric measurements including waist circumference or waist–hip ratio |
| ‐Blood pressure |
| ‐Pubertal staging |
| ‐Skin |
| Acanthosis nigricans at the neck, axilla, and skin folds |
| Xanthelesmas |
| Acne and hirsutism |
| Striae |
| ‐Short stature, dysmorphism, developmental delay (might be hints of an underlying genetic syndrome) |
| ‐Head and neck |
| Tonsillar size |
| ‐Overall mood and affect |
| Abdomen: Hepatomegaly |
| Endocrine |
| ‐Goiter |
| ‐Signs of Cushing syndrome, including extensive striae, buffalo hump, and plethoric face |
| Neurological: Papilledema and reduced venous pulsations on fundi exam (pseudotumor cerebri) |
| Musculoskeletal |
| ‐Bow legs (Blount disease) |
| ‐Pain in the groin, thigh, or knee area (slipped capital femoral epiphysis) |