Table 3.

Communication about body mass index (BMI) status

Physician	When we do this BMI calculation and put the BMI number on a chart, we have a little more information than with  just weight and height alone. [Physician and parent look at BMI chart together.] This BMI chart is color-coded  so that when we look at your daughter’s BMI we can see that it falls here in the green zone. This means she is  below the 85th percentile and considered to be a healthy weight for a 4-year-old girl at her height, which  is wonderful. As far as growth, she is right where we want her to be.
Parent	That’s good news, but I thought she was actually too thin.
Physician	No, not too thin. Just right! Children look thin at this age, but what this chart tells me is that your daughter is at a  good weight for her height and her age right now and she probably has some healthy habits she is developing  that help her stay in the green zone. When you filled out the questionnaire in the waiting room, you indicated  you are already helping your daughter eat healthy and be more active. That is great.
	If it is OK with you, I would like to look over the questionnaire and identify the healthy habits and also note the  habits where good changes can be made so we can work to make sure your daughter stays in the green zone  from year to year. By identifying and encouraging healthy habits now, we can help prevent her from developing  health problems like diabetes, high cholesterol, and problems with knees and ankles down the road. These are  problems that children who gain too much weight often develop. How do you feel about that?
Parent	Sounds good to me.

Adapted from Ammerman A, Perrin EM, Flower K. Promoting healthy nutrition. In: Osborn LM, DeWitt TG, First LG, Zenel JA, editors. Pediatrics. Philadelphia: Mosby; 2005. Box 20-1, p. 196.