Comparing two diagnostic frameworks for obesity in Mexican children attending a pediatric obesity clinic.
cross_sectional · Level IV
Where this comes from
- Record sourced from PubMed, PMID 42711563.
- Also identified by DOI 10.1038/s41390-026-05479-2.
- No licence information is recorded for this record.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
Body mass index (BMI) is widely used to assess pediatric obesity but does not fully capture adiposity-related organ dysfunction. The Clinical Framework of Obesity 2025 (CFO-2025), proposed by The Lancet Diabetes & Endocrinology Commission, offers a complementary clinical approach. To evaluate pediatric obesity classification using Centers for Disease Control and Prevention BMI (CDC-BMI) criteria and the CFO-2025, and to describe organ-system involvement in clinical obesity. This cross-sectional study analyzed 220 patients aged 4-16 years from a pediatric obesity clinic in northeastern Mexico. Obesity was classified using CDC-BMI criteria and the CFO-2025 with pediatric adaptations. Under the CFO-2025, patients were categorized as having preclinical or clinical obesity based on organ-system involvement. Concordance was assessed using Cohen's kappa. Obesity prevalence was 80% by CDC-BMI criteria and 95% by the CFO-2025, with fair concordance (κ = 0.321; p < 0.001). Clinical obesity was identified in 83.2% of patients, including those classified as having normal weight or overweight by CDC-BMI; metabolic (73.2%) and cardiovascular (59%) systems were most frequently affected. Applied alongside BMI, the CFO-2025 identified additional multisystem involvement. Although not yet validated in children, it may support a more comprehensive clinical assessment of pediatric obesity. In the Pediatric Obesity Clinic at a referral hospital in northeastern Mexico, the Clinical Framework of Obesity 2025 (CFO-2025) classified a higher proportion of children as having obesity compared with the CDC-BMI criteria, with only fair concordance between systems. We provide preliminary pediatric evidence that the CFO-2025 identifies multisystem involvement, including metabolic and cardiovascular abnormalities, even among children categorized as normal weight or overweight by BMI. Although the CFO-2025 has not yet been validated in pediatric populations, integrating BMI with the CFO-2025 may support a more structured and comprehensive assessment of obesity-related organ involvement in children.