Body Mass Index Extremes in a British Adolescent Gynecology Clinic

Study Objective To identify the prevalence of patients with BMI extremes (BMI > 88% or < 2%) in our Adolescent Gynecology clinic and audit their weight management. Design Retrospective case series. Setting The Adolescent Gynecology Clinic of a British District General Hospital Participants All patients aged 12–17 years when first seen in the Adolescent Gynecology clinic from 1997 to 2003. Interventions Retrospective data collection on biometry and weight management interventions. Main Outcome Measures The percentage of obese (BMI > 98th percentile for age), overweight (BMI 88th–98th percentile) and underweight (BMI < 2nd percentile) based on published percentile BMI curves for the UK adolescent population, the proportion of patients with extreme BMI that were offered intervention, the types of intervention offered, the proportion of patients whose BMI improved after the intervention, and the number of patients with BMI > 88% among smokers were compared to non-smokers. Results Of the 125 patients 24% were obese, an additional 17% overweight and 1% underweight. The expected figures in the general population are 2%, 10% and 2% respectively (P< 0.001; test of a single proportion). Weight management intervention was offered to 47% of patients with extreme BMI. The BMI improved in 36% of the patients who were offered and 14% of patients who were not offered intervention (P = 0.066; χ2). There was no statistically significant difference between smokers and non-smokers in the proportion of patients with BMI > 88% (P = 0.93; χ2). Conclusion There is significantly increased prevalence of obese and overweight women among adolescent gynecological patients. The need for management of the BMI of these patients has not been always been recognized and treatment is not particularly effective. The results indicate a need for defined strategies and additional resources for obesity management.