Outpatient Specialty Care and Primary Care Clinical Pathway
for BMI-based Evaluation and Management in Children

Child Well Visit ≥ 2 yrs
History and Physical
Obtain weight and height, assess BMI trajectory
Obtain permission from family to discuss weight and growth
Children with BMI Percentile < 85%
  1. Continue 5210 Messaging
  2. Check trend of BMI
  3. Assess for risk factors
  4. Evaluate family’s access to healthy foods and exercise
  5. Reassess at each visit
Children with BMI Percentile ≥ 85%
  • Evaluation and Treatment
    • Comprehensive History and Physical
    • Laboratory Studies
      • Based on age and BMI category
    • Social Determinants of Health Evaluation
    • Mental and Behavioral Health Screening
    • Evaluate family’s access to healthy foods and exercise
  • Treatment
    • Health Behavior and Lifestyle Treatment
      • Recommended ≥ 6 yrs
      • Consider for < 6 yrs
  • Add appropriate BMI diagnosis to problem list
  • Continue 5210 Messaging
  • Engage family in one behavioral goal related to 5210 Messaging
Child/family not interested
in more frequent visits
Child/family interested in
more frequent visits
  • Weight check every 3-6 mos
  • Evaluate family’s access to healthy foods and exercise
  • Reassess interest in more frequent visits
Nurse educator, if available, and/or referral to registered dietician for additional nutrition counseling
Posted: July 2014
Revised: June 2023
Editors: Clinical Pathways Team