Quality statement 2: Recording BMI in children and young people aged over 2 years
Quality statement
Children and young people aged over 2 years have opportunistic recording of their BMI at key points of contact with a healthcare professional. [new 2025]
Rationale
Measurement and recording of BMI during key points of contact allows all of the following:
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definition of overweight and obesity
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prediction or identification of weight-related conditions
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identification of changes in weight.
Healthcare professionals should seek permission from the family or carer and the child or young person in a sensitive, non-judgmental way before discussing and measuring weight, because they may then be more receptive to offers of support that could have a positive impact on their health. Healthcare professionals should avoid attributing all symptoms to weight (diagnostic overshadowing) and the purpose of the appointment should always be prioritised.
Quality measures
The following measures can be used to assess the quality of care or service provision specified in the statement. They are examples of how the statement can be measured, and can be adapted and used flexibly.
Process
Proportion of children and young people aged over 2 years that have had an appointment with a healthcare professional in the last 12 months, who have a recorded BMI in the last 12 months.
Numerator – the number in the denominator who have a recorded BMI in the last 12 months.
Denominator – the number of children and young people aged over 2 years that have had an appointment with a healthcare professional in the last 12 months.
Data source: Data can be collected from information recorded locally by healthcare professionals and provider organisations, for example from the electronic medical record.
What the quality statement means for different audiences
Service providers (such as primary care services and secondary care services) ensure that children and young people can have their BMI recorded opportunistically. They ensure that healthcare professionals have appropriate equipment to measure height and weight, and systems to record BMI.
Healthcare professionals (such as doctors, nurses and allied health professionals) accurately measure and record height and weight of children and young people opportunistically. They are able to identify when it is appropriate to take measurements and ask for permission before discussing weight. They approach conversations in a sensitive, non-judgemental way and respect the person's choice (and that of their family or carer, if relevant) if they do not wish to discuss their weight.
Commissioners ensure that they commission services in which children and young people can have their BMI recorded.
Children and young people aged over 2 years have their BMI (weight and height) taken and recorded by healthcare professionals when there is an appropriate opportunity at routine health checks and non-urgent appointments, if they consent to this.
Source guidance
Overweight and obesity management. NICE guideline NG246 (2025), recommendations 1.10.1 to 1.10.4, and 1.10.7
The 12-month timeframe in the process measure is based on advice from the NICE quality standards advisory committee. The timeframe is not derived from the NICE guideline on overweight and obesity management. It is considered a practical timeframe to enable stakeholders to measure performance.
Definitions of terms used in this quality statement
Key points of contact
Recording of BMI can take place based on practitioner judgement and with permission at potentially suitable opportunities such as routine health checks and non-urgent appointments (such as immunisation appointments). [Adapted from NICE's guideline on overweight and obesity management, recommendations 1.10.3 and1.10.4]
Equality and diversity considerations
Reasonable adjustments should be considered when measuring height and weight in children and young people with a learning or physical disability. This may include special growth charts, use of seated or hoisted scales, or scales that will accept a wheelchair, measuring height with a tape measure, rollameter, or with the person lying down. Measurements may need to be modified for example using sitting height or demi-span (the distance between the mid-point of the sternal notch and the finger roots with the arms outstretched laterally) instead of overall height, meaning specialist assessment may be needed. [NICE's guideline on overweight and obesity, rationale and impact section for measures of overweight, obesity and central adiposity in children and young people and Public Health England's guidance on obesity and weight measurement for people with learning disabilities].