Underreporting of Overweight and Obesity in Primary Care: A Cross-sectional Study of Children Aged 6–11 Years old

Abstract

Aims: To explore the underreporting of nutritional status among children aged 6–11 years old in primary care, assessed using BMI categories (from World Health Organization). Additionally, the study will evaluate the prevalence of overweight and obesity by age and sex and examine whether identified cases are being referred to specialised services, such as paediatrics or nutrition. Study Design:  A descriptive and cross-sectional study was conducted through a retrospective review of medical records. Place and Duration of Study: Ambulatory Care Medical Unit. The study was carried out from February 1st to December 31st, 2024, with Mexican paediatric patients attending outpatient consultations in the Family Medicine Specialty and General Medicine departments at the "División del Norte" Family Medicine Clinic, ISSSTE, in Mexico City, Mexico. The data was collected from  January, 2022 to December, 2022. Methodology: Data on health and sociodemographic variables was collected through a retrospective design, using medical records. Results: We included 363 medical records of paediatric patients, mainly boys (50.7%, 95% CI: 45.5–55.9). The age average, weight, height and BMI was similar between girls and boys (p value >0.05). The largest proportion of children were underweight (n=204, 56.2%; CI95% 51.5-61.2), followed by normal weight (n=130, 35.9%; CI95% 30.3-41.3). Smaller proportions were classified as overweight (n=25, 6.9%; CI95% 4.7-9.6) and with obesity (N=4, 1.1%; CI95% 0.3-2.5). A total of 10 patients (2.8%) were diagnosed during consultations, leaving a significant majority undiagnosed (n=353, 97.2% CI95% 95.3-98.6). Boys were four times more likely than girls to be referred to paediatric services (25% vs. 5.9%). In contrast, girls showed a slightly higher likelihood of being referred to nutrition services compared to boys (23.5% vs. 16.7%). Conclusion: Malnutrition is the most prevalent nutritional disorder. Overweight and obesity are significantly underreported. This study emphasises the importance of improving the identification, diagnosis, and referral of children with nutritional disorders in primary care settings.