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BMI Assessment & Nutrition/Physical Activity Counseling Case Examples

Case Example 1: Documenting BMI Data in Electronic Health Records

Providers from one Connecticut SBHC conduct BMI screenings during each initial patient visit and provide nutrition and physical activity counseling to everyone. They offer a subsequent weight management and nutrition visit to any clients with a BMI greater than 85%. Based on the client’s responses to questions about readiness for change, providers schedule an additional follow-up appointment. To be able to document, track, and report this work, the sponsoring organization developed an EHR template with discrete fields so they could extract BMI data (including nutrition and physical activity counseling).

Case Example 2: Developing Standard Recommendations for Each BMI Weight Category

Staff at one Colorado SBHC developed these standard recommendations for each weight category:

  • BMI <5%: “Your child has a BMI of <5 percentile. Your child should gain weight. Offer three whole milk servings per day. Encourage your child to eat higher calorie foods through three meals and two healthy snacks per day. Make sure to follow-up as planned.”
  • BMI 5-85%: “All children need five servings of fruit and vegetables per day, four servings of water, and three servings of dairy. They should have one hour or more of daily activity, 8-10 hours of sleep, and less than two hours of screen time per day.”
  • BMI 85%-95%: “Your child’s BMI is between the 85th and 95th percentile. They will either need to maintain their weight as they grow, or lose weight if they are no longer growing. Children need 60 minutes of active play every day and should keep screen time to no more than two hours per day. Drinks should be limited to 24 oz. of 1% milk, four servings of water, and no more than 4 oz. of juice each day. Limit soda to 0-1 each week and eating in restaurants 0-1 each week. To help keep your child healthy, encourage them to eat five servings of fruits and vegetables every day in addition to breakfast each morning.”
  • BMI >95%: “Your child’s BMI is over the 95th percentile and we recommended they lose weight for their health and well-being. Children need 60 minutes of active play every day and should keep screen time to no more than two hours per day. Drinks should be limited to 24 oz. of 1% milk, four servings of water, and no more than 4 oz. of juice each day. Limit soda to 0-1 each week and eating in restaurants 0-1 each week. To help keep your child healthy, encourage them to eat five servings of fruits and vegetables every day in addition to breakfast each morning.”