title: Obesity in pediatric specialty clinics: an underestimated comorbidity.
abstract: OBJECTIVE
  (a) To examine the prevalence of obesity across 31 subspecialties in a tertiary care children's hospital and (b) to examine the percentage of obesity-specified diagnosis codes used for obese patient visits.
  
  
  METHODS
  We analyzed 48 479 youth aged 2 to 18 years in 31 outpatient subspecialty clinics at Seattle Children's Hospital between 2005 and 2007. Body mass index (BMI) percentiles were determined by age- and gender-adjusted BMI calculated from height/weight obtained at clinic visits. For obese patients, the percentage of diagnoses coded as obesity-specific (278.11, 278.01, 272.02, 783.1) were determined by evaluation of standard diagnostic codes.
  
  
  RESULTS
  Twenty-two of the 31 clinics had patient obesity rates greater than 15%. Analysis of International Classification of Diseases, 9th Revision, codes for obese patient visits as defined by BMI revealed only 2 clinics used obesity-specific codes for >5% of all diagnoses.
  
  
  CONCLUSIONS
  Given the prevalence of obesity across all subspecialties, more recognition and resources are needed to screen, diagnosis, and provide coordinated services for healthy weight management.
authors.affiliation: University of Washington, Seattle, WA, USA. joyce.yi-frazier@seattlechildrens.org
authors.forename: Joyce P
authors.initials: JP
authors.lastname: Yi-Frazier
authors.forename: Cindy
authors.initials: C
authors.lastname: Larison
authors.forename: John M
authors.initials: JM
authors.lastname: Neff
authors.forename: H Mollie Greves
authors.initials: HM
authors.lastname: Grow
authors.forename: Lenna L
authors.initials: LL
authors.lastname: Liu
mesh_terms: D000293:Adolescent; D000465:Algorithms; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006776:Hospitals, Pediatric / Q000706:statistics & numerical data; D006785:Hospitals, University; D006801:Humans; D008297:Male; D016347:Medical Records Systems, Computerized; D009765:Obesity / Q000175:diagnosis* / Q000453:epidemiology*; D056128:Obesity, Abdominal / Q000453:epidemiology; D009767:Obesity, Morbid / Q000453:epidemiology; D050177:Overweight / Q000453:epidemiology; D015995:Prevalence; D012494:Sampling Studies; D014861:Washington / Q000453:epidemiology