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One tool that practitioners can use when assessing student health and weight is to calculate a
student¶s body mass index (BMI). BMI, based on a student¶s height and weight, correlates with
other measures of body fat percentage, and is easy and inexpensive to calculate. For children
and teens, BMI is age and sex specific, and can be used to screen for whether a child is
overweight, healthy weight, or underweight. BMI can be a helpful tool for health center staff to
begin to assess weight in children and teens.

Both the Centers for Disease Control and Prevention, and the American Academy of Pediatrics
recommend annual BMI calculations for screening weight problems in youth. When working
with youth, it is important to use a BMI-for-age percentile, which is age and sex specific, and
different from conventional adult BMI charts. For more information regarding use of BMI in
children and teens, please refer to the CDC¶s guide online, which includes a child and teen BMI
calculator. This can be accessed by visiting the CDC website at CDC.gov, and searching for
³teen BMI calculators,´ or by following the link below:

http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html

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Flower, K., Perrin,E. M., Viadro, C.I., and Ammerman, A.S. (2007). Using Body Mass Index to
Identify Overweight Children: Barriers and Facilitators in Primary Care. Ambulatory
Pediatrics; 7(1), 38-44. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1852499/
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Using motivational interviewing (MI) techniques can help providers address nutrition and
obesity issues in youth. Motivational interviewing is an important technique for providers to
help guide patients in discovering their own motivation for behavior change. While providers
still share expertise and guidance, the exchange of information is more collaborative.

Motivational interviewing has been found to be effective when used for weight and nutrition
problems, and can be implemented in clinical practice in the school based health centers. Some
tips for working with students:
¬ Keep the tone conversational ± open-ended questions, lots of listening
¬ Focus not only on what a student needs to improve, but also on what they are already
doing well
¬ The goal is to encourage students to be internally motivated to make health changes, not
to force behavior change
¬ Even small changes can make positive health impacts. A small change that a student
feels confident about trying can go a long way towards motivating larger changes later on

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ubak, S. (2005). Motivational Interviewing: A systematic review and meta-analysis. British
Journal of General Practice; 55(513), 305-312.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1463134/

Irby, M., Kaplan, S. Garner-Edwards, D. Kolbash, S., and Skelton, J.A. (2010). Motivational
Interviewing in a Family-Based Pediatric Obesity Program: A Case Study. American
Psychological Association: Families, Systems, and Health Vol. 28, No. 3, 236-246.