In-depth assessments are required to identify children and adolescents with positive screens who are truly overweight, to diagnose any underlying causes and to provide a basis for treatment.

A thorough medical history must be conducted to identify any underlying syndromes or secondary complications.

A family history is needed to identify risks for obesity. These risks include the presence of obesity, eating disorders, type 2 diabetes mellitus, cardiovascular disease, hypertension, dyslipidemia, and gallbladder disease in parents, siblings, aunts, uncles, and grandparents.⁷

A dietary history identifies eating practices, including the quantity, quality, and timing of foods consumed, and eating behaviors that may lead to excessive caloric intake and obesity.

A physical activity history is needed to determine children's and adolescents' physical activity levels as well as how much time they spend participating in sedentary behaviors. Contraindications to physical activity (e.g., uncontrolled asthma, joint disease) should be noted.

A physical examination identifies children's and adolescents' degree of overweight and any potential syndromes and complications of obesity.

Degree of overweight, family history, and the physical examination will guide the choice of laboratory tests.