• Public health

The author's reply: In response to the comments on my recent editorial, I would like to emphasise that I agree with the clarification of de Groot et al.1 Indeed, in youths between 2 and 18 years of age, obesity is defined as a body mass index (BMI) of 95th percentile or BMI of ≥30 kg/m², whichever is lower. For children <2 years of age, BMI normative values are not available.2 Data indicate that extreme obesity in children is increasing in prevalence, and these children are at high risk for multiple cardiovascular disease (CVD) risk factors. A proposed definition of severe childhood obesity is 99th percentile BMI, which corresponds to a BMI of approximately 30–32 kg/m^{2 …}