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Ideal body weight in the precision era: recommendations for prescribing in obesity require thought for computer-assisted methods
  1. Nicholas Appelbaum1,2,
  2. Carmen Rodriguez-Gonzalvez1,2,
  3. Jonathan Clarke1,2
  1. 1 Surgery and Cancer, Imperial College London, London, UK
  2. 2 Helix Centre for Design in Healthcare, Imperial College London, London, United Kingdom
  1. Correspondence to Dr Nicholas Appelbaum, Surgery and Cancer, Imperial College London, London W22NY, UK; n.appelbaum{at}

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As the prevalence of childhood obesity continues to increase, there has been comparatively slow growth in the literature describing how best to dose obese children. For medications with low lipid solubility where doses are calculated by the total body weight (TBW) of the child, increasing adiposity may lead to the administration of doses well in excess of that required for therapeutic effect, and potentially beyond the safe therapeutic interval of the medication. This concern underlies recommendations to use alternative bodyweight measurements for some medications when dosing obese children.

There are numerous alternative bodyweight scalars which are used in obese children, including ideal body weight (IBW), lean body mass and adjusted body weight.1 IBW is probably the most commonly used in obesity and is the only alternative to TBW mentioned in the British National Formulary for Children.2 There is little consensus on how best …

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