Morbid Obesity and Acanthosis Nigricans Referral Guidelines

NOTE: If Obesity starts after age 5, and no lab abnormalities, then refer out to community weight management programs. *NO ENDOCRINOLOGY REFERRAL NEEDED*

Clinical Findings

  • Obesity (BMI > 97%ile)
  • Darkening & thickening of skin around neck, elbow, waist, knuckles, axilla
  • Irregular menses

Referral Timeframe

Routine: Referrals will be evaluated

Pre-Referral Workup

  • HgA1C (abnormal if > 6%)
  • Fasting Blood Glucose (Abnl 100-125)
  • 2 hour OGTT (abnl 2 hour level above 140 mg/dl). For 8 years and over, use 1.75 grams of glucola/kg to max of 75 grams

Referral Requirements

  • Growth chart
  • Laboratory results
  • Recent clinical notes