Objective. To evaluate classification accuracy of NC and compare it with body mass index (BMI) in identifying overweight/obese US children. Methods. Data were collected from 92 children (boys: 61) aged 7 to 13 over a 2-year period. NC, BMI, and percent of body fat (BF%) were measured in each child and their corresponding cut-off values were applied to classify the children as being overweight/obese. Classification accuracy of NC and BMI was systematically investigated for boys and girls in relation to true overweight/obesity categorization as assessed with a criterion measure of BF% (i.e., Bod Pod). Results. For boys, Cohen’s (0.25), sensitivity (38.1%), and specificity (85.0%) of NC were smaller in comparison with Cohen’s (0.57), sensitivity (57.1%), and specificity (95.0%) of BMI in relation to BF% categorization. For girls, Cohen’s (0.45), sensitivity (50.0%), and specificity (91.3%) of NC were smaller in comparison with Cohen’s (0.52), sensitivity (50.0%), and specificity (95.7%) of BMI. Conclusion. NC measurement was not better than BMI in classifying childhood overweight/obesity and, for boys, NC was inferior to BMI. Pediatricians and/or pediatric researchers should be cautious or wary about incorporating NC measurements in their pediatric care and/or research. 1. Introduction The prevalence of childhood overweight/obesity in the US has increased during the past 30 years [1]. Childhood overweight/obesity is associated with health risk factors both during childhood [2, 3] and adulthood [4, 5], and with tracking to adulthood obesity [6–8]. Consequently, identification of overweight/obese children early in life may be an important part of an overall health screening process that could be used to improve well-being in this population [9, 10]. The most commonly used screening tool for detecting childhood overweight/obesity is the body mass index (BMI; weight (kg)/height (m) squared). The standard method used in the United States relies on the use of gender and age-specific BMI growth charts from the Centers for Disease Control and Prevention (CDC) [11]. Youth above the standard 85th percentile are considered overweight while youth above the 95th percentile are considered obese. While the BMI is widely used and accepted, there has been recent interest in the use of neck circumference (NC) as an alternative screening method. A study by Nafiu et al. [12] established age- and gender-specific cut-offs for NC using receiver operating characteristics curve (ROC curve) on a large sample of children ( , 52% boys, aged 6 to 18？yrs). The analyses were designed to
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