The Gomez classification of protein-energy malnutrition (PEM) uses weight-for-age as <60% of median reference weight for Grade III malnutrition. The key limitation of the Gomez classification compared to the Wellcome Trust classification is:

• A Gomez does not account for height, so stunted children appear heavier than they are
• B Gomez cannot distinguish oedematous (kwashiorkor) from non-oedematous (marasmus) severe malnutrition ✓
• C Gomez uses a less reliable anthropometric measurement than arm circumference
• D Gomez grades do not correlate with mortality risk

Explanation

The Gomez classification grades malnutrition solely by weight-for-age percentage of reference median (Grade I: 75–90%, Grade II: 60–74%, Grade III: <60%) without considering oedema. Kwashiorkor and marasmic-kwashiorkor may have normal or above-normal weight due to fluid retention, placing them in lower grades despite severe illness. The Wellcome Trust classification specifically uses weight-for-age AND the presence/absence of oedema to distinguish marasmus (no oedema, <60%), kwashiorkor (oedema, 60–80%), marasmic-kwashiorkor (oedema, <60%), and undernutrition (no oedema, 60–80%).

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.