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Introduction: Worldwide, childhood obesity is on the rise. A lot of debate exists within the scientific community regarding the best way to define overweight and obesity in different populations. Currently, three sets of growth references are in use internationally: the 2007 World Health Organization (WHO) growth standards, the International Obesity Task Force (IOTF) reference, and the 2000 Center for Disease Control and Prevention (CDC) growth charts. We examined the impact of using these international growth references on diagnosing obesity in a group of overweight and obese Romanian children. Afterwards, we evaluated the relationship between diagnosed obesity and insulin resistance status. Material and method: We studied retrospectively the observation charts of children who had their insulin levels tested in our hospital's laboratory between January 1st 2008 and December 31st 2009. The study population consisted of 76 children. We analyzed: age, gender, body mass index (BMI), the homeostatic model assessment: insulin resistance (HOMA-IR). We divided the children into two categories according to their HOMA-IR values. We used each of the standards and grouped the study population into two BMI groups: overweight and obese. We used One-Way ANOVA to evaluate the differences between the three definitions. Results: We found significant differences between the WHO and the IOTF and CDC references. The WHO standards identified the least overweight children with insulin resistance. Conclusions: Our study shows that using WHO growth standards may be the proper method to diagnose obese children. A large populational study is needed to establish the proper growth references for our population. [ABSTRACT FROM AUTHOR]