Overweight and Obesity in Children
Understanding, preventing, and addressing weight concerns in children with compassion
Understanding Weight and Health
Doctors use the medical terms "overweight" or "obese" to tell if someone has a greater chance of developing weight-related health problems.
Childhood obesity has become a significant health concern in recent years, affecting millions of children and families worldwide. The good news is that childhood weight issues are both preventable and treatable with the right approach, support, and commitment from the whole family. Understanding the factors that contribute to weight gain and the health implications helps parents make informed decisions about their child's wellbeing.
It's important to approach weight concerns with sensitivity and compassion. Children are developing not just physically, but emotionally and psychologically. Focusing on healthy habits rather than weight numbers, and creating a supportive environment where the whole family participates in healthier choices, leads to better long-term outcomes than restrictive diets or weight-focused conversations that can harm a child's relationship with food and their body image.
Every child is unique, and what works for one family may not work for another. Some children naturally have larger frames or carry more weight during certain developmental stages before growing taller. The key is working with your healthcare provider to understand your child's individual growth pattern and determine whether their weight is affecting their health or development, rather than comparing them to other children or ideal standards.
How Are Overweight and Obesity Defined?
Body mass index (BMI) uses height and weight measurements to estimate a person's body fat. But calculating BMI on your own can be complicated. An easier way is to use a BMI calculator.
After calculating BMI and plotting the result on standard BMI charts, doctors use four categories to describe weight in kids ages 2 to 19:
Underweight
BMI below the 5th percentile
Normal Weight
BMI at the 5th and less than the 85th percentile
Overweight
BMI at the 85th and below 95th percentiles
Obese
BMI at or above 95th percentile
👶 For Kids Younger Than 2 Years Old
Doctors use weight-for-length charts instead of BMI to determine how a baby's weight compares with their length.
A child under 2 who falls at or above the 95th percentile is considered overweight.
Important to Know
BMI is not a perfect measure of body fat and can be misleading in some cases. For example:
- •A muscular person may have a high BMI without being overweight (extra muscle adds to body weight — but not fatness)
- •BMI might be hard to interpret during puberty when kids have periods of fast growth
Remember, BMI is usually a good indicator of body fat, but it's not a direct measurement.
When to See the Doctor
If you're worried about your child's weight, take them to see the doctor. The doctor will ask about eating and activity habits and make suggestions on how to make healthy lifestyle changes.
The doctor also may order blood tests to look for some of the medical problems linked to obesity.
The Doctor May:
- •Refer you to a registered dietitian
- •Recommend a weight management program
- •Prescribe medicine for some kids
- •Recommend surgery in certain cases
Depending on your child's BMI (or weight-for-length measurement) and health, professional support is available to help your family make positive changes.
Why Do Kids Become Overweight or Obese?
Things that can contribute to a person becoming overweight include poor diet habits, not enough exercise, genetics, or a combination of these. Lack of access to healthy food and safe places to be active is a challenge for many families.
Note: Rarely, too much weight gain may be due to an endocrine problem, genetic syndrome, or some medicines.
🍔 Diet and Lifestyle
We often choose foods that are quick and easy to eat — from fast food to processed and prepackaged meals and snacks. Busy schedules can leave little time to make healthier meals or to squeeze in some exercise. Portion sizes, at home and away, are too large.
Plus, modern life is sedentary. Kids often spend more time playing with electronic devices than actively playing outside.
The modern food environment presents unique challenges that previous generations didn't face. Highly processed foods designed to be hyperpalatable are readily available and often cheaper than fresh, whole foods. Marketing campaigns target children with colorful packaging and appealing characters, making unhealthy choices seem more attractive. Many neighborhoods lack access to fresh produce and safe outdoor spaces for physical activity, creating what experts call "food deserts" and limiting opportunities for exercise.
Additionally, the portion sizes served at restaurants and even at home have grown significantly over the past few decades. What was once considered a normal serving is now often half of what people typically eat. Children learn eating habits from their environment, and when large portions become the norm, it's difficult for them to recognize appropriate serving sizes. This combination of convenient but unhealthy food options, aggressive marketing, limited access to healthy alternatives, and distorted portion expectations creates a perfect storm for weight gain in children.
📱 Screen Time Effects
- • Kids who spend a lot of time in front of screens are more likely to be overweight
- • Screen time interferes with sleep
- • Kids who don't get enough sleep are more likely to be overweight
🍕 Food Challenges
- • Quick and easy processed foods
- • Large portion sizes
- • Less time for home cooking
- • Limited access to healthy options
🏃 Exercise and Physical Activity
Many kids don't get enough physical activity.
👦 Older kids and teens: Should get 1 hour or more of moderate to vigorous exercise every day, including aerobic and muscle- and bone-strengthening activities
👶 Kids ages 2 to 5 years: Should be active at least 3 hours throughout each day
🧬 Genetics
Genetics can play a role in what kids weigh. Our genes help determine body type and how the body stores and burns fat. But genes alone can't explain the current obesity crisis.
Because both genes and habits are passed down from one generation to the next, multiple members of a family may struggle with weight.
People in the same family tend to have similar:
- •Eating patterns
- •Sedentary behaviors
- •Levels of physical activity
A child's chances of being overweight increase if a parent is overweight or obese.
What Health Problems Can Being Overweight Cause?
People with high BMI are more likely to have weight-related health problems. These include type 2 diabetes, high blood pressure, and high cholesterol — all of which used to be considered adult diseases.
Physical Health Problems
🏥 Medical Conditions
- • Type 2 diabetes
- • High blood pressure
- • High cholesterol
- • Bone and joint problems
- • Liver and gallbladder disease
😮 Breathing Issues
- • Shortness of breath during exercise
- • Makes sports and physical activity harder
- • Can worsen asthma symptoms
- • May lead kids to develop asthma
- • Sleep problems (obstructive sleep apnea)
⏰ Early Maturation
A tendency to mature earlier. Overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are.
🩺 Reproductive Issues
Irregular menstrual cycles and fertility problems in adulthood
❤️ Long-Term Cardiovascular Risk
Cardiovascular risk factors (including high blood pressure, high cholesterol, and diabetes) that develop in childhood can lead to heart disease and stroke in adulthood.
Preventing or treating overweight and obesity in kids may help protect them from these problems as they get older.
💔 Emotional and Social Issues
Kids also might have emotional issues to deal with (such as low self-esteem), and may be teased, bullied, or rejected by peers.
Kids who are unhappy with their weight can be at risk for:
- •Unhealthy dieting and eating disorders
- •Depression
- •Substance abuse
How Can We Prevent Overweight and Obesity?
Preventing kids from becoming overweight means making choices about how your family eats, exercises, and spends time together. Helping kids adopt a healthy lifestyle begins with parents who lead by example.
To keep kids of all ages at a healthy weight, take a whole-family approach. Make healthy eating and exercise a family affair. Get your kids involved by letting them help you plan and prepare healthy meals. Take them along when you go grocery shopping. Teach them how to make good food choices.
Prevention is always easier than treatment when it comes to childhood weight issues. Establishing healthy habits early creates a foundation that children carry into adulthood. Rather than waiting until weight becomes a problem, families can work together to build an environment that naturally supports healthy choices. This doesn't mean perfection—it means creating consistent patterns where nutritious foods are readily available, physical activity is a regular part of daily life, and everyone feels supported in making good choices.
One of the most powerful tools parents have is their own behavior. Children are keen observers and tend to model what they see at home more than what they're told. If parents regularly choose vegetables, enjoy physical activity, and have a positive relationship with food, children are much more likely to develop similar habits. Conversely, if parents constantly diet, skip meals, or use food for emotional comfort, children may learn these patterns as well.
It's also important to recognize that preventing obesity isn't about restriction or deprivation. In fact, overly restrictive approaches often backfire, leading children to sneak food, overeat when treats are available, or develop unhealthy relationships with eating. The goal is balance—enjoying a wide variety of foods including occasional treats, staying active in ways that feel fun rather than punishing, and creating a home environment where health is valued without obsessing over weight or appearance.
🚫 Common Traps to Avoid
❌ Don't Use Food as Reward or Punishment
Don't reward kids for good behavior or try to stop bad behavior with sweets or treats. Talk to your doctor about other ways to change behavior.
❌ Don't Have a Clean-Plate Policy
Even babies turn away from the bottle or breast to send signals that they're full. If kids are satisfied, don't force them to keep eating.
Reinforce the idea that they should eat only when they're hungry and stop when they're full.
❌ Don't Talk About "Bad Foods"
Don't completely ban all sweets and favorite snacks. Kids may rebel and overeat forbidden foods outside the home or sneak them in on their own.
Serve healthy foods most of the time and offer treats once in a while.
Recommendations by Age
👶 Birth to Age 1
Besides its many health benefits, breastfeeding may help prevent excessive weight gain.
Follow your doctor's recommendations about when to introduce solid foods.
🧸 Ages 1 to 5
Start good habits early. Help shape food preferences by offering a variety of healthy foods.
Encourage kids' natural tendency to be active and help them build on developing skills.
🎒 Ages 6 to 12
- •Encourage kids to be physically active every day, whether through an organized sports team or being active during recess
- •Keep your kids active at home with everyday activities like playing outside or going for a family walk
- •Teach them to make good food choices and get them involved in preparing food, such as packing lunch
🎓 Ages 13 to 18
- •Teach teens how to prepare healthy meals and snacks at home
- •Encourage them to make healthy choices when outside the home
- •Encourage them to be active every day
⭐ For All Ages
- ✓Cut down on TV, phone, computer, and video game time
- ✓Discourage eating in front of a screen
- ✓Serve a variety of healthy foods
- ✓Eat family meals together as often as possible
- ✓Encourage kids to eat breakfast every day
- ✓Have at least 5 servings of fruits and vegetables daily
- ✓Limit sugar-sweetened beverages (soda, juice, sports drinks)
- ✓Make sure they get enough sleep
Be a Role Model
Talk to kids about the importance of eating well and being active. Be a role model by eating well, exercising regularly, and building healthy habits into your own daily life.
Make it a family affair, and a healthy lifestyle will be second nature for everyone.
Children learn more from what they observe than from what they're told. When parents demonstrate a positive relationship with food—eating when hungry, stopping when full, enjoying a variety of foods without guilt—children internalize these attitudes. Similarly, when parents find joy in movement and physical activity rather than viewing exercise as punishment or a chore, children are more likely to develop an active lifestyle that feels natural and enjoyable rather than forced.
Remember that being a role model doesn't mean being perfect. It means showing your children how to make the best choices you can most of the time, and how to handle it when things don't go as planned. If you have a day where you eat too much or skip your workout, demonstrate self-compassion and simply get back on track the next day. This teaches children that healthy living is about long-term patterns, not perfection, and that everyone has ups and downs in their journey toward better health.
Remember
Small, consistent changes make a big difference. Focus on building healthy habits as a family, not just on weight. With patience, support, and positive role modeling, you can help your child develop a healthy relationship with food and activity that lasts a lifetime.