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Childhood Obesity and Weight Problems

Helping Your Child Reach and Maintain a Healthy Weight

Boy eating chips on bed

As a parent, few things are cuter than your full-cheeked baby or the chubby knees of your toddler. For some children, however, that adorable baby fat may turn into a health concern. If you’re watching your child struggle with their weight, you may feel alone or helpless; in reality, you are neither. Childhood obesity affects an enormous number of families around the world, but the vast majority of these cases are preventable—and can still be reversed. With support, encouragement, and positive role modeling, you can help your child reach and maintain a healthy weight.

Childhood obesity: understanding the problem

Today, nearly 1 out of 4 children and teens in developed countries are overweight or obese. Those extra pounds put kids at risk for developing serious health problems, including diabetes, heart disease, and asthma. Childhood obesity also takes an emotional toll. Overweight children often have trouble keeping up with other kids and joining in sports and activities. Other kids may tease and exclude them, leading to low self-esteem, negative body image, and even depression.

But there’s plenty you can do to help your kids. Diagnosing weight problems and obesity in children as early as possible can reduce their risk of developing serious medical conditions as they get older. And by getting the whole family involved, you can break the cycle of weight problems and obesity, boost your children’s physical and mental health, and help them establish a healthy relationship with food that will last a lifetime. Whatever your children’s weight, let them know that you love them and that all you want to do is help them be healthy and happy.

Is your child overweight?

Children grow at different rates at different times, so it is not always easy to tell if a child is overweight. Body mass index (BMI) uses height and weight measurements to estimate how much body fat a child has. However, while BMI is usually a good indicator, it is NOT a perfect measure of body fat and can even be misleading at times when children are experiencing periods of rapid growth.

If your child registers a high BMI-for-age measurement, your health care provider may need to perform further assessments and screenings to determine if excess fat is a problem.

Causes of weight problems and obesity in children

Understanding how children become overweight in the first place is an important step toward breaking the cycle. Most cases of childhood obesity are caused by eating too much and exercising too little. Children need enough food to support healthy growth and development. But when they take in more calories than they burn throughout the day, the result is weight gain.

Causes of weight problems in children may include:

  • Busy families cooking at home less and eating out more.
  • Easy access to cheap, high-calorie fast food and junk food.
  • Bigger food portions, both in restaurants and at home.
  • Kids consuming huge amounts of sugar in sweetened drinks and hidden in an array of foods.
  • Kids spending less time actively playing outside, and more time watching TV, playing video games, and sitting at the computer.
  • Many schools eliminating or cutting back their physical education programs.
Myths and Facts about Weight Problems and Obesity in Children

Myth 1: Childhood obesity is genetic, so there’s nothing you can do about it.

Fact: While a person’s genes do influence weight, they are only one small part of the equation. Although some children are more prone to gaining weight than others, that doesn’t mean they’re destined for weight problems. Most kids can maintain a healthy weight if they eat right and exercise.

Myth 2: Children who are obese or overweight should be put on a diet.

Fact: Unless directed by your child’s doctor otherwise, the treatment for childhood obesity is not weight loss. The goal should be to slow or stop weight gain, allowing your child to grow into his or her ideal weight.

Myth 3: It’s just baby fat. Children will outgrow the weight.

Fact: Childhood obesity doesn’t always lead to obesity in adulthood, but it does raise the risks dramatically. The majority of children who are overweight at any time during the preschool or elementary school are still overweight as they enter their teens. Most kids do not outgrow the problem.

To combat weight problems, get the whole family involved

Healthy habits start at home. The best way to fight or prevent childhood obesity and weight problems is to get the whole family on a healthier track. Making better food choices and becoming more active will benefit everyone, regardless of weight.

You can also make a huge impact on your children’s health by getting involved with the details of their lives. Spending time with your kids—talking about their day, playing, reading, cooking—can supply them with the self-esteem boost they may need to make positive changes.

Leading by example

If your children see you eating your vegetables, being active, and limiting your TV time, there’s a good chance that they will do the same.

What you eat: Tell your child about the healthy food you are eating, while you are eating it. You might say, “I’m eating broccoli with garlic sauce. Want a bite?”

When you cook: Cook healthily in front of your children. Better yet, give them an age-appropriate job in the kitchen. Tell them about what you are making and why it’s good for your body.

How you move: Exercise in some way, every day. Be authentic—do things you enjoy. Tell your kids what you’re doing, and invite them to join you.

Your free time: Avoid the television or too much computer time. Kids are much less likely to turn screens on if they are off and you are doing something they can get involved in.

Strategies for Real Life

  • Recognize that you have more control than you might think. You can turn off the TV, computer, or video game. You can choose to get off the bus one stop earlier than usual and walk the rest of the way, especially when you are with your kids. You can give your family more vegetables for dinner.
  • Think about the immediate benefits. If reducing the risk of future heart disease seems abstract, focus on the good things that can happen right now. You won’t feel uncomfortably full if you have a smaller portion or skip dessert. Going hiking with your teenager might lead to a wonderful talk that neither of you anticipated. Dancing or playing with your kids is lots of fun and can give you a great workout.
  • Make small, easy changes over time. Suggesting that family members take a run together every day will probably get you lots of eye-rolling. It’s easier and more appealing to start out with some new approaches to nutrition and physical activity that the whole family is really willing to try. For example, take a walk after dinner a couple of nights a week instead of turning on the TV.

Source: We Can! Families Finding the Balance, U.S. Dept. of Health & Human Services

Make healthier food choices

While you may need to make major changes to your family’s eating habits, changing everything at once usually leads to cheating or giving up. Instead, start by making small, gradual steps—like adding a salad to dinner every night or swapping out French fries for steamed vegetables—rather than one big drastic switch. As small changes become habit, you can continue to add more healthy choices.

Eat the rainbow. Serve and encourage consumption of a wide variety of fruits and vegetables. This should include red (beets, tomatoes), orange (carrots, squash), yellow (potatoes, bananas), green (lettuce, broccoli) and so on—just like eating a rainbow.

Make breakfast a priority. Children who eat breakfast are less likely to be overweight or obese than those who skip the first meal of the day. It’s important to focus on healthy choices, though, like oatmeal, fresh fruit, whole grain cereal high in fiber and low in sugar, and low-fat milk instead of sugary cereals, donuts, or toaster pastries.

Look for hidden sugar. Reducing the amount of candy and desserts you and your child eat is only part of the battle. Sugar is also hidden in foods as diverse as bread, canned soups, pasta sauce, instant mashed potatoes, frozen dinners, low-fat meals, fast food, and ketchup. The body gets all it needs from sugar naturally occurring in food—so anything added amounts to nothing but a lot of empty calories. Check labels and opt for low sugar products and use fresh or frozen ingredients instead of canned goods.

Schedule regular meal times. The majority of children like routine. If your kids know they will only get food at certain times, they will be more likely to eat what they get when they get it.

Limit dining out. If you must eat out, try to avoid fast food.

Don't go no fat, go good fat

Not all fats contribute to weight gain. So instead of trying to cut out fat from your child’s diet, focus on replacing unhealthy fats with healthy fats.

Avoid trans fats that are dangerous to your child’s health. Try to eliminate or cut back on commercially-baked goods packaged snack foods, fried foods, and anything with “partially hydrogenated” oil in the ingredients, even if it claims to be trans fat-free.

Add more healthy fats that can help a child control blood sugar and avoid diabetes. Unsaturated or “good” fats include avocados, olive oil, nuts, fatty fish, soy, tofu, flaxseed, Brussels sprouts, kale, and spinach.

Choose saturated fat wisely. The USDA recommends limiting saturated fat to 10 percent of your child’s daily calories. Focus on the source of saturated fats consumed: A glass of whole milk or natural cheese rather than a hot dog, donut, or pastry, for example, or grilled chicken or fish instead of fried chicken.

Be smart about snacks and sweet food

Your home is where your child most likely eats the majority of meals and snacks, so it is vital that your kitchen is stocked with healthy choices.

Look for hidden sugar. Reducing the amount of candy and desserts you and your child eat is only part of the battle. Sugar is also hidden in foods as diverse as bread, canned soups, pasta sauce, instant mashed potatoes, frozen dinners, and low-fat meals. The body gets all it needs from sugar naturally occurring in food—so anything added amounts to nothing but a lot of empty calories. Check labels and opt for low sugar products and use fresh or frozen ingredients instead of canned goods.

Don’t ban sweets entirely. While many kids' consume too much sugar, having a no sweets rule is an invitation for cravings and overindulging when given the chance. Instead, limit the amount of cookies, candies, and baked goods your child eats and introduce fruit-based snacks and desserts instead.

Limit juice, soda, and coffee drinks. Soft drinks are loaded with sugar and shakes and coffee drinks can be just as bad. Many juices aren’t any better nutritionally, so offer your child sparkling water with a twist of lime, fresh mint, or a splash of fruit juice instead.

Keep snacks small. Don’t turn snacks into a meal. Limit them to 100 to 150 calories.

Go for reduced-sugar options. When buying foods such as syrups, jellies, and sauces, opt for products labeled “reduced sugar” or “no added sugar.”

Focus on fruit. Keep a bowl of fruit out for your children to snack on—kids love satsuma or tangerine oranges. And offer fruit as a sweet treat—frozen juice bars, fruit smoothies, strawberries and a dollop of whipped cream, fresh fruit added to plain yogurt, or sliced apples with peanut butter.

Experiment with herbs and spices. Use sweet-tasting herbs and spices such as mint, cinnamon, allspice, or nutmeg to add sweetness to food without the empty calories.

Check the sugar content of your kid’s cereal. There’s a huge disparity in the amount of added sugar between different brands of cereal. Some cereals are more than 50% sugar by weight. Try mixing a low sugar, high-fiber cereal with your child’s favorite sweetened cereal, or add fresh or dried fruit to oatmeal for a natural sweet taste.

Snacks at home
Snacks to stock up: Snacks to cut back:

Fresh fruit and vegetables that can be taken on the go or packed in a lunch.

Soda, sweetened lemonade, fruit punch, and fruit juice with added sugar.

Milk and dairy products, including string cheese.

Hot dogs, fatty lunch meats, sausage, chicken nuggets.

Whole grain breads and cereals, pretzels, nuts, olives.

White bread, sugary breakfast cereals, chips.

Greek yogurt, frozen fruit juice bars, fig bars, ginger snaps.

Cookies, cakes, candy, ice cream, donuts.

Watch portion sizes

There are strategies you can employ to retrain you and your family’s appetites and avoid oversized servings when eating out.

Learn what a regular portion size looks like. The portion sizes that you and your family are used to eating may be equal to two or three true servings. To keep calories in check, try to limit portions to the size of your fist.

Read food labels. Information about serving size and calories can be found on the backs of packaging. You may be surprised at how small the recommended portions are or how many calories are in the dish.

Use smaller dishes. Portions will look bigger and you’ll eat less when you use small bowls or plates.

Dish up in the kitchen. To minimize the temptation of second and third helpings, serve food on individual plates, instead of putting the serving dishes on the table.

Divide food from large packages into smaller containers. The larger the package, the more people tend to eat without realizing it.

Cut up high-calorie treats such as cheese, pizza, or chocolate into smaller pieces—and offer your child fewer pieces.

Downsize orders. When eating out, share an entrée with your child or order just an appetizer instead. Order half-orders or a medium size instead of a large.

Get your kids moving

Children who sit too much and move too little are at the highest risk for becoming overweight. Kids need an hour of exercise daily for optimum health. This may seem like a lot, but exercise doesn’t have to happen in a gym or all at once. Instead, try to incorporate movement into your family’s regular routine.

Exercise ideas for kids

It used to be commonplace to find children running around and playing in the streets of their neighborhoods, naturally expending energy and getting exercise. In today’s world, that’s not always an option, but you still have options for boosting their activity level.

Play active indoor games. Put the remote away and organize some active indoor games. You can play tag (perhaps crawling tag, so that you keep messes to a minimum), hide-and-seek, or Simon Says (think jumping jacks and stretches).

Try activity-based video games, such as those from Wii and Kinect which are played standing up and moving around—simulating dancing, skateboarding, soccer, bowling, or tennis. Once your child gains in confidence, get away from the screen and play the real thing outside. 

Get active outside with your child. Take a walk together, bike around the neighborhood, explore a local park, visit a playground, or play in the yard. If it makes sense for your neighborhood and schedule, walk to and from activities and school.

Do chores together. Perhaps it’s not your child’s first choice, but doing household chores is a very effective way to get exercise. Mopping, sweeping, taking out trash, dusting or vacuuming burns a surprising number of calories.

Enroll children in after school sports or other activities. If your budget allows, sign children up to play a sport or get involved in an activity where they are physically active. The local YMCA, YWCA, or Boys’ and Girls’ Club are safe places for children to exercise and play.

Sign up for a 5 or 10K walk/run with your child. Sometimes having a goal in mind can motivate even the most reluctant exercisers. Find a kid-friendly event in your area and tell your child you’ll be “training” for it together. Be sure to celebrate when you accomplish this feat.

Reduce screen time

The less time your children spend watching TV, playing video games, or using computers or mobile devices, the more time they’ll spend on active pastimes. Remember how important it is for you to be a positive role model—so you may have to cut down on your own viewing habits, too.

Limit daily screen time. Studies show a link between screen time and obesity, so set limits on your child’s TV-watching, gaming, and web surfing. Experts recommend no more than two hours per day.

Stop eating in front of the TV. Limit your child’s calorie intake by limiting time spent eating in front of the tube. Tell your child that, starting now, your family does all their eating at the table.

Pick a different reward or punishment. Instead of rewarding your child with more time in front of the television or computer, promise something different, such as an outing or an activity of their choice.

Encourage your child to develop new hobbies

Making major lifestyle changes has the potential to add more stress to a child’s life. At times, your overweight or obese child might feel singled out, sad, angry, embarrassed, or discouraged. In the past, they might have dealt with stress by eating or zoning out in front of the TV. Since this is no longer an option, help them find a healthy alternative. Ask your child what he or she might like to take up as a hobby. Hobbies can help kids boost their self-esteem, relieve stress, and provide a positive outlet.

More help for diets

Resources and references

General information about weight problems and obesity in children

Overweight and Obesity – Learn how to tell if your child is overweight, explore the causes and effects of childhood obesity, and find helpful tips for preventing weight problems. (KidsHealth)

We Can! Families Finding the Balance: A Parent Handbook (PDF) – Guide to tackling the problem of childhood obesity and making healthy changes for the whole family. (U.S. Dept. of Health & Human Services)

Helping Your Child Who is Overweight – Parent’s guide to helping an obese or overweight child begin to eat better and be more active. (National Institute of Diabetes and Digestive and Kidney Diseases)

Is Dieting Okay for Kids? – Discover why the majority of overweight kids should not diet, and find out healthier strategies for combating childhood obesity. (KidsHealth)

Resources for parents

Be a Healthy Role Model for Children (PDF) – Ten tips for setting a good example for your child and preventing childhood overweight and obesity. (USDA)

Cut Back on Sweet Treats (PDF) – Ten tips for fighting childhood obesity and overweight by cutting back on added sugar. (USDA)

How to Talk to Kids about Weight and Obesity – Advice for addressing the sensitive subject of weight and offering support to an overweight or obese child. (Academy of Nutrition and Dietetics)

Sugar and obesity in children

Sugary Drinks and Obesity Fact Sheet – How sugary drinks are a major contributor to the current obesity epidemic. (Harvard School of Public Health)

Sugar Intake, Diabetes and Kids – Q&A with a pediatric obesity expert about the link between added sugar and childhood weight gain and diabetes problems. (Stanford Medicine)

BMI Calculators

BMI Percentile Calculator – Use this calculator for children and teens, aged 2 through 19 years old. (CDC)

Authors: Melinda Smith, M.A. and Lawrence Robinson. Last updated: May 2017.