Childhood Obesity and Weight Problems

Reviewed by Rose Britt, RDN, CNSC, a Certified Registered Dietitian at Top Nutrition Coaching working with clients who have pediatric feeding disorders and ARFID, as well as those looking to reduce feeding and mealtime battles

Understanding childhood weight problems

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.

Today, nearly one out of five children and teens in the United States are overweight or obese. The picture is similar in many other developed countries. 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.

If you’re watching your child struggle with their weight, it’s easy to feel overwhelmed or helpless. But there’s plenty you can do to help your child. Diagnosing weight problems and obesity as early as possible can reduce your child’s 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 child’s physical and mental health, and help them establish a healthy relationship with food that will last a lifetime. Whatever your child’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.

[Read: Healthy Food for Kids]

If your child registers a high BMI-for-age measurement, your doctor 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. However, the causes of childhood weight problems are complex and may include:

• Busy families cooking at home less and eating out more.
• Easier access to cheap, high-calorie fast food and junk food.
• Limited access to fresh produce and grocery stores.
• Limited access to safe spaces for children to play and move.
• Large food portions, both in restaurants and at home.
• Kids consuming higher amounts of calories from sugar in sweetened drinks (such as soda, juice, and sports drinks).
• Kids spending less time actively playing outside, and more time sitting in front of screens.
• Schools eliminating or cutting back physical education programs.

Myths and Facts about Weight Problems and Obesity in Children

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 child sees you eating your vegetables, being active, and limiting your screen 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’re making and ask them to stir, wash, or interact with the food in some way.

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. You may also find that you are more present for your child when screens are off.

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 towards healthy eating and weight loss—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 habits, 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 when available.

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. Limiting snacks in the one to two hours before a mealtime can also help ensure they’ll eat what is served.

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

Don’t go no fat, go good fat

Not all fats are created equal, and fat is an important part of brain development in young children. 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. While trans fats have been effectively outlawed in the U.S. and some other countries, products containing trans fat may still be on store shelves. Check labels on commercially-baked goods, packaged snack foods, and fried foods, and avoid anything with “partially hydrogenated” oil in the ingredients, even if it claims to be trans fat-free.

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.

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

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.

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 cookies, candies, and baked goods your child eats and introduce fruit-based snacks and desserts instead.

[Read: Refined Carbs and Sugar: The Diet Saboteurs]

Limit juice, soda, sports and coffee drinks. The American Academy of Pediatrics (AAP) recommends limiting juice to less than 4oz daily for toddlers, and less than 8oz daily for older children. The added sugar and calories from these drinks are considered “empty” calories. Instead, offer your child sparkling water with a twist of lime, fresh mint, or a splash of fruit juice.

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 of potato chips, for example, 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 a day 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 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 your child 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.

[Read: Social Media and Mental Health]

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 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 they might like to take up as a hobby. Hobbies can help kids boost their self-esteem, relieve stress, and provide a positive outlet. Some examples include art, music, cooking, or journaling.

Body image and disordered eating

Hearing negative comments about their appearance or eating habits can impact your child’s body image and leave them feeling anxious, self-conscious, or cause them to overly restrict their diet, potentially even contributing to the development of an eating disorder. 

If you are concerned your child may be negatively impacted by their body image, there are ways to help your child manage fat shaming or other critical comments, and achieve body acceptance.

Last updated or reviewed on August 21, 2024