Childhood Obesity

What is childhood obesity?

Childhood obesity is a complex disease that can occur when your child is above a healthy weight for their age and height. The medical definition of childhood obesity is having a body mass index (BMI) at or above the 95th percentile on the Centers for Disease Control and Prevention’s (CDC) specific growth charts. Children’s BMI factors differ from adults. For children, BMI is age- and sex-specific because their body compositions vary as they age. They also vary between children assigned male at birth and children assigned female at birth.

You can calculate your child’s BMI by dividing their weight in kilograms by their height in meters squared (kg/m2). For instance, if your 10-year-old child weighs 102 pounds (46.2 kg) and is 56 inches tall (1.4 m), their BMI would be 23.6 kg/m2. This places them in the 95th percentile for BMI-for-age, which means they have obesity.

Healthcare providers use BMI-for-age growth charts to measure size and growth patterns in children. A high BMI may be a sign of high body fat. BMI doesn’t measure body fat directly. But it alerts your child’s healthcare provider your child may need more tests to see if excess fat is a problem. BMI percentile cutoffs define a level above which your child may be more likely to develop weight-related health issues.

Why is childhood obesity a problem?

The facts about childhood obesity are clear. Childhood obesity in the United States is a serious public health problem. According to the CDC, 1 in 5 children and adolescents in the United States has obesity. Children who have obesity are more likely to carry the condition over into adulthood.

Children who have obesity are at a higher risk of developing many health conditions. These conditions include:

• Asthma.
• Sleep apnea.
• Type 2 diabetes.
• High blood pressure (hypertension).
• High cholesterol.
• Heart disease.
• Stroke.
• Musculoskeletal disorders such as osteoarthritis.
• Certain cancers, including colon cancer and breast cancer.
• Fatty liver.

In addition, children who have obesity are at a higher risk of experiencing:

• Bullying.
• Social isolation.
• Low self-esteem.
• Depression.

How common is childhood obesity?

According to the most recent statistics from the CDC, childhood obesity continues to rise. Recent statistics show:

• 13.4% of children ages 2 to 5 have obesity.
• 20.3% of children ages 6 to 11 have obesity.
• 21.2% of children ages 12 to 19 have obesity.

Overall, 19.3% of children, or 14.4 million children in the United States, have obesity.

Who does childhood obesity affect?

Childhood obesity can affect any child, but it’s more common among certain groups. Socioeconomic status and ethnicity continue to play a role in the frequency of childhood obesity.

Recent statistics show rates of childhood obesity dropped as the head of a household’s level of education increased. In the lowest income group, 18.9% of children and adolescents had obesity. In the highest income group, 10.9% of children and adolescents had obesity.

In addition, statistics show childhood obesity affects:

• 25.6% of Hispanic children.
• 24.2% of non-Hispanic Black children.
• 16.1% of non-Hispanic white children.
• 8.7% of non-Hispanic Asian children.

What causes childhood obesity?

Childhood obesity is a complicated disease that has many contributing factors. It’s not laziness or a lack of willpower. Your child needs a certain amount of calories for growth and development. But when they take in more calories than they use, their body stores the extra calories as fat. Children gain excess weight for many of the same reasons adults do. Causes of childhood obesity include:

Behavior

Shared family behaviors such as eating habits and being inactive can contribute to childhood obesity. The balance of calories consumed with calories burned plays a role in determining your child’s weight.

Busy families are consuming more foods and beverages high in fat, sugar and calories. These foods and beverages tend to be low in vitamins, minerals and other vital nutrients. At the same time, many children are spending less time outdoors and more time indoors being inactive. As video games, tablets and smartphones continue to grow in popularity, the number of hours of inactivity may only increase.

Genetics

Genetic factors can increase the likelihood that a child will have obesity. Children whose parents or siblings have obesity may be at an increased risk of developing the condition themselves. Studies have shown various genes may contribute to weight gain. Although weight problems run in families, not all children with a family history of obesity will develop it.

Socioeconomics and community

Where your child lives can have a direct effect on their risk of developing obesity. The foods and drinks that schools and daycare centers serve your child have a direct effect on their diet. They also contribute to the amount of physical activity your child gets every day. Other socioeconomic factors that contribute to childhood obesity include:

• The cost and accessibility of healthy food options.
• Your network or social support system.
• Limited access to recreational facilities or parks in your community, or other safe places to be active.

Cultural factors

Advertising for fast food chains and unhealthy snack foods can contribute to childhood obesity. Children see commercials on TV and advertisements splashed across billboards in their neighborhoods. More often than not, these foods have lots of calories and/or come in large portion sizes.

A combination of these factors can cause childhood obesity. Hormone disorders are another risk factor for childhood obesity. However, diseases are rarely the cause of childhood obesity. A physical examination and some blood tests will rule out the possibility of a medical condition. Some medications can increase the risk for increased body weight and obesity.

How is childhood obesity diagnosed?

It’s important to seek medical help if you’re worried about your child’s condition. Your child’s healthcare provider can help you determine whether your child has obesity. They may use a BMI-for-age growth chart to see if your child is at a healthy weight.

If your child’s healthcare provider determines your child has obesity, they can help you come up with a healthy weight loss plan. They may talk to you about healthy food choices and the right amount of physical activity for your child. If necessary, they’ll refer you to a weight management program that’s suitable for your child.

How can I help my child if they have obesity?

The most important thing you can do to help your child is to focus on their health, not their weight. It’s very important that you support your child in their journey toward better health. Your child’s feelings about themselves are often based on your feelings about them. If you accept your child at any weight, they’ll be more likely to feel good about themselves. Avoid placing blame on your child, yourself or others.

It’s also important to talk to your child about their weight in a nonjudgmental way. You should allow your child to share their concerns with you. You can help your child by gradually changing your family’s physical activity and eating habits. That way your entire family can benefit from new healthy behaviors.

There are many ways to involve the entire family, but increasing physical activity is especially important. Aim for your child to get at least one hour of regular physical activity each day. Some ways to accomplish this include:

• Lead by example: Parents have a direct effect on childhood obesity. If your child sees that you’re physically active and having fun, they’re more likely to be active and stay active for the rest of their lives.
• Plan family activities: Plan activities that provide everyone in your family with exercise. These activities may include walking, biking or swimming.
• Be sensitive to your child’s needs: It’s important to help your child find physical activities they enjoy and that aren’t too difficult.
• Take a break from the screens: Make an effort to reduce the amount of time your family spends doing stationary (sedentary) activities. This includes activities such as watching TV or playing video games. You should limit your child’s screen time to no more than two hours a day.

Make the most of the opportunities you have with your family to be healthier and more active.

How can I teach my child healthy eating habits?

The eating habits your child picks up when they’re young will help them maintain a healthy lifestyle when they’re adults. If you’re unsure how to select and prepare a variety of foods for your family, ask your child’s healthcare provider. They can refer you to a registered dietitian for nutrition counseling. They can also point you in the direction of resources in your community that offer healthy food options.

Do not place your child on a restrictive diet to lose weight. You should only place your child on a diet if their healthcare provider supervises one for medical reasons. Restrictive diets are hard to stay on and can lead to eating disorders and disordered eating patterns.

One way to begin teaching healthy eating habits is to serve a variety of fruits and vegetables to your family. Provide a “rainbow” of fruits and vegetables with every meal, including snacks. Avoid sugary drinks like soda, sweet tea, lemonade and sports drinks. The average child takes in more than 120 calories per day from these drinks alone.

Other approaches you can take to help your child include:

• Guide your family’s choices rather than dictate foods: Make sure a wide variety of healthy foods are available in your house. This practice will help your child learn how to make their own healthy food choices.
• Involve your child in food shopping and preparing meals: These activities can offer hints about your child’s food preferences. They can also help you teach your child about nutrition and provide your child with a feeling of accomplishment. In addition, your child may be more willing to eat or try foods that they help prepare.
• Encourage your child to eat slowly: Your child can detect hunger and fullness better when they eat slowly.
• Eat meals together as a family as often as possible: Try to make mealtimes pleasant with conversation and sharing, not scolding or arguing. If mealtimes are unpleasant, your child may try to eat faster to leave the table as soon as possible. Then they may associate eating with stress.
• Plan for snacks: Continuous snacking may lead to overeating. But if you plan for snacks at specific times throughout the day, they can become part of a healthy diet. They won’t spoil your child’s appetite at mealtimes. Try making snacks as nutritious as possible.
• Discourage eating meals or snacks in front of the TV: Try to eat only in designated areas of your home, such as the dining room or kitchen. If your child eats while watching TV, it may be harder to pay attention to feelings of fullness. It may also lead to overeating. They may also be exposed to ads for unhealthy foods.
• Try not to use food to reward your child: When you use foods such as sweets as a reward, your child may assume these foods are better than other foods. For example, telling your child they’ll get a dessert if they eat all their vegetables sends the wrong message about vegetables.
• Monitor your child’s meals outside your home: Find out if your child’s school lunch program provides a balanced meal. If you can, pack your child’s lunch to include a variety of foods. When dining out at restaurants, choose more nutritious items and think about portion sizes. Be a good example for your child and take half of the meal home for a second meal.

How can I prevent childhood obesity?

There aren’t any simple solutions to tackle childhood obesity. But parents and caregivers can help with childhood obesity prevention in many ways. Ways you can prevent childhood obesity include:

• Be a role model: Parents can affect childhood obesity by switching to healthy habits. Your child imitates what you do. If they see you eating healthy and being physically active, they’ll be more likely to change their habits too.
• Reduce sugar intake: If your child is older than two, sugar should make up less than 10% of their daily calories. Avoid sugar-filled drinks, and offer water or low-fat milk instead. Children younger than 2 years of age shouldn’t have any added sugar in their diet at all.
• Encourage better sleep: Children ages 6 to 12 need nine to 12 hours of sleep every night. Adolescents ages 13 to 18 need eight to 10 hours of sleep every night. Poor sleep can lead to obesity because it makes your child want to eat more and be less physically active.
• Keep your child’s well-child appointments: Your child’s healthcare provider can support you and your child on their journey toward a healthy lifestyle. Your child is more likely to gain weight during periods of missed appointments. Make sure your child sees their healthcare provider every year.

When should my child see their healthcare provider?

If your efforts at home don’t help your child reach a healthy weight, make a call to your child’s healthcare provider. If they determine your child’s health is at risk unless they lose weight, you may want to consider a formal treatment program.

You should look for certain characteristics when choosing a weight management program for your child. The program should have a variety of health professionals on the staff. The best programs may include:

• Registered dietitians.
• Exercise physiologists.
• Pediatricians.
• Family physicians.
• Nurse practitioners.
• Psychiatrists.
• Psychologists.

Other features you should look for when selecting a weight management program for your child include:

• Premedical evaluation of your child: A healthcare provider should review your child’s weight and growth before enrollment. During the program, they should track your child’s weight, height, growth and health at regular intervals.
• Focus on the whole family: A good weight management program will focus on changes your entire family can make, not just your child.
• Adapted to specific ages and capabilities: A program for a 4-year-old child should have different expectations than a program for a 12-year-old.
• Focus on behavioral changes: The program should teach your child how to select a variety of foods in appropriate portions. The program should also encourage daily activity and limit sedentary activity.
• Include a maintenance program: The program should provide support and referral resources to reinforce the new behaviors. It should also provide resources for dealing with underlying issues that may have led to your child’s weight problem.

A note from Cleveland Clinic

Childhood obesity is a complex disease that can lead to lifelong complications. Seeing your child deal with weight issues can feel heartbreaking. It’s important to support your child no matter their weight. Focus on their health and encourage them by explaining why you want them to stay healthy. If you’re worried your child may have obesity, reach out to their healthcare provider. Their provider can help you determine if your child’s weight is something to worry about. They can help you develop a plan to get your family back on track with healthy eating habits and increased physical activity.