Calories are consumed from food and drinks. They are necessary for physical activity and all basic body functions. A healthy weight is reached by balancing the number of calories you eat and the number of calories you use.

Weight gain occurs when the number of calories eaten is greater than the number of calories used. If this happens regularly, it will lead to obesity. Calorie imbalances happen most often with eating too much food and low levels of physical activity. Less often, it may be caused by a medical condition or medication.

Risk Factors

Children of African American, Hispanic, and Native American descent at are greater risk of obesity.

Factors that may increase your child's risk of obesity include:

Sleep problems, such as poor sleeping habits or lack of sleep
Large birth weight
Lack of exercise
High level of sedentary activities like watching TV, playing on the computer, or playing video games
High consumption of fast food
High consumption of sugar-sweetened drinks
Overeating or binging—short periods when a very large amounts of food are eaten
Stressful life events or change
Family and peer problems
Low self-esteem
Depression and other emotional problems
Family history
Genetic factors
Taking certain medications
Having certain illnesses or conditions

Symptoms

The main symptom of obesity is increased weight. The midsection is the most common area to increase in thickness. There will also be obvious areas of fat deposits all over the body.

Obese Body

Complications of Untreated Obesity

Excess weight increases the chance of a child having:

High blood pressure
High cholesterol
Type 2 diabetes
Bone and joint problems
Asthma
Sleep problems such as sleep apnea
Vitamin and mineral deficiencies
Problems with anesthesia during surgery
Liver and gallbladder disease
Depression
Unhealthy eating habits, including eating disorders
Substance abuse problems
Problems during adulthood—more likely to develop severe obesity, stroke, and heart disease as adults, early death in adulthood

Diagnosis

You will be asked about your child's symptoms and medical history. A physical exam will be done.

Your child's doctor may use the body mass index (BMI). This is a tool to determine if a child's weight is ideal or outside of the desired range. BMI is based on height and weight. Normal values are based on a child's sex and age. In children, the BMI results are compared to the results of other children and teens in the same age range. This will account for growth and body changes as a child ages. BMI levels for anyone under age 20 are as follows:

Underweight —BMI at or below the 5th percentile for the age group
Desired weight —BMI between the 5th-84th percentiles for the age group
Overweight —BMI between the 85th-94th percentiles for the age group
Obese —BMI at or above the 95th percentile for the age group

Fat may need to be measured. This can be done with:

Tape measurements of the waist, hip, and abdomen—used to estimate the amount of fat deposited in the skin and inside the abdominal cavity
Skinfold caliper—a small tool that measures the fat just beneath the skin
Electrical measurements—a small electrical pulse can help measure the amount of fat tissue and non-fat tissue in the body

Blood tests may be done to look for other conditions that may increase body weight.

Other tests may be done to check for complications of obesity. These may include checking your child's blood pressure, glucose, and cholesterol levels.

Treatment

Personal habits, lifestyle, and family culture can all influence obesity. This means that a mix of treatment approaches is best. To help your child manage weight, encourage healthy behaviors in your child and your family.

Your doctor may recommend the following:

Diet

Your child may be referred to a dietitian. A dietitian can help make a diet plan for your child. The plan may include a daily calorie goal, healthy food options, and tips to change your child’s diet.

Have your child follow basic healthy eating habits, such as:

Eat a diet low in saturated fat. Check food labels. Saturated fats are common in processed snacks and fried foods.
Avoid trans fats. These are also common in snack foods like cookies, crackers, cakes, and donuts.
Limit sugar-sweetened beverages. This includes sodas, sport drinks, and juices. Encourage your child to drink water.
Switch to low- or non-fat dairy products.
Limit refined carbohydrates. This includes sugars, white rice, and white bread.
Eat a high-fiber diet. This includes plenty of fruits, vegetables, and whole grains.
Eat a diet that is low in sodium.
Eat breakfast every day.

Children rarely prepare their own foods. It is important that a parent participate in healthier eating habits. For example:

Pay attention to how food is prepared. Foods cooked or seasoned with high amounts of fat can quickly increase calories.
Limit fast food, take-out, and dining out.
Give your child healthy lunches and snacks to take to school. This may keep your child from buying unhealthy options at school.
Don’t use sweets as a reward for good behavior or test scores. Think of other, more active rewards.
Set a good example. Prepare healthy meals at home. Children are strongly influenced by their parents behavior. Eat together as a family.
When grocery shopping, choose healthy foods. Focus on unprocessed foods. Teach your child how to make good choices in the grocery store.
Teach your child about proper portion sizes. Your child may be able to continue eating favorite foods, just in smaller portion sizes. Also, cook less food at mealtime and don't bring it all to the table.
Focus on healthy foods your child can eat. Don’t eliminate all sweets and treats. Overdoing this may make your child want them more. Include occasional treats in proper amounts.

In more severe cases, your child may have to follow a meal plan.

Physical Activity

Encourage your child to participate in physical activity. Sign older children up for sports or activities. Develop some family-based activities that everyone can enjoy.

General guidelines for your child include:

Get at least 1 hour of physical activity every day.
Limit time in front of a TV, game, or computer screen to 1-2 hours per day. If your child is under 2 years old, avoid screen time.

In more severe cases, your doctor may provide a specific activity plan.

Counseling and Support

Your child may struggle with weight loss or being obese. Some support options or actions include:

A weight-loss program and active video gaming. Your child may also be referred to a therapist. This type of support may give your child insight into losing weight. Therapy that includes the whole family may also be helpful.
Ask friends and family members to support your child. Time and motivation will keep your child on track.
Make sure a healthy lifestyle is promoted at school or other organizations your child is involved with. Help your child to feel confident in making healthy choices even when the other children are not.

Other Treatment

Some children who are obese may already have serious conditions due to weight. This may include problems with the heart or lungs, diabetes, or bone and joint problems. These conditions may require separate treatment.

Other children may have a hard time losing weight despite following guidelines. For these teenagers, other options may be considered, such as:

Medication may assist weight loss when added to lifestyle changes, but teens need to be closely monitored for side effects.
- Note: Over-the-counter and herbal products that are marketed as weight loss drugs may not be effective and some may be dangerous. Talk to the doctor before your child takes any of these.
Bariatric surgery may be an option for some obese teens. This surgery will change the size of the stomach. This option is generally only considered if all other options have failed.

Prevention

To help reduce your child’s chance of being overweight or obese:

Encourage your child to eat a healthy diet. It should be rich in fruits, vegetables, and whole grains.
Choose lean meats, poultry, and fish.
Serve reasonable portion sizes. Eat healthy meals together as a family.
Limit sugar-sweetened drinks, even fruit juices. Encourage your child to drink water.
Encourage your child to get at least 60 minutes of activity most days of the week. The activity should be moderate to vigorous intensity. Ask your doctor for specific guidelines if your child is younger that 2 years old.
Limit screen time to 2 hours a day.
Make sure your child is getting enough sleep.
Set a good example for your children. Choose healthy food options. Be physically active.

RESOURCES:

American Heart Association
http://www.heart.org

Healthy Children—American Academy of Pediatrics
http://www.healthychildren.org

CANADIAN RESOURCES:

Dietitians of Canada
http://www.dietitians.ca

Health Canada
https://www.canada.ca

References:

Children's BMI tool for schools. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Accessed January 28, 2021.

NHLBI integrated guidelines for pediatric cardiovascular risk reduction. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Accessed January 28, 2021.

Obesity in children and adolescents. EBSCO DynaMed website. Available at:
...(Click grey area to select URL)
Accessed January 28, 2021.

Obesity in children and teens. American Academy of Child and Adolescent Psychiatry website. Available at:
...(Click grey area to select URL)
Accessed January 28, 2021.

Overweight and obesity. Kid's Health—Nemours Foundation website. Available at:
...(Click grey area to select URL)
Accessed January 28, 2021.

Overweight in children. American Heart Association website. Available at:
...(Click grey area to select URL)
Accessed January 28, 2021.

Tips for parents: Ideas to help children maintain a healthy weight. Centers for Disease Control and Prevention website. Available at:
...(Click grey area to select URL)
Accessed January 28, 2021.

3/10/2014 DynaMed Plus Systematic Literature Surveillance http://www.dynamed... : Trost SG, Sundal D. et al. Effects of a pediatric weight management program with and without active video games: a randomized trial. JAMA Pediatr. 2014;168(5):407-413.

Last reviewed March 2020 by EBSCO Medical Review Board Chelsea Skucek, MSN, BS, RNC-NIC
Last Updated: 1/28/2021

EBSCO Information Services is fully accredited by URAC. URAC is an independent, nonprofit health care accrediting organization dedicated to promoting health care quality through accreditation, certification and commendation.

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

To send comments or feedback to our Editorial Team regarding the content please email us at healthlibrarysupport@ebsco.com. Our Health Library Support team will respond to your email request within 2 business days.