Children & Obesity – A Parent’s Guide

Child Obesity

Childhood obesity is a significant problem in the United States. If you’re a parent, you’re likely concerned about how you can help your child or teenager to maintain a healthy weight. You may also be worried if they’re already showing signs of being overweight.

Statistics from the Centers for Disease Control and Prevention show that for the years 2017 to 2018, the prevalence of obesity was 19.3 percent among children and adolescents between the ages of 2 and 19. This means obesity affected around 14.4 million young people [mfn][/mfn].

The rate was highest among 12 to 19-year-olds at 21.2 percent but 6 to 11-year-olds were a close second at 20.3 percent.

Diagnosing Obesity in Childhood

Childhood obesity refers to when a child is well above the normal weight for his or her age and height. Your child’s doctor will likely use the body mass index (BMI) and other measures to help determine whether they are overweight or obese.

Doctors calculate the child’s BMI and then check where it falls on the BMI-for-age growth chart.
This chart will allow the doctor to determine how your child compares with others of the same sex and age.

If your child is in the 70th percentile, it means that 70 percent of children of the same age and sex have a lower BMI.

A child with a BMI in the 85th to 94th percentile is considered overweight. The 95th percentile and above is considered obese and a child who falls into the 99th percentile or higher is considered severely obese.

It’s important to note that BMI is not a perfect measure. It doesn’t take muscle or body frame into account. Also, each child will have a different pattern of development. Therefore, doctors will also consider other factors before concluding that a child’s weight is concerning.

The doctor may also look at your child’s eating habits and activity levels as well as your family history of obesity and related health problems.

If the child has other health concerns or psychosocial challenges, these will also be taken into consideration. The doctor may order blood tests to check cholesterol, blood sugar, and hormonal imbalances.

Causes of Childhood Obesity

There are several factors that increase children’s risk of becoming overweight. These factors often work together.


Children and teens are likely to gain unhealthy amounts of weight when they regularly eat high-calorie foods, candy, and sweet desserts. Sugary drinks such as soda, sports drinks, and sweetened fruit juices can also contribute to obesity.

One study identified poor eating habits as the main cause of childhood obesity. While acknowledging the various factors that contribute to the problem, the researchers determined that most children were overweight because they take in more calories than they burn.

Lack of Exercise

Children are more likely to gain weight if they don’t get enough exercise since they don’t use up as many calories. If your child spends a lot of time playing video games or watching television, this can make the problem worse.

Familial Factors

A number of familial characteristics have been linked to obesity in children. These include the types of food available in the house and what family members prefer to eat. The activity levels of other people in the household also influence children and teens [mfn][/mfn].

Some research also shows that having an overweight mother and residing in a single-parent household are connected with childhood obesity.

Socioeconomic Factors

While childhood obesity affects all socioeconomic backgrounds, it is more prevalent in lower socioeconomic groups. One reason for this is that low-income families often can’t afford healthy foods or they don’t have easy access to them. People who live in low-income communities may also lack safe places to exercise.

Psychological Factors

Not only does personal stress increase a child’s risk of becoming obese but stress on the part of the parent or family plays a role. Children who are dealing with difficult emotions may eat to cope with their problems. Similar tendencies may be observed in their parents[mfn][/mfn].

Medications and Medical Conditions

Some conditions increase children’s appetite and over time, this can increase the risk of developing obesity. These conditions include hypothyroidism and certain hormone disorders.

Children who take some prescription medications may be at greater risk of becoming overweight or obese. These drugs include amitriptyline, prednisone, paroxetine, lithium, gabapentin, and propranolol.

Risks Associated with Obesity in Childhood

According to the Centers for Disease Control and Prevention, obesity during childhood can lead to a variety of health issues. Obese children are more likely to have:

  • Asthma, sleep apnea, and other breathing problems
  • High cholesterol and high blood pressure
  • Increased risk of developing type 2 diabetes
  • Joint and musculoskeletal problems
  • Gastro-esophageal reflux, fatty liver disease, and gallstones

In addition to these physical challenges, childhood obesity is also linked to:

  • Anxiety, depression, and other psychological problems
  • Bullying and other social challenges
  • Low self-esteem and a lower reported quality of life

Also of note, young people who have obesity are more likely to become adults with obesity. Adult obesity is linked to an increased risk of serious health conditions such as cancer, heart disease, and type 2 diabetes.

The CDC also points out that if children are obese, both their obesity and their risk factors for other health conditions are likely to be more severe.

Unhealthy Eating Habits Parents Need to Be Aware Of

Given the dangers associated with obesity in childhood and adolescence, parents need to ensure their children eat as healthily as possible. It’s important to recognize unhealthy eating habits in the early stages and at the youngest possible age so they can be addressed promptly.

Here are some of the behaviors that you need to be on the lookout for in younger children.

Refusing to Eat Vegetables

Vegetables are extremely important to a healthy diet. They provide the body with fiber, vitamins A and C, and a variety of minerals. Children who eat veggies tend to continue eating them in adulthood.

Furthermore, a diet that includes lots of fruits and vegetables is linked to a lower risk of chronic illness and a healthier body weight.

What to Do

If your child is refusing to eat their broccoli, try adding a little cheese, butter, or oil. Healthy fats can make vegetables taste better and they won’t add too many extra calories when used in moderation.

You can also try having the child’s favorite dip or condiment at the dinner table. Just make sure that you use products that contain real ingredients and no high fructose corn syrup. Asparagus may seem more palatable with a little ketchup or ranch dressing.

Whatever you do, don’t punish a child because they won’t eat a particular food. Instead, have veggies on the table during meal times, set a good example by eating them, and mention how tasty they are. Eventually, the child may become curious enough to try them.

Snacking All Day

When children snack all throughout the day, they won’t have an appetite at mealtime. Also, they won’t learn to recognize hunger and fullness. This is a skill that will help them to control how much they eat as they grow up.

Even if your child eating mostly healthy snacks, you’ll still want to get them to stick to a schedule.

What to Do

Get the child in the habit of eating two or three snacks per day while sitting at the table. That way, you can properly monitor what they’re consuming. If they ask for a snack at another time, remind them meal or snack time is soon approaching. Otherwise, offer a small piece of fruit.

Drinking Lots of Juice Instead of Water

Childrens’ diets can include a small amount of pure 100 percent juice. However, drinking multiple cups per day could add lots of extra calories. Also, if you opt for juice drinks with added sugar, you’ll be doing more harm than good. There are healthier ways to get the vitamin C and other nutrients that may be in fruit juices.

What to Do

When your child is particularly thirsty, such as after running around on the playground, give them water rather than juice. If you offer juice, they can easily gulp down too much. Provide a small amount of juice later when they’re no longer so thirsty.

When you do serve juice dilute it with water. However, you should still limit this mix to one to two cups per day.

Sugary Drinks

Consuming Too Much Sugar

Most kids like sweet things. However, foods with added sugar often pack lots of calories without providing much nutrition. This is especially true with things like cake, cookies, and ice cream.

Sugary foods leave less room for vegetables, whole grains, and low-fat dairy products. The American Heart Association recommends that children between the ages of 2 and 28 have less than six teaspoons or 25 grams of sugar per day.

What to Do

Pay closer attention to the sugar content in the food you give your child. You may not realize how much sugar is in their favorite cereal or yogurt. Control portions and seek out low-sugar options whenever possible.

Limiting the number of sugary foods in the home can also make a big difference, especially for younger children who can’t purchase items on their own.

It’s also a good idea to limit when your child can have sweet treats. Maybe they get one small cookie or a square of chocolate after dinner.

Eating A Carb-Heavy Diet

Some young children refuse to eat meat and poultry and instead prefer white bread or pasta. These foods are digested quickly so the child will feel hungry soon after mealtime. Not eating foods rich in protein also prevents children from getting the nutrients they need.

What to Do

Ensure the meat you provide is soft and easy to chew. Some children opt not to eat meat because it’s tough. Use the slow cooker for meat or add ground turkey to spaghetti sauce to make it easier to eat.

Alternatively, provide another protein source such as eggs, beans, dairy, or peanut butter.

You can also improve your child’s eating habits by offering whole grains when you serve carbs. Brown rice, whole wheat bread, or buckwheat pancakes will be more filling and they contain lots of fiber and nutrients.

Teenagers may have different eating habits from young children. Here’s what you need to be on the lookout for where your adolescent is concerned.

Not Eating Breakfast

According to the American Academy of Pediatrics, 20 to 30 percent of teens don’t eat breakfast regularly. This can affect metabolism which is involved in not just weight control but mood and performance in school.

What to Do

Make breakfast a part of the family’s morning routine. Ensure healthy options are readily available and sit at the table with your teen to enjoy breakfast together. If your schedules are too busy for this, look for quick but nutritious meals you can have on the go.

Fatty Foods

Eating Lots of Fatty, Calorie-Laden Foods

The foods that teens enjoy most often fit into the “others” food group. These are foods that should be consumed less than all the other items in the food pyramid such as soft drinks, ice cream, cake, candy, and chips.

Teens who eat lots of these foods often don’t get enough nutritious foods into their diets.

What to Do

Have healthy snacks and fruits on hand at all times and avoid having highly processed foods in the kitchen. You should also make a point of not purchasing items containing high fructose corn syrup.

It’s also best to set a good example with your own meal and snack choices.

Eating Out Frequently

Teenagers tend to eat out more often than younger children. They may have after-school jobs or participate in extra-curricular activities that cause them to skip family dinner. Also, hanging out with friends may involve heading to a pizza place or a burger joint.

What to Do

Advise your teen to only eat fast food once per week. If they can’t make it home in time for dinner, prepare a nutritious plate that they can easily heat up when they arrive.

Treatment for Childhood and Adolescent Obesity

Doctors typically treat childhood obesity based on the child’s age and whether they have other medical conditions. Early intervention usually involves changes in diet and physical activity levels.

Lifestyle changes play an important role in weight reduction. However, medication or weight loss surgery may be recommended in certain situations.

Researchers have found that lifestyle modifications show modest results, especially in young people with severe obesity. Furthermore, there’s not a lot of data on the effectiveness of weight-loss medications in children.

The Role of Bariatric Surgery

Bariatric surgery has proven to be the most effective way to achieve weight loss and send obesity-related conditions into remission in obese adults. Recent studies also indicate that it is also effective for adolescents with severe obesity.

The American Society for Metabolic and Bariatric Surgery (ASMBS) and the American Academy of Pediatrics have developed guidelines recommending that bariatric surgery be considered for:

  • Young people with a BMI of 35 kg/m2 or more with severe comorbid diseases
  • Those with BMIs of 40 kg/m2 or greater even without comorbid diseases

How is Bariatric Surgery Performed?

There are several types of bariatric procedures but the vertical sleeve gastrectomy, otherwise called the gastric sleeve surgery, offers the best outcome for adolescents.

This procedure is usually performed laparoscopically. The surgeon makes small incisions in the upper abdomen and removes about 80 percent of the stomach. What’s left is about the size and shape of a banana.

Reducing the size of the stomach limits the amount of food an individual can consume. Sleeve gastrectomy also causes hormonal changes that help with weight loss and relieves conditions linked to obesity such as heart disease and high blood pressure.

This type of bariatric procedure doesn’t affect digestion or nutrient absorption. This is important since teenagers need nutrients to support their growth and development.

Gastric bypass surgery is less common in children and teens because it affects nutrient absorption. This is because along with making the stomach smaller, it also makes food bypass some parts of the small intestines.

Still, in some cases, gastric bypass is offered to young people who don’t lose enough weight following sleeve gastrectomy.

What to Do if Your Child is Overweight

One of the best ways to help children and teens maintain a healthy weight is to ensure they burn more calories than they consume. In addition to encouraging them to move more, it’s important to identify bad eating habits and take steps to correct them.

Providing healthy food options and setting a good example with your own diet is an excellent place to start.

However, sometimes children need more help than their families can provide. If your child has tried a number of weight-loss strategies without success, bariatric surgery may be a solution.

Talk to one of the specialists at Renew Bariatrics if you’d like to know more about what’s involved. If your child is a good candidate for weight loss surgery, we advise you to do it as early as possible.

Children who are obese will continue to gain weight as they grow and this can make the surgery less beneficial. Contact us today to discuss how we can help you and your child or adolescent.

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