How common is obesity and overweight?
In the years 2003-2004, 17.1% of children and teens, aged 2-19 years (over 12 and a half million young people) were overweight, and 32.2% of adults (over 66 million) were obese. Almost 5% of adults were extremely obese .
Researchers estimate that 15% of all children in the U.S. are overweight, and nearly 25% of Black and Hispanic children weigh too much . Obesity is common enough among children that we can consider it an epidemic. Studies have shown a dramatic rise in the number of obese children in the last few decades in this country. Between 1980 and 2000 obesity rates doubled among children and tripled among teens .
What are the concerns about obesity in general?
Being obese increases a child's risk for some serious childhood medical problems              . These include:
- Pre-diabetes and diabetes
- Heart disease, high blood pressure (hypertension)
- Hyperlipidemia (too much cholesterol in the blood, which can clog the arteries)
- Sleep apnea and breathing problems (see Sleep Problems on YourChild)
- Bone conditions, such as hip problems
- Gastro-intestinal diseases
- Early puberty
- Psychological problems, like poor self-esteem and depression
In addition to the risks to kids in childhood, research over the last 40 years tells us that overweight kids are at greater risk of becoming obese adults  [  , with all the health problems associated with obesity lasting through the lifespan. These obesity-associated health problems include high blood pressure, heart disease, Type 2 diabetes, gout, pulmonary problems, gall bladder disease, liver disease, psychosocial problems, reproductive problems, and some types of cancer.
The CDC (Centers for Disease Control and Prevention) estimates that about 112,000 deaths are associated with obesity each year in the US. The CDC notes that this number may be adjusted as the science continues to evolve .
- More on the health risks of being overweight
How can I tell if my child is overweight?
If you are concerned about your child’s weight, you should take them to see their doctor. There are some different measurements a doctor may take to tell whether your child is overweight.
- Weight and height can be compared and plotted on a growth chart.
- Skinfold thickness—measured at the triceps (back of the upper arm) with a caliper that pinches the skin and fat together—will be higher than expected in an overweight child.
- The best measurement to take is body mass index (BMI). It is fairly complicated to calculate and understand. You can use the link above to read about how BMI is used with children, calculate your child’s BMI on the web calculator, and check your child’s BMI against the right chart for their age and sex to find out their percentile.
- A BMI above the 85th percentile for the child’s age and sex is “at risk for overweight.”
- A BMI above the 95th percentile is “overweight or obese.”
How do kids become obese or overweight?
Like most chronic health problems, obesity is caused by complex interactions between genes, environment and behavior/habits.
Many studies have shown that there is not a big difference in the amount of food eaten and physical activity between obese and non-obese kids. Probably small differences in eating and activity over time really add up and lead to weight gain. Obese children do tend to eat larger portions or higher calorie foods, like high-fat foods.
Physical activity and inactivity are very important factors. Many studies have shown that kids who spend more time watching television  and playing video games are at higher risk of becoming overweight. One in three high school youth do not engage in vigorous physical activity. Less than 30% attend daily gym class . Sprawling development that discourages physical activity and makes walking and biking difficult or dangerous is also a factor .
Kids in families with obese parents tend to be obese themselves. If one parent is obese or overweight, their teen has an 80% chance of being overweight. This is probably because of a combination of genetics and family behavior and habits. Children of moms who have diabetes are more likely to be overweight.
Very rarely, obesity is caused by an underlying medical condition. Illnesses that can cause obesity include endocrine problems and some genetic syndromes. Your doctor will probably be able to rule out an underlying medical problem by a physical exam and by taking your child’s medical history. Sometimes lab tests are needed.
Some studies indicate that environmental chemicals may play a role. Researchers hypothesize that in utero or newborn exposures to chemicals such as endocrine disruptors (for example xenoestrogen bisphenol A—which is in food and drink containers) may damage the body’s weight-control mechanisms and lead to obesity  .
Can medication help my child lose weight?
None of the new medicines to treat obesity are approved for children or adolescents to use. They may affect your child’s growth and development, and the risk of dangerous complications is far greater than any benefit they might have.
By far the best approach is helping your whole family—including your child—change their behavior.
How can I help my child lose weight, or stay a healthy weight?
- Obesity develops over time and cannot be solved overnight. Remember that this is not an emergency. Do not expect dramatic change. That is unrealistic.
- The best way to have a healthy weight is prevention. Be sure your family has healthy habits from the beginning, and prevent yourself and your children from becoming overweight. It is much easier to maintain a healthy weight than it is to lose weight.
Make it a whole family effort:
- Obesity is not just your child’s problem. It is a problem that the whole family must be involved in solving. Your child lives within your family environment.
- Chances are, someone else in your family has also struggled with weight or experienced obesity. They may be able to offer valuable help and support in developing realistic goals for your child.
- As a family try to think of problems that you have solved successfully. This will help you stay positive, and look for other areas that are opportunities for change.
- Mealtimes should be family times. Create a relaxed atmosphere around mealtime. Eat slowly and enjoy your food. Eat together as a family, and don’t watch TV during meals. Families that do not eat together tend to consume more fried foods and soda and less fruits and veggies than families that share meals. Here are some tools to help get family meals going:
- Say “YES” to Family Meals
- Let’s Talk About Mealtime
- Family meal calendar, "design a dinner" and grocery list worksheet
- The SpendSmart EatSmart site from Iowa State University offers tips for planning, shopping and eating, including recipes and food prep video.
- Here are some tips for making family meals work, and a family mealtime goal planner.
- Reduce power struggles at mealtime by deciding who does what.
- Find our more tips for how to make weight loss a family affair.
Be a positive role model:
- Remember the old adage: “Kids will do as you do, not as you say”? Your kids look to you, the parents, to see how to behave. If your whole family eats healthy foods and gets active, and then your child will, too!
Help your child set goals:
- Set short-term goals for changes in your child’s diet and exercise on a weekly basis. Update your goals each week. Write them down. Examples of goals include setting a time limit on TV watching, and taking a walk every day.
- Make sure the goals you set are realistic. For example, exercising an hour every day is unrealistic for a child who is de-conditioned, and not used to even minimal physical activity.
- Use rewards when your child meets their weekly goals. Rewards could be special time with you doing an activity your child enjoys or a special toy.
- Have your child keep a record of their food intake and exercise. This will allow them to be more self-aware of their behavior. Then look at the record together, one-on-one, and go over it. Give them positive feedback.
- Praise your child for healthy food choices and physical activity. Remember: criticism and punishment just don’t work.
- Make sure your child understands that they can make a difference in their weight and that you will support them all the way.
- Help your child recognize hunger and fullness signals. Stop eating when you’re full and turn down helpings when you are no longer hungry. Help your child do the same.
- Help your child figure out what kinds of emotions and situations trigger overeating for them.
- Make your child’s behavior changes a positive, fun experience by planning healthy foods, fun activities, and rewards for positive behavior.
Watch their “media diet,” too:
- Think about all the media your child uses: television, computer, video games, hand-held computer games. These are all activities that replace physical activity in your child's daily routine. Placing time limits on them will free up time for a more active lifestyle. Watching TV can use less energy than simply sitting and resting! Also, we tend to snack on high calorie foods during these inactive times.
- Teach your child to be media savvy. The media bombards us with images of thin people having fun while eating and drinking high calorie foods. Kids don't necessarily have the cognitive abilities to process this paradox.
- Limit inactive things like TV, video games and computer time. Watching TV can use less energy than simply sitting and resting! Also, we tend to snack on high calorie foods during these inactive times.
- Have structured mealtimes and snacks on a schedule. Model and insist on good meal habits— eating less breakfast and more dinner or skipping breakfast increase the risk for obesity.
- Don't mistake healthy eating for dieting. Eating large amounts of high calorie foods ("Want to super-size that?") and frequent snacking have become commonplace. Bad eating habits become accepted as normal eating habits. Eating healthful foods in a healthy manner is not the same as dieting.
- The food pyramid is a thing of the past. Use MyPlate to help guide your food choices for your family. The emphasis should be on a variety of vegetables, with half your plate being vegetables and fruits. Grains should be whole grains.
- Keep only healthy foods in your home. Keeping junk food around for other family members, and trying to “police” what your child eats, only promotes sneak eating. The American Dietetic Association offers information on eating healthy—check out their daily tips and nutrition fact sheets.
- Children under 2 may need a little more fat in their diet for proper brain development. Between ages 2-3 you can gradually transition your child to the lower-fat diet that is healthiest for the rest of the family.
- Pay attention to snacks. They count! Lots of snacking leads to a higher calorie intake, and many typical snack foods are not very nutritious. Keep healthy snacks on hand, like fruit and cut up veggies. Allow your child easy access to them.
- Encourage physical activity. As kids move into adolescence, their levels of activity tend to drop too low. Do active things together as a family, like bike riding, hiking, walking and swimming. Here are some great ideas (in print, audio and Spanish) for helping to get your child and your family more active.
- Build activity into your family's daily life with household chores, walking to school, parking farther from buildings and taking the stairs. Decreasing inactivity works better for long-term weight loss than focusing on vigorous aerobic exercise. It's also an easier lifestyle change for your family to make!
- Make sure your kid gets outside during daylight hours. You could make it a policy in your family that unless the weather is bad, your children play outdoors after school. This encourages physical activity, and rules out the inactive pursuits of TV and other media.
For more information and tips:
- For more practical tips, see what our own Dr. Gahagan has to say about how parents can fight obesity in their kids.
- The National Institutes of Health has a great online pamphlet on Helping Your Overweight Child. It includes many useful tips and resources.
What if everything you suggest does not seem to be working?
If making these changes at home does not seem to be helping, you can talk to your child’s doctor about a formal weight-control program, such as the UMHS Michigan Pediatric Outpatient Weight Evaluation and Reduction (MPOWER) program for young people ages 13-17. MPOWERis a comprehensive program that helps kids motivate, build confidence, and create new lifestyle habits.
A weight-control program should:
- Have the overriding goal of helping the whole family make and maintain healthy changes in their eating and activity habits.
- Have dieticians, exercise physiologists, doctors, and either psychiatrists or psychologists on staff.
- Perform a medical evaluation of your child—including weight, growth, and health—before starting the program, and at regular intervals throughout the program.
- Be developmentally appropriate for the age and capabilities of your child.
- Focus on behavior changes.
- Teach your child how to choose a healthy variety of foods and the right size portion.
- Encourage daily physical activity.
- Include a maintenance program and other support and referrals.
- Focus on your whole family—not just your overweight child.
- How to Get Your Kid to Eat…But Not Too Much, by Ellyn Satter. This is a book all parents should read, whether their children are overweight or not. It applies to kids from birth through the teen years. The advice in this book can help your child develop a healthy relationship with food that will last a lifetime.
- Ending the Food Fight: Guide Your Child to a Healthy Weight in a Fast Food/Fake Food World, by David Ludwig.
A nine-week program with all the tools you need to help your kids develop healthy eating habits.
- The Stoplight Diet for Children: An Eight-Week Program for Parents and Children, by Leonard Epstein and Sally Squires. This book is out of print, but should be available in your public library.
- Red Yellow Green: System for Weight Management, by Karen Balko, RD. “This book will give you calories, cup sizes and visual tips to providing a structured food plan. A 7-day meal plan is included for 800, 1000, 1200 and 1350 calorie plans.” It is available to order from PWA-USA for $25.00. Scroll down the “R’s” on the publication order form.
- Shapedown books and workbooks for parents and kids ages 6-20—find out more about this program at the bottom of this page.
- YourChild Commentary: How Parents can Fight the Obesity Epidemic
- YourChild: Feeding Your Child and Teen
- YourChild: Feeding Your Baby and Toddler
- YourChild: Eating Disorders
- YourChild: Sleep Problems
- YourChild: Managing Television—Tips for your Family
- YourChild: Precocious Puberty
- YourChild: Food Safety
AmericanAcademy of Pediatrics (AAP) Policy Statements and Clinical Reports:
- Prevention of Pediatric Overweight and Obesity
- Active Healthy Living: Prevention of Childhood Obesity Through Increased Physical Activity
- Dietary Recommendations for Children and Adolescents: A Guide for Practitioners
- Prevention and Treatment of Type 2 Diabetes Mellitus in Children, With Special Emphasis on American Indian and Alaska Native Children
- Soft Drinks in Schools
Information for Parents:
- The National Institutes of Health (NIH) has a toll-free consumer health information line on weight control. Call 1-877-946-4627. They can help you and your child with pamphlets, fact sheets and referrals.
- Weight and Diabetes—weight can influence diabetes, and diabetes can influence a person’s weight.
- The Nutrition and Fitness Center at Kidshealth has information and the latest news on food and exercise.
- The Weight-control Information Network provides information about weight control, obesity, and related topics to health professionals and the public. Develops, identifies, and distributes educational materials. Phone: (202) 828-1025 or 1-877-946-4627.
Information for kids and teens:
- For Kids: What being overweight means
- The Kids’ Nutrition and Fitness Center on Kidshealth.org has lots of information about eating right and staying fit.
- For Teens: When Being Overweight is a Problem
- For Teens: The Deal with Diets
- The Teens’ Nutrition and Fitness Center has good stuff for teens on food and exercise, including recipes and a BMI calculator.
Organizations and Support:
- The UMHS Michigan Pediatric Outpatient Weight Evaluation and Reduction (MPOWER) program, for kids ages 13-17, is a comprehensive program that helps kids motivate, build confidence, and create new lifestyle habits.
- Find a Registered Dietician in your area through the American Dietetic Association’s website.
- The Nutrition Information Service is part of the University of Alabama-Birmingham, and provides up-to-date, accurate, and useful nutrition, health, and food information to the community and health care professionals. They will answer nutrition questions from health professionals and the public. Phone: 1-800-231-DIET (3438).
- The Vegetarian Resource Group (VRG) educates the public on vegetarianism, health, nutrition, and more.
- The Council on Size and Weight Discrimination, Inc. provides information on eating disorders, "sizism," the non-dieting movement, and size discrimination. Phone: (914) 679-1209.
- The National Association to Advance Fat Acceptance provides support and attempts to eliminate discrimination against overweight people. Provides information to health professionals on how to treat very large patients (e.g., weighing). Phone: (916) 558-6880.
- The President's Challenge works to promote the development of physical fitness facilities and programs. Offers a variety of testing, recognition, and incentive programs. Phone: 1-800-258-8146.
- The American Dietetic Association works to serve the public through the promotion of optimal nutrition, health, and well-being. Phone: 1-800-877-1600, ext. 5000 (for publications).
- The Obesity Society is the leading scientific society dedicated to the study of obesity. It is dedicated to public education about the dangers of obesity, preventing obesity in children, advocating for good health care and adequate insurance coverage for obesity treatment, supporting research on obesity, and ending discrimination against people with obesity. Phone 1-800-98-OBESE (1-800-986-2373) or 202-776-7711.
- Shapedown is a weight management program for children and adolescents. It was developed at the University of California, San Francisco, School of Medicine and includes contributions from nutrition, exercise physiology, endocrinology, psychology, family therapy, adolescent medicine, family medicine and behavioral and developmental pediatrics. Shapedown is continually reviewed and revised to ensure that it reflects current scientific and clinical understandings. The program helps kids and teens enhance their self-esteem, improve peer relationships, adopt healthier habits and begin to normalize their weight within their genetic potential. Parents feel better about their parenting and about their child. The family becomes healthier and closer. The results of Shapedown go far beyond weight.
If you order a workbook for your child and a parent's guide for yourself, you get an audiotape introduction to the program and a referral to the program nearest you.
St. Joseph Mercy Health System in Ann Arbor, MI offers Shapedown classes. Here's the information:
- Parents and kids work together in this innovative 10-week weight management program to learn how healthy eating, an active lifestyle and effective communication promote weight loss and family unity. Program and orientation offered at various sites and at different dates/times for both kid and teen groups. Call 734-712-5694
Written and compiled by Kyla Boyse, RN. Reviewed by Kathy Clark, RN, CS, MSN.
Updated August 2011