Overweight and Obesity

Preventing kids from becoming overweight means making choices in the way your family eats and exercises, and how you spend time together. Helping kids lead healthy lifestyles begins with parents who lead by example.

What Health Problems Can Obesity Cause?

Obesity puts kids at risk for medical problems that can affect their health now and in the future. These include serious conditions like type 2 diabetes, high blood pressure, and high cholesterol — all once considered adult diseases.

Overweight and obese kids are also at risk for:

• bone and joint problems
• shortness of breath that makes exercise, sports, or any physical activity more difficult. This also can make asthma symptoms worse or lead kids to develop asthma.
• restless sleep or breathing problems at night, such as obstructive sleep apnea
• a tendency to mature earlier. Overweight kids may be taller and more sexually mature than their peers, raising expectations that they should act as old as they look, not as old as they are. Overweight girls may have irregular menstrual cycles and fertility problems in adulthood.
• liver and gallbladder disease

Cardiovascular risk factors (including high blood pressure, high cholesterol, and diabetes) that develop in childhood can lead to heart disease, heart failure, and stroke in adulthood. Preventing or treating overweight and obesity in kids may help protect them from these problems as they get older.

Obese kids also might have emotional issues to deal with (such as low self-esteem), and may be teased, bullied, or rejected by peers. Kids who are unhappy with their weight can be at risk for:

• unhealthy dieting and eating disorders
• depression
• substance abuse

How Are Overweight and Obesity Defined?

Body mass index (BMI) uses height and weight measurements to estimate a person's body fat. But calculating BMI on your own can be complicated. An easier way is to use a BMI calculator.

On a standard BMI chart, kids ages 2 to 19 fall into one of four categories:

1. underweight: BMI below the 5th percentile
2. normal weight: BMI at the 5th and less than the 85th percentile
3. overweight: BMI at the 85th and below 95th percentiles
4. obese: BMI at or above 95th percentile

For kids younger than 2 years old, doctors use weight-for-length charts instead of BMI to determine how a baby's weight compares with his or her length. Any child under 2 who falls at or above the 95th percentile may be considered overweight.

BMI is not a perfect measure of body fat and can be misleading in some cases. For example, a muscular person may have a high BMI without being overweight (extra muscle adds to body weight — but not fatness). Also, BMI might be hard to interpret during puberty when kids have periods of fast growth. Remember, BMI is usually a good indicator of body fat, but it's not a direct measurement.

If you're worried, take your child or teen to see the doctor. The doctor will ask about eating and activity habits and make suggestions on how to make positive changes. The doctor also may order blood tests to look for some of the medical problems associated with obesity.

Depending on your child's BMI (or weight-for-length measurement) and health, the doctor may refer you to a registered dietitian or a weight management program.

Why Do Kids Become Overweight or Obese?

A number of things contribute to a person becoming overweight. Diet habits, lack of exercise, genetics, or a combination of these can be involved. In some instances, too much weight gain may be due to an endocrine problem, genetic syndrome , or some medicines.

Diet and Lifestyle

Much of what we eat is quick and easy — from fat-filled fast food to processed and prepackaged meals. Daily schedules are so busy that there's little time to make healthier meals or to squeeze in some exercise. Portion sizes, in the home and out, are too large.

Plus, modern life is sedentary. Kids spend more time playing with electronic devices than actively playing outside. Kids who watch TV more than 4 hours a day are more likely to be overweight compared with kids who watch 2 hours or less. And kids who have a TV in the bedroom also are more likely to be overweight.

Exercise and Physical Activity

Many kids don't get enough physical activity. Older kids and teens should get 1 hour or more of moderate to vigorous exercise every day, including aerobic and muscle- and bone-strengthening activities. Kids ages 2 to 5 years should play actively several times each day.

Genetics

Genetics can play a role in what kids weigh. Our genes help determine body type and how the body stores and burns fat. But genes alone can't explain the current obesity crisis. Because both genes and habits are passed down from one generation to the next, multiple members of a family may struggle with weight.

People in the same family tend to have similar eating patterns, levels of physical activity, and attitudes toward being overweight. A child's chances of being overweight increase if one or both parent is overweight or obese.

How Can We Prevent Overweight and Obesity?

The key to keeping kids of all ages at a healthy weight is taking a whole-family approach. Make healthy eating and exercise a family affair. Get your kids involved by letting them help you plan and prepare healthy meals. Take them along when you go grocery shopping. Teach them how to make good food choices.

Try to avoid these common traps:

• Don't reward kids for good behavior or try to stop bad behavior with sweets or treats. Find other ways to change behavior.
• Don't have a clean-plate policy. Even babies turn away from the bottle or breast to send signals that they're full. If kids are satisfied, don't force them to keep eating. Reinforce the idea that they should only eat when they're hungry.
• Don't talk about "bad foods" or completely ban all sweets and favorite snacks. Kids may rebel and overeat forbidden foods outside the home or sneak them in on their own. Serve healthy foods most of the time and offer treats once in a while.

Recommendations by Age

Additional recommendations for kids of all ages:

• Birth to age 1: Besides its many health benefits, breastfeeding may help prevent excessive weight gain.
• Ages 1 to 5: Start good habits early. Help shape food preferences by offering a variety of healthy foods. Encourage kids' natural tendency to be active and help them build on developing skills.
• Ages 6 to 12: Encourage kids to be physically active every day, whether through an organized sports team or a pick-up game of soccer during recess. Keep your kids active at home with everyday activities like playing outside or going for a family walk. Let them be more involved in making good food choices, such as packing lunch.
• Ages 13 to 18: Teach teens how to prepare healthy meals and snacks at home. Encourage them to make healthy choices when outside the home and to be active every day.
• All ages: Cut down on TV, phone, computer, and video game time and discourage eating in front of a screen (TV or otherwise). Serve a variety of healthy foods and eat family meals together as often as possible. Encourage kids to eat breakfast every day, have at least five servings of fruits and vegetables daily, and limit sugar-sweetened beverages.

Talk to kids about the importance of eating well and being active. Be a role model by eating well, exercising regularly, and building healthy habits into your own daily life. Make it a family affair that will become second nature for everyone.