What's the definition of child obesity?
Overweight and obesity are defined by the World Health Organization as "abnormal or excessive fat accumulation that presents a risk to health." People of all ages can be affected, including children.
Childhood obesity is defined using a tool called body mass index-for-age. BMI is calculated using your child's height and weight, which is converted into a percentile (using a percentile calculator or growth chart). Just like the baby growth charts used to track your newborn's height, weight, and head circumference, your child's BMI is compared with other children of the same age and sex.
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Your child's BMI will fall into one of these four ranges:
- Underweight: Below the 5th percentile
- Healthy weight: 5th to 85th percentile
- Overweight: 85th to 95th percentile
- Obese: Above the 95th percentile
If your child's BMI is above the 95th percentile – meaning it's higher than that of 95 percent of children their same age and sex – they're considered obese. A healthy BMI for kids is one that falls somewhere between the 5th and 85th percentile.
Currently, according to the Centers for Disease Control and Prevention, about 13 percent of 2- to 5-year-olds are classified as obese; that number jumps to 20 percent among 6- to 11-year-olds. Obesity also occurs in higher rates (about 24 to 25 percent) among Hispanic and Black children.
Which factors contribute to child obesity?
Two of the biggest factors that contribute to obesity in children include poor diet and lack of physical activity, but there are many other elements that also play a role, including:
- Family history
- Genetics
- Race and ethnicity
- Access to healthcare
- Government and school policies
- Sedentary behavior
- Screen time
- Parents' lifestyles
- Easy access to ultra-processed food
- Mental health
- Health knowledge/education
Several of these factors can be somewhat managed by you as a parent, but many of them point to systemic issues – such as inadequate access to healthcare, food, or exercise facilities – that require more sweeping attention and repair at the government or community level. Some systemic problems are beyond the simple advice to "eat right and move more," since not everyone has this luxury.
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How can I tell if my child is overweight or obese?
During your child's regular checkups, their doctor will monitor their height and weight (BMI) on a growth chart to determine whether they meet the clinical definition of overweight or obesity. Your child's BMI will be ranked in percentiles compared to their peers.
Children come in all shapes and sizes, so it's important to remember that health is about more than just BMI or a number on a scale. In addition to BMI, your child's doctor will likely consider their overall lifestyle habits, including nutrition, exercise, screen time, sleep, and mental health.
Children who follow a nutritious diet, are physically active, sleep well, and have good mental health can still be healthy, even if their weight is above a certain BMI cut-off point. Not all children carrying extra pounds are overweight. Athletic kids, for example, may have a BMI in the overweight or obese range, but may simply be muscular, and some children have larger than average body frames.
Can my toddler be overweight?
Yes. About 13 percent of children ages 2 to 5 are obese. Talk to your child's doctor if you're concerned about your toddler's weight, as they may have advice for getting your child to a healthier place on the growth curve. In the meantime, follow the same guidance (below) for making healthy lifestyle choices for your whole family.
How can I help my child lose weight?
Weight loss for kids is a serious topic. Experts recommend that it's best not to put your child on a weight-loss diet unless it has been specifically recommended by their doctor to manage a medical condition. A restrictive diet can be harmful to a child's health and interfere with their development. Children are still growing, and weight gain is a natural part of that process.
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It's important to avoid telling your child they need to lose weight: You may just be trying to motivate them, but this can often backfire. Being overly critical of your child's weight can damage their self-esteem and increase their risk of future social isolation, binge eating, and weight gain. This kind of mindset may also lead to your child growing up and avoiding healthcare services for fear of ridicule.
Stay positive! Instead of focusing on how to help your child lose weight, there are many healthy lifestyle tips and approaches that can help your child grow into the body that's right for them. And remember – kids aren't all the same size and shape, and that's perfectly acceptable. These healthy lifestyle habits can be the focus for all kids, regardless of their weight.
- Share meals together. Studies show that sharing family meals three to five times a week is associated with a better diet quality and a lower BMI. It can be any meal – breakfast, lunch, dinner, snacks, or brunch – whatever works for your household is fine.
- Eat well. Be a role model and teach your kids how to build balanced meals. Serve vegetables, fruit, grains, dairy, and protein sources (poultry, fish, eggs, tofu, and legumes) at meals and snacks. Explore MyPlate, a website that helps you plan balanced meals based on five food groups, which provide the nutrients needed for overall wellness. You may also consult a dietitian to help you create a balanced eating plan for your family.
- Respect appetites. Offer a range of nourishing foods and snacks, and let your child determine what and how much they want to eat. If your child learns to monitor their own hunger and fullness cues, they'll be better able to manage their weight. Don't tell kids to "clean their plate," and remember that it's okay if they ask for seconds.
- Choose better beverages. Serve water most often. Save soda and other sweet beverages for special occasions. If you serve juice, choose 100-percent fruit juice without added sugars. Limit juice to four fluid ounces for children ages 1 to 3, and six ounces for children ages 4 to 6.
- Don't shun sweets. Completely avoiding treats will make them more desirable to kids. Instead, strive for balance by having cookies, ice cream, or cake as part of nutritious meals and snacks. Restricting foods can lead to kids sneaking and hiding them, which sets up an imbalance of trust. It's better to enjoy them together occasionally.
- Manage mealtimes. Set a predictable eating schedule with regular meals and snacks. Kids have smaller tummies than adults and it's normal for them to be hungry every three hours or so. Having regular eating times helps prevent constant grazing, which can mess with appetites.
- Encourage joyful movement. Children should get 60 minutes of physical activity daily, but many don't. Help your child get moving by finding activities that you can enjoy together. Instead of sitting on the couch after dinner, encourage your family to walk, bike, or ride scooters. For many children, heading outdoors is all it takes to have more active playtime.
- Monitor screen time. For children age 2 to 5, aim to limit non-educational screen time to about one hour on weekdays, and no more than three hours on weekend days. Kids age 6 or older can get a bit more screen time, but it's best balanced with physical activity. Avoid eating meals in front of screens: They can distract children from feeling full, so they may overeat.
What are the short and long-term effects of child obesity?
Childhood obesity may increase the chance of your child developing health problems now or later in life. These may include:
- Breathing problems
- Joint pain
- Type 2 diabetes
- High blood pressure
- High cholesterol
- Heart disease
- Depression
- Low self-esteem
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Some studies show that obese children are at higher risk of being obese as adults and may have an increased risk of developing type 2 diabetes, coronary heart disease, and some types of cancer.
However, other studies show that childhood BMI isn't a good way to predict adult diseases. Researchers note that children at healthy weights can also develop diabetes and heart disease as adults and warn that targeting obesity reduction solely at overweight children can be harmful. It's important that all children learn to eat well and enjoy being active, and weight bias (being shamed for weight) shouldn't be directed at children in larger bodies.
Instead of focusing on weight loss, shift your focus to establishing healthy habits, and know that pressuring a child to lose weight isn't a winning tactic. For the best results, move forward with support, love, inclusion, and family-based changes.
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