Can Children Outgrow Obesity?

Obesity is a complex medical condition that can start in childhood. Many things can affect it, including behavior, genetics, environment, and even the bacteria living in your intestines. Many kids who are considered obese continue to face it as adults.

The good news is that some children can outgrow childhood obesity. With support and guidance from a healthcare team, kids may learn new ways to eat and move. Some may join a program that helps with healthy habits. Others might need special medical care, like surgery. 

Let’s take a closer look at what causes childhood obesity, the problems it can lead to, and the treatments that may help kids outgrow it.

What is childhood obesity?

As kids grow, their weight changes a lot. Babies can gain weight quickly and may have chubby cheeks and soft rolls on their arms and legs — that’s totally normal. Toddlers might have round bellies that stick out a bit, and that’s nothing to worry about either. So, how can we tell if a child’s weight is in a healthy range? 

Since kids are still growing, pediatricians look at more than just the number on the scale. They use growth charts and something called body mass index (BMI). BMI is a number calculated by comparing a person’s weight to their height. A child’s BMI is compared against a standard chart of other kids of the same age and sex. If a child’s BMI is higher than 95 out of 100 of kids like them, they’re considered to have childhood obesity.

For most kids, BMI drops a little during the preschool years and hits its lowest point around age 5 or 6. After that, it usually starts to rise again as they get older, leveling out in the late teen years and early adulthood.

Obesity classes

Obesity specialists group childhood obesity into three classes — class 1, class 2, and class 3 — based on how far above the healthy BMI range a child is:

• Class 1 obesity: BMI is at or above the 95th percentile but less than 120% of the 95th percentile for the child’s age and sex

• Class 2 obesity: BMI is greater than or equal to120% to less than 140% of 95th percentile 

• Class 3 obesity: BMI is 140% or more of the 95th percentile 

Children with class 2 or class 3 obesity are much more likely to have health problems related to their weight. But if a child’s BMI is just a little over the 95th percentile, they usually face fewer health risks. They also have a better chance of reaching a healthy weight range in the future than a child who has a much higher body weight for their height and age.

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Some people may wonder if BMI is a good way to measure health, since it only looks at height and weight. While BMI isn’t perfect, it’s a helpful tool for understanding body fat and the risks of problems like diabetes and heart disease. For example, athletes like wrestlers or football players might have a high BMI because of muscle, not fat. On the other hand, some kids with excess body fat may not have a high BMI. Still, for most kids, a high BMI is a good sign they may have excess body fat .

The consequences of childhood obesity

Many adult health conditions — like heart disease, diabetes, and stroke — can actually begin in childhood. Kids who are considered obese are more likely to face physical health issues, like:

• A higher risk of cancer (like breast, colon, kidney, and pancreatic cancer)

• Cardiovascular disease (like heart and blood vessel disease)

• Type 2 diabetes

• Sleep apnea (trouble breathing during sleep)

• Polycystic ovarian syndrome (PCOS)

• Bone and joint problems

Links between childhood obesity and adult obesity

The link between childhood obesity and adult obesity is complex. Even though more kids than ever before in the U.S. have a body size that’s considered obese. This is likely because of social, genetic, and environmental factors that can impact the likelihood of adult obesity.

Here are some factors that play a role in how children who are considered obese become adults with a larger body size.

Age

A 1997 study found that, in general, the older a child was when they were diagnosed with obesity, the more likely they were to still have it in adulthood. For example, a child that’s considered obese and between the ages of 1 and 2 has an almost 20% risk of having it as an adult. But if the child was between 10 and 14 years old, that risk jumped to 75%. The risk is even higher if this child has a diagnosis of severe obesity. 

Parental obesity 

The same researchers found that when one parent was considered obese, the child was two to three times more likely to be considered obese as an adult than children whose parents weren’t.

Severe obesity 

When children fall into the severely obese category of BMI (Class 2 or higher), they become much less likely to outgrow it. A study from 2017 found that toddlers who were considered severely obese had only a 1 in 5 chance of reaching a healthy weight range by age 35. For teens that were considered to have severe obesity, the chance dropped to just 1 in 20. 

Food insecurity

Not having access to nutritious food or living in a “food desert” can raise the risk of having a BMI that’s considered obese as an adult. Food deserts are communities where fresh fruits, vegetables, and meats are much harder to find. Living in a food desert can increase the risk of having a BMI that is considered obese by 30%. Infants and young children who go through food insecurity are more likely to gain too much weight later in life.

Sleep quality

Sleep quality and quantity has a big impact on the hormones that regulate your weight. Both children and adults that have ongoing sleep deficits are much more likely to have a weight that is in an unhealthy range. In a vicious cycle, having a larger body size can also lead to sleep apnea — which can make weight gain more likely.

Walkable neighborhoods

The simple act of walking can burn lots of calories. People living in neighborhoods where walking is safe and convenient are more likely to stay at a weight that’s in a healthy range compared to those who live where walking is dangerous or difficult.

Negative social biases

Children who are considered obese often face teasing and negative comments. Studies tell us that this harassment — whether from kids or even adults — can worsen their self-esteem. It can also lead to even more weight gain over time.

Treatments that work for childhood obesity

Previously, it was believed that people gained excess weight simply because they ate too much and exercised too little. But decades of research have shown that metabolism — and weight — is much more complicated. Because of this, healthcare professionals have largely shifted their focus away from trying to reach a “perfect” weight or BMI and more on building habits that promote better health outcomes. 

Here are some treatment options that can help manage childhood obesity.

Nutritious eating and exercise

Some lifestyle changes can be a good first step toward improving health and wellbeing. These changes include:

• Replacing processed foods with fresh foods

• Eating more fruit and vegetables

• Getting plenty of physical activity 

While these are all habits that help to promote overall health, studies haven't shown that they can reduce BMI or weight in a lasting way. But they’re important because they reduce the risk of long-term complications like heart disease, diabetes, and stroke.

Reducing screen time

Watching too much TV or using screens passively (like just watching programs) has been strongly related to a body weight that stays in an unhealthy range even into adulthood. The data for video games or more active screen-media use is less clear. Decreasing passive screen time may help kids reach a weight that is in a healthy range.

Reducing sugar-sweetened beverages

Sweetened beverages add a lot of calories without making you feel full. Sweetened beverages to limit include:

• Soda

• Sweetened tea

• Energy and sports drinks

• Juice

Choosing water or milk instead can help to prevent excess weight gain. 

Family meals

Sitting down to eat together as a group has many dietary benefits for kids. Family meals can lead to:

• Eating more fruits, vegetables, grains, and foods rich in calcium and fiber

• Drinking less soda 

Even though family meals are linked to better nutrition, their impact on BMI is harder to demonstrate.

Improving sleep

Getting enough quality sleep is important for a healthy metabolism. Researchers have linked not sleeping well to obesity in children and adolescents. Improving sleep can help in the management of childhood obesity by:

• Keeping a regular sleep schedule

• Avoiding screens before bedtime

• Addressing sleep issues like sleep apnea 

Multidisciplinary treatment programs

Families of children who are considered to have severe obesity may find a multidisciplinary obesity program helpful. Programs may include residential treatment or regular outpatient visits over a period of time. They encourage participation from all family members. This is because the whole family will be involved in making lifestyle changes. Team members often include physicians, dietitians, psychologists, and even physical therapists. These programs help children and their families build habits to promote better health. But even these comprehensive programs can have limited success in helping children reach a healthy weight range over the long term.

Bariatric (metabolic) surgery

Metabolic or bariatric surgery changes the anatomy of your stomach and upper intestinal tract. This helps to reduce calorie absorption. After surgery, adults and children who have this surgery must change how and what they eat. 

Weight loss surgery may seem extreme compared to lifestyle changes or medications. But in many cases, it’s the only treatment that leads to long-term improvements in body weight and complications of obesity. 

Newer data suggest that youths who have surgery earlier (between ages 12 and 16) do better than those who have it later (after age 16). 

Medications used to treat childhood obesity

Healthcare professionals may recommend different treatments based on a child’s age, health, and weight. Along with the lifestyle changes, some older children and teens may also benefit from medication.

FDA-approved medications for teens who are considered obese include:

• Metformin is typically used for diabetes, but can be prescribed for children and adolescents who are considered obese

• Orlistat (Alli, Xenical) reduces fat absorption in the body

• Phentermine is a short-term appetite suppressant

• Phentermine / topiramate (Qsymia) lowers appetite and helps with weight loss

• Semaglutide (Wegovy) is weekly injection that reduces hunger

These medications are usually only for teens who are considered to have severe obesity or health problems due to their weight. They’re most helpful when combined with other health and lifestyle changes.

Frequently asked questions

Bottom Line

Childhood obesity is a serious health issue, but it’s not a life sentence. With the right support and steady changes, children can outgrow obesity. Even small steps — like adding more fruits and vegetables to meals, moving more each day, and getting good sleep — can lead to big improvements. Caregivers can work with a healthcare team to create a treatment plan to prevent complications from childhood obesity.

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Written by:

Bernadette Anderson, MD, MPH

A native of Saginaw, Michigan, Dr. Bernadette earned an undergraduate degree in psychology from the University of Michigan, Ann Arbor. She completed a master's degree in public health at the University of California, Berkeley, and a doctorate of medicine from the Medical College of Ohio.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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