Preventing Childhood Obesity: What Pediatricians Want Parents to Know

Managing weight in children is tricky business. Of course, being in a healthy weight range can prevent everything playground stigma to chronic illnesses, which every parent obviously wants for their child. As of 2020, 19.7 percent of American children were classified as obese, according to the Centers for Disease Control and Prevention. But the reality is that raising healthy eaters and active kids is harder than ever in today’s junk food and iPad-saturated culture.

Experts use body mass index, or BMI, to determine whether your child is at a healthy weight. Falling above the 85th percentile is considered overweight, and above the 95th percentile is considered obese. This figure takes height and weight into account; for children, it also considers age and sex. “For example, a three-year-old we expect to have more body fat than a 10-year-old,” says Frances Largeman-Roth, RDN, a nutritionist in New York City.

Extra weight can affect almost every part of the body, says New York City pediatrician Dyan Hes, MD, who is double board certified in pediatrics and obesity medicine. Here are some conditions linked to obesity:

• Extra pressure on joints. Because of this strain, arthritis affects a third of people who are obese, according to the Arthritis Foundation.

• Increased risk of asthma. The American Lung Association reports that 11 percent of people who are obese have asthma, compared to 7 percent of people whose BMI is considered normal.

• Type 2 diabetes. “We have seen children as young as 9 get diagnosed with type 2 diabetes,” says Alok Patel, MD, a pediatrician at New York Presbyterian-Morgan Stanley Children’s Hospital.

• Heart disease. Extra weight forces the heart to work harder, which weakens the heart muscle over time.

• Depression and anxiety. Mental health and weight appear to have a reciprocal interaction, with depressive symptoms influencing weight change and vice versa, according to a 2008 study in International Journal of Child Health and Human Development.

Of course, preventing obesity in your child shouldn’t mean putting him on a restrictive diet. Children are still growing, after all, and they need to gain weight and get taller. And you don’t want to run the risk of pushing your child toward developing body image issues or an eating disorder. Many people with eating disorders reported that their symptoms began by age 10 or earlier. (Learn about the signs of eating disorders here.) Clearly, how adults talk about weight with their children has to be a careful balance.

“We really don’t talk about diet so much,” says Dr. Hes. “We talk about improving our lifestyle and nutrition.” Here are the tips experts recommend to prevent childhood obesity while nurturing your child’s self-image.

• Aim for 60 minutes of physical activity a day. “That doesn’t mean running for an hour,” says Largeman-Roth. “The more you can get them outside where they can play and be active, the better.”

• Make healthy eating a family effort. No child — or even adult — wants to feel singled out, especially because of their appearance. “[Try to] empower children,” says Dr. Patel. “Say things like, ‘I want you to eat healthy because I want to eat healthy, and this is going to be a team effort.”

• Practice moderation. “If you become too restrictive, then the child wants it even more,” says Preeti Parikh, MD, a pediatrician at The Mount Sinai Hospital and Executive Medical Director at GoodRx. It’s totally OK to let your kiddo enjoy an occasional treat in a reasonable portion size. “It’s not the end of the world and it teaches the child to regulate themselves.” (Here are proven tricks to help kids eat less sweets.)

• Avoid sodas and other sugar-sweetened beverages. These hyper-sweet drinks are high in calories and contain zero nutritional benefits (not to mention their effect on altering children’s taste buds). Recent studies found that sodas make up around 13 percent of the average teenager’s diet, according to the Obesity Action Coalition.  “There’s really not a place for it in a growing kid’s diet,” says Largeman-Roth.

Taking on these habits as a family empowers the child with weight management strategies they can use for life. “When you surround your kids with healthy eating choices, it creates an environment where you can say yes more often than you have to say no,” says Largeman-Roth.