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Childhood Obesity (FAQ)

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Answers to questions families often have about caring for their child with childhood obesity

What is pediatric obesity and what causes it?

Pediatric obesity is defined as children who have a body mass index (BMI), as determined by plotting on BMI growth curves, at or above the 95th percentile. Overweight is defined as children who have a BMI between the 85th and 95th percentiles. Every effort should be made during childhood and adolescence to help children avoid BMIs that put them at risk for overweight or obesity. If overweight or obese, parents should not wait to address the issue until adulthood, when lifestyles and habits are more difficult to change and the health changes associated with overweight and obesity are established. Childhood obesity has become very common in the US and, increasingly, in the rest of the world. [Ogden: 2006] [Silventoinen: 2004] If present trends continue, it is estimated that the current generation of children will be the first in U.S. history to have a shorter life expectancy than that of their parents. [Olshansky: 2005] Because, for the most part, treatment of children with established obesity has not been very successful, most experts agree that preventing children from becoming obese is critical.

What are the symptoms of pediatric obesity?

Obese children are more likely than healthy-weight children to have risk factors for cardiovascular disease. In a population-based sample of 5- to 10-year-old children with obesity, 58% have one cardiovascular risk factor, and 25% have two. [Hughes: 2008]

In addition, obese children are more likely than non-obese children to develop: [Hughes: 2008] [Daniels: 2005] [Dietz: 2005]
  • Type 2 diabetes mellitus
  • High glucose levels and increased insulin resistance
  • Metabolic syndrome (risk factors for heart disease)
  • Bone and joint problems
  • Sleep apnea
  • Social and psychological problems such as stigmatization and poor self-esteem

How is it diagnosed?

The definitions of overweight and obesity are based on BMI, derived from the child’s height and weight: BMI = (Weight [lb] / Height [inches] x Height [inches]) x 703. In children older than two, BMI percentiles specific to the age and sex of the child are used. A variety of charts, wheels, websites (Online BMI Calculator (verywell.com)), and computer and smartphone applications are available to assist with calculating the BMI and assessing the percentile. It is critical that both the height and weight be obtained accurately.

What is the prognosis?

Childhood obesity is associated with a spectrum of complications that may affect short- and long-term physical and mental health. Common co-morbid conditions include hypertension, diabetes, sleep apnea, chronic inflammation, polycystic ovarian syndrome (PCOS), asthma, liver and gall bladder disease, and orthopedic problems. [Daniels: 2006] [Hughes: 2008] Research suggests that obese children have weaker immune systems and are at increased risk of chronic illnesses. [Herrera: 2004] Obese children have an increased chance of becoming obese adults. [Jelalian: 2007] Prognosis often depends on the treatment, timing that it begins, and support of the family.

What is the risk for other family members or future babies?

Some genetic syndromes associated with pediatric obesity are Prader-Willi syndrome, Turner syndrome, and Laurence-Moon-Bardet-Biedl syndrome. Findings such as developmental delay, short stature/delayed growth, dysmorphic features, abnormal or absent genitalia, and digital anomalies should raise suspicion of an underlying genetic anomaly. Obesity is one of the most heritable conditions. A child born to two obese parents has about an 80% risk of developing obesity. [Reilly: 2005] Determining whether there is a history of obesity and/or type 2 diabetes in first and second-degree relatives is a potentially very useful approach to identifying children at greater than average risk of becoming obese.

What treatments/therapies/medications are recommended or available?

Preventing and treating obesity are lifelong habits. For infants, breastfeeding will provide adequate nutrition and may reduce the risk of obesity later in life. The 5-2-1-0 message has been widely disseminated and supported by a number of groups and organizations as a way to prevent and address obesity. It is an easy-to-deliver message for parents and children:
  • Five servings of fruits and vegetables
  • Less than two hours of screen time
  • More than one hour of exercise
  • Zero sweetened beverages
Medical treatments, such as behavior therapy, medications, and surgery, are available depending upon the cause, severity, and other diagnoses related to the obesity.

How will my child and our family be impacted?

Parents that are a healthy weight are more likely to have children with a healthy weight. Parents can model healthy behaviors and encourage those healthy behaviors in siblings.

Do insurances pay for obesity services?

As of February 2014, obesity screening and counseling are covered under the Affordable Care Act. Depending on the insurance plan, children may be able to receive services at no cost to families. Source: Help Your Child Stay at a Healthy Weight - Healthfinder.gov

Resources

Information & Support

Related Portal Content
Obesity in Children
Assessment and management information for the primary care clinician caring for the child with childhood obesity.

Care Notebook
Medical information in one place with fillable templates to help both families and providers. Choose only the pages needed to keep track of the current health care summary, care team, care plan, health coverage, expenses, scheduling, and legal documents. Available in English and Spanish.

For Parents and Patients

Let's Move! (obamawhitehousearchives.gov)
Resources for families, parents, children, communities, and health care providers for providing healthy food in schools, improving access to healthy, affordable foods, and increasing physical activity; First Lady Michelle Obama’s initiative for healthy families.

Nutrition & Fitness (KidsHealth)
Nutrition, fitness, and overall health information for parents, kids, teens, and educators. Includes recipes, safety tips, and discussion of feelings; sponsored by the Nemours Foundation.

Bright Bodies Program
Weight management program for children ages 7-16. Includes recommendations for education, exercise, and lifestyle modification; Yale Center for Clinical Investigation and Pediatric Endocrinology, Yale School of Medicine.

Aim for a Healthy Weight (NHLBI)
Research, training, and education programs to enhance health, and prevent and treat obesity; National Heart, Lung and Blood Institute.

Camp Shane - Weight Loss Camps
Pediatric weight-loss camp located in California, Arizona, New York, and Georgia.

Ending the Food Fight: Guide Your Child to a Healthy Weight in a Fast Food/ Fake Food World
A book, containing a nine-week program offering the tools -- including tasty recipes, motivational tips, and activities -- that can help families prevent the kitchen table from becoming a battleground.

Patient Education

MyPlate Tip Sheets (USDA)
Easy-to-print patient education in English and Spanish that has practical tips for healthy eating habits. Topics can be sorted by age group and category; U.S. Department of Agriculture.

BAM! Body and Mind (CDC)
Learn about nutrition, physical activity, stress, and safety, or diseases through interactive, online activities. Designed for youth 9–12 years old and their teachers and parents; Centers for Disease Control and Prevention.

Live Well (Intermountain Healthcare)
Education for families about healthy lifestyles; Intermountain Healthcare.

About BMI for Children and Teens (CDC)
Answers to frequently asked questions about BMI such as how it is calculated, what percentiles mean, and how children BMIs differ from adult BMI calculators; Centers for Disease Control and Prevention.

Services for Patients & Families in Idaho (ID)

For services not listed above, browse our Services categories or search our database.

* number of provider listings may vary by how states categorize services, whether providers are listed by organization or individual, how services are organized in the state, and other factors; Nationwide (NW) providers are generally limited to web-based services, provider locator services, and organizations that serve children from across the nation.

Studies

Adolescent Weight Control Registry (WCDRC)
Registry for adolescents; Weight Control and Diabetes Research Center.

Pediatric Obesity (clinicaltrials.gov)
Studies looking at better understanding, diagnosing, and treating this condition; from the National Library of Medicine.

Authors & Reviewers

Initial publication: March 2014; last update/revision: August 2019
Current Authors and Reviewers:
Author: Alfred N. Romeo, RN, PhD

Page Bibliography

Daniels SR, Arnett DK, Eckel RH, Gidding SS, Hayman LL, Kumanyika S, Robinson TN, Scott BJ, St Jeor S, Williams CL.
Overweight in children and adolescents: pathophysiology, consequences, prevention, and treatment.
Circulation. 2005;111(15):1999-2012. PubMed abstract

Daniels, Stephen.
Consequences of Childhood Overweight and Obesity.
The Future of Children; (2006) https://www.ncbi.nlm.nih.gov/pubmed/16532658. Volume 16 Number 1 Spring 2006. Accessed on Jan. 2014.
Co-morbid conditions associated with obesity; publication of the Woodrow Wilson School of Public and International Affairs at Princeton University and the Brookings Institution.

Dietz WH, Robinson TN.
Overweight Children and Adolescents.
The New England Journal of Medicine. 2005;352(20):2100-9. PubMed abstract

Herrera EA, Johnston CA, Steele RG.
A comparison of cognitive and behavioral treatments for pediatric obesity.
Children's Health Care. 2004;33(2):151-67.

Hughes AR, Reilly JJ.
Disease management programs targeting obesity in children: setting the scene for wellness in the future.
Disease Management & Health Outcomes. 2008;16(4):255-66.

Jelalian E, Wember YM, Bungeroth H, Birmaher V.
Practitioner review: bridging the gap between research and clinical practice in pediatric obesity.
J Child Psychol Psychiatry. 2007;48(2):115-27. PubMed abstract

Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. .
Prevalence of overweight and obesity in the United States, 1999-2004.
JAMA. 2006;295((13)):1549-1555. PubMed abstract / Full Text
The increase in the prevalence of overweight among children and adolescents and obesity among men suggest that the increases in body weight are continuing in men and in children and adolescents while they may be leveling off in women.

Olshansky SJ, Passaro DJ, Hershow RC, Layden J, Carnes BA, Brody J, Hayflick L, Butler RN, Allison DB, Ludwig DS.
A potential decline in life expectancy in the United States in the 21st century.
N Engl J Med. 2005;352(11):1138-45. PubMed abstract

Reilly JJ, Armstrong J, Dorosty AR, Emmett PM, Ness A, Rogers I, Steer C, Sherriff A.
Early life risk factors for obesity in childhood: cohort study.
BMJ. 2005;330(7504):1357. PubMed abstract / Full Text

Silventoinen K, Sans S, Tolonen H, Monterde D, Kuulasmaa K, Kesteloot H, Tuomilehto J.
Trends in obesity and energy supply in the WHO MONICA Project.
Int J Obes Relat Metab Disord. 2004;28(5):710-8. PubMed abstract