Obesity Guideline: Information for Kids and Families

Not all people with overweight or obesity are unhealthy. However, overweight and obesity have been linked to serious health risks. In children and adolescents, overweight and obesity can lead to asthma, diabetes, hypertension, obstructive sleep apnea, and other health problems. In addition, children and adolescents with overweight or obesity have a higher likelihood of carrying excess body fat as adults, which is a risk factor for other health conditions. Treatment programs to reduce overweight and obesity can be effective for children and adolescents. It works best when the whole family is involved and guided by a health care professional.

It is important to recognize that while overweight can affect a person’s health, it does not define the person or make the person less worthy of respect.  Bullying, shaming or prejudice towards people for their weight is wrong. Blaming people for their weight is also wrong — as well as ineffective in helping them address overweight. A positive focus on health is most likely to help people of any age, including children and adolescents, reduce their overweight or obesity.

BMI is a relationship between weight and height that can indicate overweight or obesity. While the BMI is an imperfect measure—it doesn’t distinguish between muscle and fat, for example—it can be a useful tool.  For children and adolescents, BMI is interpreted based on their age and sex.

BMI can be determined by entering information into an online BMI calculator, like this one  provided by the Centers for Disease Control and Preventionopens in new window. The results can help you decide whether to talk with a health care provider about a child’s or adolescent’s weight.

A clinical practice guideline from the American Psychological Association shows that family-based, multicomponent behavioral interventions can be effective in reducing or maintaining a child’s BMI.

What does that mean?

Put simply, it means working with a health care provider (or team of providers) to make positive changes in the family’s patterns, including food choices, portion sizes and activity levels, so that everyone benefits, not just those who have overweight or obesity.

A health care provider—such as a physician, psychologist, nurse, dietician or social worker—can work with you to develop a strategy that works for your family.

For example, your health care provider may help your family to:

• Incorporate more physical activity into your daily lives, such as walking, cycling, sports and other activities.
• Spend less time with computers, mobile phones and TV. 
• Eat the healthiest, most nutritious food available, and, as needed, reduce portion sizes. 
• Ensure that all members of the family, especially parents or caregivers, are active participants in these strategies.

An effective plan should: 

• Involve the expertise of a health care provider. 
• Focus on the promotion of health and wellness.
• Use behavioral strategies to make healthy changes in family members’ patterns of eating and physical activity.
• Include a supportive and participating parent or caregiver.

If one of these components is missing, treatment may not be as effective.

Healthy behavioral changes will need to be carried over into all of the child’s environments, including school and childcare. Providers may work with the family to identify healthier options in those places, such as changing school lunches, promoting free play or enrolling in physical education or community activity programs.

For younger children, parents are encouraged to look for active childcare. Subsidies may be available to help families access high quality care.

Local community centers or faith-based entities may offer active programming for children and adolescents at low or no cost. As new habits are developing, family members—and for adolescents, peers—can play an important role in supporting and sustaining the positive changes.

For some adolescents with obesity, medication or surgery may be appropriate as well. When medication or surgery are appropriate, multicomponent behavioral interventions (as described above) are typically part of the treatment package. Your primary care provider can provide information about these options and refer you to other health care professionals specializing in those treatments.

For example, you may have difficulty finding and paying for treatment. You may be concerned about the cost of more healthful food or not sure how to prepare it so that family members will enjoy eating it.  You may live in a neighborhood that doesn’t feel safe, or one that lacks parks, walking paths and other places to play and exercise. You may have family or cultural traditions that center on food and celebrants may be reluctant to change any aspect of those traditions. Food shopping, meal preparation and physical activities can also take considerable amounts of time and effort. Adults may have time constraints or health challenges of their own that make completing these tasks difficult.

These barriers are real, but don’t be discouraged. A health care provider can help tailor a plan for your family members that takes their unique needs, environment and culture into account.  The provider can also help you think through financial issues, learn time management strategies, identify what gets in the way of making changes, gain emotional support and develop problem-solving skills.

The provider can determine whether the child or adolescent person has overweight or obesity and check for other health conditions. After talking with you, the provider may suggest strategies for addressing weight that are individualized to your family.

The provider might also refer you to a weight management program or another health provider, such as a psychologist or a dietitian, who can provide additional specialized care.  You can ask for programs and providers that have expertise in family-based, multicomponent treatment.

Some weight management programs have multiple providers with different areas of expertise (e.g., medical, psychological, dietary, physical fitness) who work as a team at a hospital or community health center. Since programs vary, you may want to consider these factors when looking at options:

• Do providers work together to create a treatment plan that is appropriate for your family?
• Do the appointment hours fit your school and work schedules?
• Is it a group or individual program?
• Is the program appropriate for the age and developmental stage of the child or adolescent?
• Does the program have a positive focus on health promotion?
• Do the possible results seem realistic?
• Is your family able and ready to commit to a structured program?
• Is the program covered by insurance?
• How many visits are covered?

Although no comprehensive list is available, ConscienHealth developed A Partial List of U.S. Pediatric Obesity Treatment Centers (PDF, 249KB)opens in new window. Registered dieticians who specialize in childhood obesity and overweight can be found through the Academy of Nutrition and Dietetics. Local health professionals may also have this expertise, and so it is worth asking your current health care provider for guidance.