Preventing Childhood Obesity: What Pediatricians Want Parents to Know
It might start with reassessing your own eating habits.

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 2014, 17 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:
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Extra pressure on joints. Because of this strain, arthritis affects a third of people who are obese, according to the Arthritis Foundation.
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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.
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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.
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Heart disease. Extra weight forces the heart to work harder, which weakens the heart muscle over time.
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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.
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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.” (Here are tips to build physical activity into the family routine.)
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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.”
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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 chief medical editor at HealthiNation. 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.)
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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.
Dr. Hes is a pediatrician and medical director of Gramercy Pediatrics in New York City. She is double board certified in pediatrics and obesity medicine.
Frances Largeman-RothFrances Largeman-Roth is a nutritionist and cookbook author in New York City.
Alok PatelDr. Patel is a pediatrician at New York Presbyterian-Morgan Stanley Children's Hospital.
Preeti ParikhPreeti Parikh, MD serves as the Chief Medical Officer of HealthiNation. She is a board-certified pediatrician practicing at Westside Pediatrics, is an Assistant Clinical Professor at the Mount Sinai School of Medicine, and is an American Academy of Pediatrics spokesperson. She holds degrees from Columbia University and Rutgers Robert Wood Johnson Medical School and has completed post-graduate training at the Mount Sinai School of Medicine.
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Patients should change their eating habits
so it's gonna become the new normal.
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So we really don't talk about diet so
much, we talk about improving our
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lifestyle and nutrition.
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[MUSIC]
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If your child is overweight,
you may not know it.
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It may not be completely obvious to you.
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That's why we use BMI.
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BMI is a relationship between height and
weight.
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And for kids, it also takes gender and
age into effect.
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So for example, a three year old we expect
to have more body fat than a ten year old.
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When we plot BMI for a child, for
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their age when you hit past the 85th
percentile, you are considered overweight.
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Has a 95th percentile,
we consider that obesity.
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So being overweight
causes a myriad of problems.
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When you grow larger from fat,
all of your body grows larger.
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You have more weight on your joints.
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It can effect asthma if
you're predisposed to asthma.
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We have seen children as young
as nine actually get diagnosed
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with Type II diabetes.
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We see children in their early teens
get athlerosclerosis, heart disease.
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And the largest side effect we see from
being overweight is actually mental and
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depression and anxiety in children.
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We should all be getting 60
minutes of physical activity a day.
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That doesn't mean running for an hour.
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So that can add up throughout the day.
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So for example,
maybe you're walking to school, and
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then later on you're going on
a family walk with the dog.
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That may not be a possibility every day,
but
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the more you can get them outside where
they can play and be active, the better.
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I think it's very important to be
encouraging, to kind of empower children,
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say things like I want you to eat healthy
because I want to eat healthy and
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this is going to be a team effort.
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One of the other things I like to
talk to parents about is moderation,
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because if you become too restrictive,
then the child wants it even more.
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So giving them the right portion sizes and
the right amount, and
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giving it once in a while, a treat,
it's not the end of the world and
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it teaches the child to
regulate themselves also.
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The only food that
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I really tell parents that their kid just
should not be eating at all is soda.
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There's really not a place for
it in a growing kid's diet.
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So it is just a good habit to
never offer you child sugary drinks.
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If they never had it, they don't miss it.
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When you surround your kids with
healthy eating choices, it creates
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an environment where you can say yes
more often than you have to say no.
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Childhood obesity facts. Atlanta, GA: Centers for Disease Control and Prevention. (Accessed on march 20, 2021 at https://www.cdc.gov/obesity/data/childhood.html.)
Childhood obesity: the link to drinks. Tampa, FL: Obesity Action Coalition. (Accessed on February 15, 2018 at http://www.obesityaction.org/educational-resources/resource-articles-2/childhood-obesity-resource-articles/childhood-obesity-the-link-to-drinks.) Eating disorder statistics. Tucson, AZ: Mirasol Recovery Centers. (Accessed on February 15, 2018 at https://www.mirasol.net/learning-center/eating-disorder-statistics.php.) How fat affects arthritis. Atlanta, GA: Arthritis Foundation. (Accessed on February 15, 2018 at https://www.arthritis.org/living-with-arthritis/comorbidities/obesity-arthritis/fat-and-arthritis.php.) Reeves GM, Postolache TT, Snitker S. Childhood obesity and depression: connection between these growing problems in growing children. Int J Child Health Hum Dev. 2008 Aug;1(2):103-114. The link between asthma and weight. Chicago, IL: American Lung Association, 2016. (Accessed on February 15, 2018 at http://www.lung.org/about-us/blog/2016/07/the-link-between-asthma-weight.html?referrer=https://www.google.com/)