Treatment for childhood obesity is based on your child's age and if he or she has other medical conditions. Treatment usually includes changes in your child's diet and level of physical activity. In certain circumstances, treatment may include medications or weight-loss surgery.
Treatment for overweight children
The American Academy of Pediatrics recommends that children over the age of 2 and adolescents whose weight falls in the overweight category be put on a weight-maintenance program to slow the progress of weight gain. This strategy allows the child to add inches in height but not pounds, causing BMI-for-age to drop over time into a healthier range.
Treatment for obese children
Children ages 6-11 who are obese may be put on a diet for gradual weight loss of no more than 1 pound (or about 0.5 kilogram) a month. Older children and adolescents who are obese or severely obese may be put on a diet that aims for weight loss of up to 2 pounds (or about 1 kilogram) a week.
The methods for maintaining your child's current weight or losing weight are the same: Your child needs to eat a healthy diet — both in terms of type and amount of food — and increase his or her physical activity. Success depends largely on your commitment to helping your child make these changes.
Parents are the ones who buy groceries, cook meals and decide where the food is eaten. Even small changes can make a big difference in your child's health.
- When food shopping, choose fruits and vegetables. Cut back on convenience foods — such as cookies, crackers and prepared meals — which are often high in sugar, fat and calories. Always have healthy snacks available.
- Limit sweetened beverages. This includes those that contain fruit juice. These drinks provide little nutritional value in exchange for their high calories. They also can make your child feel too full to eat healthier foods.
- Limit fast food. Many of the menu options are high in fat and calories.
- Sit down together for family meals. Make it an event — a time to share news and tell stories. Discourage eating in front of a screen — such as a TV, computer or video game — which can lead to fast eating and lowered awareness of how much you're eating.
- Serve appropriate portion sizes. Children don't need as much food as adults do. Allow your child to eat until he or she is full, even if that means leaving food on the plate. And remember, when you eat out, those portion sizes are often significantly oversized.
A critical part of achieving and maintaining a healthy weight, especially for children, is physical activity. It not only burns calories but also builds strong bones and muscles and helps children sleep well at night and stay alert during the day. Good habits established in childhood help adolescents maintain healthy weight despite the hormonal changes, rapid growth and social influences that often lead to overeating. And active children are more likely to become fit adults.
To increase your child's activity level:
- Limit TV and recreational computer time to no more than 2 hours a day. A good way to increase your child's activity levels is to limit the number of hours he or she is allowed to watch TV each day. Other sedentary activities — playing video and computer games or talking on the phone — also should be limited.
- Emphasize activity, not exercise. Children should be moderately to vigorously active for at least an hour a day. Your child's activity doesn't have to be a structured exercise program — the object is just to get him or her moving. Free-play activities — such as playing hide-and-seek, tag or jump-rope — can be great for burning calories and improving fitness.
- Find activities your child likes to do. For instance, if your child is artistically inclined, go on a nature hike to collect leaves and rocks that your child can use to make a collage. If your child likes to climb, head for the nearest neighborhood jungle gym or climbing wall. If your child likes to read, then walk or bike to the neighborhood library for a book.
In some situations, medication may be prescribed for adolescents as part of an overall weight loss plan. Only one prescription weight-loss drug is available in the U.S. for adolescents. Orlistat (Xenical) prevents the absorption of fat in the intestines. The risks of taking a prescription medication over the long term are unknown, and the medication's effect on weight loss and weight maintenance for adolescents is still questioned.
Weight-loss surgery may be an option for severely obese adolescents who have been unable to lose weight using conventional weight-loss methods. However, as with any type of surgery, there are potential risks and long-term complications. Also, the long-term effects of weight-loss surgery on future growth and development are largely unknown.
Weight-loss surgery in adolescents is uncommon. But your doctor may recommend this surgery if your child's weight poses a greater health threat than do the potential risks of surgery. It's important that a child being considered for weight-loss surgery meet with a team of pediatric specialists, including a pediatric endocrinologist.
Weight-loss surgery isn't a miracle cure. It doesn't guarantee that an adolescent will lose all of their excess weight or that they'll be able to keep it off long term. It's also important to keep in mind that surgery doesn't replace the need for following a healthy diet and getting regular physical activity.
April 10, 2015
- About BMI for children and teens. Centers for Disease Control and Prevention. http://www.cdc.gov/healthyweight/assessing/bmi/childrens_BMI/about_childrens_BMI.html. Accessed Feb. 27, 2015.
- Understanding childhood obesity. American Heart Association. http://www.heart.org/HEARTORG/GettingHealthy/WeightManagement/Obesity/Childhood-Obesity_UCM_304347_Article.jsp. Accessed Feb. 27, 2015.
- Normal childhood nutrition & its disorders. In: Hay WW, et al. Current Diagnosis & Treatment: Pediatrics. 2nd ed. New York, N.Y.: The McGraw-Hill Companies; 2014. http://www.accessmedicine.com/. Accessed Feb. 27, 2014.
- Huang JS, et al. Childhood obesity for pediatric gastroenterologists. Journal of Pediatric Gastroenterology and Nutrition. 2013;56:99.
- Klish WJ. Definition; epidemiology; and etiology of obesity in children and adolescents. http://www.uptodate.com/home. Accessed Feb. 27, 2015.
- Barlow SE, et al. Expert committee recommendations regarding the prevention, assessment and treatment of child and adolescent overweight and obesity: Summary report. Pediatrics. 2007;120:S164.
- Currie C, et al. Is obesity at individual and national level associated with lower age at menarche? Evidence from 34 countries in the Health Behaviour in School-aged Children Study. Journal of Adolescent Health. 2012;50:621.
- Keeping children at a healthy weight: A review of the research on ways to avoid becoming overweight or obese. Agency for Healthcare Research and Quality. http://effectivehealthcare.ahrq.gov/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=1714. Accessed Feb. 17, 2015.
- Skelton JA. Management of childhood obesity in the primary care setting. http://www.uptodate.com/home. Accessed Feb. 27, 2015.
- Petjar R, et al. Pharmacological management of obese child. Archives of Diseases in Childhood Education and Practice Edition. 2013;98:108.
- Sherafat-Kazemzadeh R, et al. Pharmacotherapy for childhood obesity: Present and future prospects. International Journal of Obesity. 2013;37:1.
- Braet C, et al. The assessment of eating behaviour in children who are obese: A psychological approach. A position paper from the European childhood obesity group. Obesity Facts. 2014;7:153.
- Klish WJ. Clinical evaluation of the obese child and adolescent. http://www.uptodate.com/home. Accessed March 2, 2015.
- Media and children. American Academy of Pediatrics. https://www.aap.org/en-us/advocacy-and-policy/aap-health-initiatives/pages/media-and-children.aspx. Accessed March 2, 2015.
- Klish WJ. Comorbidities and complications of obesity in children and adolescents. http://www.uptodate.com/home. Accessed March 3, 2015.
- Papoutsakis C, et al. Childhood overweight/obesity and asthma: Is there a link? A systematic review of recent epidemiologic evidence. Journal of the Academy of Nutrition and Dietetics. 2013;113:77.
- Helping your overweight child. Weight-control Information Network. http://win.niddk.nih.gov/publications/over_child.htm#d. Accessed March 25, 2015.
- Barlow SE, et al. Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. American Academy of Pediatrics. Pediatrics. 2007;120:S164.
- Fitch A, et al. Prevention and management of obesity for children and adolescents. Bloomington, Minn.: Institute for Clinical Systems Improvement; 2013.