Childhood obesity is an excess of body fat, which occurs over time due to a positive energy balance (energy intake > energy expended). In other words, a positive energy balance occurs when the energy that your child gets from food and drinks (energy intake) is higher than the energy used from being physically active (energy out). Many other factors including genetics, medications, the home and school environments, and children’s lifestyle habits (e.g., amount of sleep; time spent viewing screens) can impact energy balance and obesity in children.
Children with obesity are at greater risk for developing chronic (long-term) diseases and conditions, including type 2 diabetes, heart disease, sleep and breathing problems, and bone and joint pain. Also, children with obesity often grow up to be adults with obesity. In order for children and families to be as healthy as possible, parents have an important role to play in talking with their health care professionals (e.g., doctors, nurses) about their children’s weight and health.
For children two years of age and older, BMI is an appropriate tool for health care professionals to screen children’s weight status. Your child’s BMI, which is usually plotted on a growth chart, provides a general measure of your child’s physical health and in relation to their height and weight. However, BMI is limited – it does not consider all of the other things that determine your child’s health (e.g., diet, activity, sleep, relationship with parents and peers, mental health and wellness). If you have more questions about your child’s BMI, ask your health care professional or click on the links below for more information.
Successful weight management is very challenging to achieve. For this reason, parents and health care professionals are encouraged to focus on preventing obesity in children.
Weight can be a sensitive and difficult topic to discuss. While many parents want to talk with their child’s doctor or nurse about their child’s weight, some may be hesitant or fearful of the way the conversation will go. This is especially true since children and parents can be judged by others (including their health care professionals) based on their weight. In order to have a productive, helpful conversation about weight, it helps to plan in advance.
- “I’ve noticed that Liam’s weight increased since our last visit with you. Would it be okay if we talk about his weight today?”
- “Does Emma’s weight put her at risk for any health problems?”
- “I want to make some healthy lifestyle changes so everyone in our family can be as healthy as possible. Are you able to help us with any suggestions? Are you able to refer us to someone with expertise in this area?”
- “You mentioned Body Mass Index (BMI) and BMI percentile. Can you please explain these terms a bit more and what they’re used for?”
As a parent, talking with your child about their weight is difficult. Concern about hurting their feelings or damaging their self-esteem are common. So, before talking with your child about their weight, it can help to have an objective measure of their weight status. Specifically, what is their weight status according to a growth chart? Are they in the underweight, normal weight, overweight or obese category? You can learn your child’s weight status by asking your child’s doctor or nurse.
Tips for talking with your child about weight
- Ask your child if it’s OK to talk about their weight
- Be respectful if they choose not to talk about their weight
- Be positive and supportive
- Avoid blaming your child
- Focus on healthy lifestyle habits that the whole family can make and maintain
- Set small, specific goals for making healthy changes that are realistic
- Avoid words such as ‘fat’, ‘diet’, and ‘obese’; words like ‘weight’ and ‘health’ are usually better choices
- Talk with other family members to ensure everyone is on the same page about supporting your child
- Recognize your child’s feelings and thank them for their willingness to share their thoughts with you
- Actions speak louder than words; work on being a healthy role model for your child and family
Success in weight management is usually measured differently by health care professionals, parents, and children. Successful treatment of obesity in children involves the adoption of lifestyle, pharmacologic (medications) or surgical (bariatric surgery) interventions.
Health care professionals
Health care professionals may view success as improvements in the quality of life, self-esteem/body image and emotional difficulties, desired weight loss which meets the expectations of the family (parents and children) and healthier lifestyle behaviors. Improvements in family functioning, as well as a reduction of risks for some chronic diseases and conditions, can also be viewed as a success by health care professionals.
Children and Parents
Parents and children may see success differently. However, if the family is motivated to make lifestyle changes, they should talk about their goals early during obesity treatment to avoid conflicting expectations.
According to the recommendations for childhood weight management, overall success is improved long-term physical health through permanent lifestyle habits. This achievement will be evident by a BMI below the 97th percentile.
In the absence of bariatric surgery, achieving and maintaining a healthy weight in children as they grow, or a modest reduction in weight can be realistic and achievable goals which can be accomplished by making healthy lifestyle changes.