Being overweight or obese means your weight is above an ideal weight range. Appropriate weight ranges are calculated using the body mass index (BMI). For anyone under 20 years of age, these scales are based on height, weight, sex, and date of birth. Child and teen BMI results differ from adult BMI. This is because they are compared to the results of other children and teens in the same age range. This extra step takes into account that children and teens are still growing. BMI levels for anyone under age 20 are as follows:

  • Underweight —BMI at or below the 5th percentile for the age group
  • Desired weight —BMI between the 5th-84th percentiles for the age group
  • Overweight —BMI between the 85th-94th percentiles for the age group
  • Obese —BMI at or above the 95th percentile for the age group


Calories are taken into your body through food and drink. They are used for:

  • Physical activity
  • Basic body functions

Excess weight gain occurs when this balance of calories taken in and calories used is not kept in place. If this happens regularly, it will lead to obesity. Some things that can cause children and teens to take in more calories than they use are:

  • Poor eating habits
  • Sedentary lifestyle (inactive)
  • Overeating or binging
  • Taking certain medicines
  • Having an illness or condition

Risk Factors

These factors increase your child’s chance of being overweight or obese:

  • Poor sleeping habits
  • Large birth weight
  • Lack of exercise
  • Lack of sleep
  • Sedentary activities (eg, watching TV, playing on the computer, playing video games)
  • High levels of fast food in diet
  • Stressful life events or change
  • Family and peer problems
  • Low self-esteem
  • Depression and other emotional problems
  • Family history
  • Genetic factors


Symptoms of obesity include:

  • Increased weight
  • Thickness around midsection
  • Obvious areas of fat deposits

Obese Body

AN00029_obese body.jpg
© 2009 Nucleus Medical Media, Inc.

Complications of Untreated Obesity

Excess weight increases the chance of a child developing:

  • High blood pressure
  • High cholesterol
  • Type 2 diabetes
  • Bone and joint problems
  • Asthma
  • Sleep problems (eg, sleep apnea )
  • Liver and gallbladder disease
  • Depression
  • Unhealthy eating habits, including eating disorders
  • Substance abuse problems
  • Problems during adulthood (more likely to develop heart disease as adults, shortened life expectancy in adulthood)


The doctor will:

  • Ask about your child’s symptoms and medical history.
  • Do a physical exam.

Tests may include the following:

  • BMI—Height and weight will be measured. This information, as well as birth date, will be used to calculate ideal weight ranges.
  • Waist circumference, sagittal diameter, and waist-to-hip ratio—These are used to estimate the amount of fat deposited in the skin and inside the abdominal cavity.
  • Skinfold caliper—This test measures fat just beneath the skin. It cannot measure fat inside the abdomen.
  • Electrical measurements—These are tests that calculate the percentage of body fat. This measures the difference between the electrical characteristics of fat and other tissues in your body.
  • Blood tests—These tests rule out other conditions that may cause excess body weight.


Obesity can be difficult to treat. Success requires that parents and caretakers play an active role. Medical professionals may also be needed to assist in weight loss, such as a:

  • Dietitian—A dietician can help assess your child’s current food intake and recommend new options so that your child has a well-balanced diet.
  • Behavioral therapist—A therapist can help change habits related to overeating or binging. This therapy may also be done in a group setting with peers. Getting the whole family involved in behavioral classes may also be beneficial.

The doctor or medical specialist may recommend:


Have your child follow basic healthy eating habits, such as:

  • Eat five fruits and vegetables every day.
  • Limit sugar-sweetened beverages, including juices.
  • Eat breakfast every day.
  • Switch to low-fat dairy products.
  • Eat a diet rich in calcium.
  • Eat a high-fiber diet.

Other steps you can take include:

  • Pay attention to how food is prepared. This can make a big difference.
  • Limit fast food, take-out, and eating in restaurants. These give you little control over how the food is prepared.
  • Set a good example. Prepare healthy meals at home.
  • Eat together as a family.

In more severe cases, your child may have to follow a meal plan.

Physical Activity

Encourage your child to:

  • Participate in physical activity. This is a healthier choice for your child than watching TV or playing on the computer.
  • Get involved in family activities. This will help him learn how to add activity into his day.

The American Academy of Pediatrics offers these general guidelines for your child:

  • Get at least one hour daily of physical activity.
  • Limit time in front of a TV, game, or computer screen to 1-2 hours per day. If your child is under two years old, avoid screen time.

In more severe cases, your doctor may provide a specific activity plan.

Other Treatment

Some children who are obese may already have serious conditions due to their weight, such as:

  • Lung or heart problems
  • Diabetes
  • Bone and joint problems

Other children may have a hard time losing weight despite following guidelines. For these children, other options may be considered, such as:

  • Certain medicines (eg, orlistat ), when added to lifestyle changes, may help teens lose weight. But teens need to be closely monitored for side effects.
  • Bariatric surgery may also be an option for some obese children and teens. This option is generally only considered if all other options have failed.


To help reduce your child’s chance of being overweight or obese:

  • Encourage at least five servings of fruits and vegetables every day.
  • Choose lean meats, poultry, and fish.
  • Serve reasonable portions, and eat healthy meals together as a family.
  • Limit sugar-sweetened drinks. Encourage your child to drink water.
  • If your child is over two years of age, encourage him to get at least 60 minutes of moderate to vigorous activity most days of the week.
  • Limit screen time to two hours a day maximum.
  • Make sure your child is getting enough sleep.
  • Set a good example for your children. Choose healthy food options. Be physically active.