The Medical Minute: Tackling childhood obesity without the stigma

Parents of children struggling with their weight might feel like they’re walking a tightrope: how can they help their kid manage their weight and health without negatively impacting their child’s body image?

Obesity affects one in five children in the U.S., and it can take serious tolls on physical and mental health.

Dr. Marsha Novick, medical director of the Healthy Weight Program for Children and Teens at Penn State Health Children’s Hospital, has advice for parents on how to navigate this issue and help their child maintain a healthy weight.

What is childhood obesity?

A child is diagnosed with obesity when they gain weight beyond what doctors consider healthy. Physicians use the Body Mass Index (BMI) to measure body fat based on a person’s weight-to-height ratio. If a child’s BMI is above the 85th percentile, doctors become concerned about the many serious medical issues associated with weight.

“Obesity increases the risk of other medical problems,” Novick said. More than 300 medical problems are associated with obesity, including heart disease, diabetes and cancer.

Children struggling with obesity are also at risk for developing mental health issues like depression, anxiety and mood disorders.

What are the causes?

Many factors contribute to obesity. Ultra-processed foods and sugary drinks can cause weight gain. In addition, many children are not getting enough physical activity, especially in the wake of COVID-19. “Kids who spend hours watching screens spend less time playing and getting the physical activity they need to be healthy,” Novick said.

Socioeconomic status is another contributing factor of obesity. Studies show children in minority communities and children who live with food insecurity face an increased risk of obesity.

What can parents do?

Parents should help children struggling with obesity, but be careful about projecting negative body images.

“Parents should see obesity as a health or medical problem rather than a willpower issue,” Novick said. “Obesity is not their child’s fault ― readily-available ultra-processed foods are the problem. The reward centers in the human brain are stimulated by processed foods, stoking good feelings and cravings.” These foods are hard to avoid, so parents can help their child by limiting access.

The 5-2-1-0 rule from the American Academy of Pediatrics is a quick and easy guide for parents to remember:

• Five servings of fruits and vegetables per day
• Two hours or less of screen time per day
• One hour of physical activity or more per day
• Zero sugar sweetened beverages per day

When should I take my child to the doctor?

“Early intervention is really important,” Novick said. If you notice your child has trouble keeping up with other children, or if you see them start to struggle with mental health issues and self-esteem, it’s time to talk to your primary care provider about your child’s weight. Parents can also watch for issues like headaches, constipation, snoring and heartburn to help gauge when to seek medical help.

Depending on how old your child is, their doctor might want to do some lab work to check for things like high cholesterol, fatty liver disease, pre-diabetes and high blood pressure. Your primary care doctor can even make a referral to a dietitian to help navigate dietary guidelines and incorporate more fruits and vegetables into your child’s diet. Lastly, be open to trying prescription weight loss medication, which can successfully help to reduce your child’s appetite and hunger.

Related content:

• The Medical Minute: Small changes can go far in preventing childhood obesity
• The Medical Minute: Three tips to lose your pandemic pounds safely 

The Medical Minute is a weekly health news feature produced by Penn State Health. Articles feature the expertise of faculty, physicians and staff, and are designed to offer timely, relevant health information of interest to a broad audience.