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Baby fat is something children are supposed to outgrow, not grow into. Obesity is a critical and growing health problem in the U.S., and it starts at a young age. One in every six children and teenagers is obese (18.5 percent). That’s more than three times the rate found in the early 1970s.

Extra pounds and too-big waistlines have serious consequences for children, including low self-esteem, social problems and increased risk for chronic diseases. Why are so many children too heavy? Experts say there is no single cause of childhood obesity. Genetics plays a role, but too little physical activity and poor food choices are more often the culprits.

Too little activity

Anyone up for a breathless game of tag, kick-the-can, hopscotch? Childhood should be filled with hours of energetic play, but children today are less active than past generations. With more families living in cities, fewer children walk to school, and parents may keep children indoors more often out of concern for their safety. Adding to the problem, many schools have cut back on physical education programs. A national survey found that 20 percent of children ages 8 to 16 in the United States are vigorously active only twice a week or less. Instead of getting the recommended 60 minutes of moderate activity a day, many children spend hours a day watching television or on their phone, tablet or computer.

Keeping an eye on screen time

Almost half of all 8- to 16-year-olds watch three to five hours of television daily. Children who watch the most television are also the most likely to be obese. A study published in the medical journal Pediatrics found a strong relationship between the number of hours a day spent watching television and childhood obesity. A study by the Harvard School of Public Health revealed that the risk of being overweight is more than four times greater in children who watch more than five hours of television daily compared with those who watch two hours or less. And having a television in the bedroom is associated with being overweight, even in very young children.

Food woes

Our environment is loaded with food temptations. High-calorie foods are available everywhere a child turns: in school vending machines, at fast-food restaurants, at corner convenience stores and even in kitchen cupboards at home. Fruits and vegetables are easily ignored in favor of high-calorie snacks such as potato chips. Hectic schedules mean home-cooked family meals are often skipped and replaced with less nutritious grab-and-go foods eaten on the run. Families eat more often at restaurants, where portion sizes have ballooned, providing too many calories and too much fat.

Why you should be concerned

Being overweight or obese places a child at risk for many health problems. An obese child is more likely to develop type 2 diabetes, a condition that used to occur only in adults.

According to the National Institutes of Health, there has been an alarming increase in diabetes among obese children and adolescents recently.

Obese children often have high cholesterol and high blood pressure, increasing their risk for heart disease. Children who are obese are more likely to have asthma and sleep apnea, a breathing problem that interrupts sleep, as well as bone and joint disorders. And overweight children are more likely to become overweight adults.

The psychological stress that overweight children experience can be as devastating as the medical problems. They are often teased by other children and as a result suffer poor self-image, low self-esteem and depression.

If you’re concerned

If you’re concerned about your child’s weight, first talk to your pediatrician or family doctor. The doctor can determine whether your child is at a healthy weight by calculating body mass index (BMI). BMI, a ratio of weight to height, is considered the best method for evaluating weight in children. Your pediatrician will compare this number with a growth chart for children of your child’s same age and sex.

Your pediatrician can help you identify appropriate weight management goals for your child. Often, the goal isn’t to lose weight, but to change behavior. Restrictive diets are not recommended for overweight children. Rather, the goal is to help them maintain their weight as they grow taller. Another approach is to help a child burn more calories by being more physically active. A registered dietitian can provide guidance on eating behaviors, meal planning and shopping. If your child is at risk for medical problems, your doctor may recommend a formal weight management program staffed by a team of health professionals, such as a pediatrician, dietitian and psychologist.

Most important, let your children know that you love them, regardless of their weight. Give your children plenty of support and approval. Helping to build your children’s self-esteem is a great way to help them develop healthy new habits.

Make healthy lifestyle changes as a family

Helping your children to have a healthy body weight is a family affair. Instead of putting the focus on the overweight child, the whole family should get involved in making healthy changes in activity and eating habits, experts say. As a parent, you are the most significant role model for your children, so it’s important that you set an example with healthy lifestyle habits.

Get up and move

• Physical activity is a great way for you to spend quality time with your children. Emphasize the fun of an activity, rather than skill.
• Build family activity into every day, perhaps taking an after-dinner walk or bike ride or dancing to fast music in the living room.
• Plan active family outings, such as hikes, ice-skating, swimming or Frisbee. Try a family vacation that emphasizes canoeing, bicycling, camping or swimming.
• On birthdays, give presents that encourage activity, such as roller skates or a basketball.
• Set guidelines for how long your children can watch television or play computer or video games.

Choose healthy foods

• Use the Kid’s Healthy Eating Plate as a guide for food choices. Serve fruits, vegetables, whole grains, beans, and lean meats and poultry. Use low-fat or nonfat milk products (except for children younger than 2 years old).
• Keep healthy snack foods in the house, such as fresh fruit, raisins, pretzels, string cheese and popcorn.
• Have your children start the day with a good breakfast, such as whole-grain cereal with fruit and low-fat milk, whole-wheat toast with peanut butter, a fruit smoothie made with yogurt, or even leftover vegetable pizza.
• Involve kids in shopping for and preparing meals. Children like to eat what they’ve helped prepare.
• Don’t forbid “bad” foods. Instead, teach your children about foods that can be eaten every day and those that should be eaten only now and then.

Keep the message positive

Children are more likely to make healthy changes when they feel good about themselves. Experts suggest that parents help their children find things to do that make them feel valuable. It might be community volunteer work, visiting the elderly neighbor down the street, helping grandma clean her yard, or pursuing a special interest such as art or music. Point out your children’s strengths and help them develop their own interests and abilities.

Sources: 2018 United States Report Card on Physical Activity for Children and Youth, The Centers for Disease Control and Prevention (CDC), Journal of Childhood Obesity

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