Childhood Obesity

Diagnosis

Diagnosis involves the steps that a healthcare professional takes to find out if your child has obesity. A healthcare professional calculates your child’s BMI and determines where it falls on a standard growth chart.

Your child’s BMI percentile shows how their weight compares with other children of the same sex and age. For example, a child in the 80th percentile has a higher BMI than 80% of children in that group.

Cutoff points on growth charts:

• Underweight — BMI 5th percentile or below

• Healthy weight — BMI between 5th and 84th percentiles

• Overweight — BMI between 85th and 94th percentiles

• Obese — BMI 95th percentile or above

• Severely obese — BMI greater than or equal to 120% of the 95th percentile

Because BMI doesn’t account for muscle mass or body frame size, the healthcare professional also considers your child’s overall growth and development.

Other factors considered include:

• Family history of obesity and related health conditions such as diabetes

• Eating habits and portion sizes

• Physical activity level and screen time

• Blood pressure and other health conditions

• Medications your child takes

• Mental health history, including depression or bullying

Blood tests may include:

• Cholesterol test

• Blood sugar test

• Liver test

• Hormone level tests or other tests related to obesity

Ask if fasting is needed before blood tests.

Treatment

Treatment for childhood obesity depends on your child’s age and overall health. It usually involves changes in eating habits, physical activity, and lifestyle, with the goal of long-term healthy habits. In some cases, medications or surgery may be considered.

Treatment generally includes:

• Guidance from a healthcare team on nutrition and exercise

• Family-based habit-building for a sustainable lifestyle

• Regular visits with a dietitian and healthcare provider

Goals for your child’s treatment depend on:

• Age

• Severity of obesity

• Presence of related health conditions

Success depends on long-term commitment from both parents and children. Healthy changes can improve overall well-being beyond what the scale shows.

Healthy Eating

Parents play a major role in shaping healthy eating habits.

Tips for encouraging good nutrition:

• Sit down for family meals and avoid screens while eating

• Serve at least five fruits and vegetables daily

• Reduce fast food, packaged snacks, and sugary treats

• Limit sugary drinks, including fruit juices

• Serve smaller portions and teach children to eat until satisfied, not full

• Keep a daily food journal to track eating and activity habits

Physical Activity

Regular activity helps maintain a healthy weight, strengthens the body, and supports emotional well-being.

To promote more activity:

• Limit screen time to no more than two hours a day for children over age 2

• Encourage at least one hour of physical activity daily

• Focus on fun, unstructured play like tag, dancing, biking, or swimming

• Choose activities your child enjoys to keep them motivated

• Encourage small movements like walking to school, taking stairs, or standing during TV time

Medications

If lifestyle changes aren’t enough, a healthcare professional may prescribe medicines. These should always be used with healthy diet and exercise.

Common options include:

• Semaglutide (Wegovy)

• Liraglutide (Saxenda)

• Phentermine and topiramate (Qsymia)

• Phentermine

• Lisdexamfetamine

Ask about side effects before starting any medication.

Surgery or Other Procedures

Weight-loss surgery may be considered for teens with severe obesity when other treatments fail. It involves evaluation by a team of specialists, including an obesity doctor, psychologist, and dietitian.

Surgery may be recommended if the health risks of obesity outweigh surgical risks. The decision should involve the teen and family support.