Childhood obesity

Child obesity is a complex issue that can have different causes in different children. That’s why we take a personalized approach to helping every child we see. Our care starts with a full evaluation to better understand your child’s eating habits and overall health. This includes looking at things like their medications, genetics, stress levels, exercise habits and sleep patterns – all of which can contribute to weight gain.

After we understand the full picture, we help you make a personalized plan to get on a healthier path. This can include everything from medications to tips on how to buy and cook healthier foods. We take great care to make sure this plan fits your child and your family.

What is childhood obesity?

Children’s obesity is a long-term condition that affects 1 in every 5 kids. It happens when a child’s weight is higher than the weight that’s considered healthy.

Obesity in childhood rarely has a single cause. That’s why treating it requires a comprehensive approach. Genetics and certain medical problems can contribute to obesity. We’re committed to helping every family we see find a healthier path that works for them.

Children’s obesity can lead to many other health problems, including diabetes, high blood pressure and breathing problems during sleep. Treatment can prevent or improve these problems, help a child feel better about themselves and improve how they learn, play and grow into adults.

What are the different types of childhood obesity?

A child’s body mass index (BMI) percentile helps determine if a child’s weight is within healthy range. BMI helps compare your child to other children of the same sex and age.

Health care providers use three categories to identify if a child is overweight and diagnose obesity. The categories are overweight, obese and severely obese.

Overweight

A child or teen is considered overweight if their BMI is between the 85th and 95th percentile.

Obese

A child or teen is considered obese if their BMI is at the 95th percentile or greater.

Severely obese

A child or teen is considered severely obese if their BMI is at 120% of the 95th percentile or greater.

To receive a diagnosis, a child must measure at the same percentile more than one time.

Learn more about BMI for children and teens.

What are the signs and symptoms of childhood obesity?

Childhood obesity symptoms include:

• Feeling short of breath when physically active

• Constipation or gastrointestinal reflux (GERD)

• Early puberty in girls

• Delayed puberty in boys

• Pain in the knees, ankles or hips

• Swelling in lower legs or feet

• Stretch marks on the belly or extra fatty tissue in the chest area

• Dark, velvety skin (acanthosis nigricans)

Children and teens who have obesity are more likely to develop other health problems.

Physical health problems that are related to obesity can include:

• Type 2 diabetes or prediabetes

• Fatty liver disease

• High blood pressure (hypertension)

• High cholesterol (hypercholesterolemia)

• Sleep apnea

• Irregular periods

• Gallstones

• Gastroesophageal reflux disease (GERD)

• Asthma

Mental health problems can include:

• Anxiety and depression

• Low self-esteem

• Social isolation (not having relationships, contact with or support from others)

How is childhood obesity diagnosed?

Your child’s pediatrician may use BMI trends to diagnose obesity at a well-child visit. Then, they may refer your child to Children’s Health^SM for specialized evaluation and care.

Our expert team includes dietitians, social workers, psychologists, endocrinologists and surgeons. They will work together to identify all the ways obesity may be affecting your child’s health. We’ll also identify all the factors that may be contributing to obesity.

We’ll start with a comprehensive physical exam. We’ll ask lots of questions about your child’s personal and family medical history. This will include questions about things like:

• Eating habits

• Activity level (including sports and exercise)

• Sleep

• Mood and feelings of sadness, anxiety or depression

• Friends and support system

• Experience at school

• Bullying and peer pressure

In some cases, we’ll order a sleep study to check how well your child breathes during sleep. We may also order a genetic test if we suspect a possible genetic condition might be contributing to your child’s obesity.

We’ll also use blood tests to check for possible causes of excess weight. These blood tests can help us identify any weight-related health conditions. Blood tests can check your child’s:

• Cholesterol to see whether it’s too high

• Blood sugar (glucose) to look for signs of diabetes

• Hormone levels and other signs of health conditions that can cause obesity

What causes childhood obesity?

Some factors that can increase a child’s risk of excess weight or obesity include:

• Diet: High-calorie foods and sugary drinks can cause weight gain in children.

• Lack of activity: Children who sit a lot or who aren’t able to get adequate exercise are more likely to have obesity.

• Genetics: Obesity tends to run in families.

• Sleep: Not sleeping well can cause hormone imbalances that make a child feel hungrier.

• Mental health issues: Stress, depression or anxiety can make us eat when we're not hungry.

• Medications: Seizure and mood medications can increase a child’s risk of obesity. So can steroid medications.

• Socioeconomics: Not all families have the same access to fresh, affordable, healthy foods.

How is childhood obesity treated?

Treatment starts after our full medical evaluation. Your child’s treatment plan will depend on which factors contribute to their obesity. This plan may include nutrition counseling or emotional counseling. It may also include free exercise and nutrition programs for your whole family – or even bariatric (weight-loss) surgery.

As you and your child go through the evaluation and treatment process, you’ll meet with doctors and:

• Dietitians to help you plan meals and snacks that work for your child and family

• Social workers to provide mental health support and connect you to more resources in your community

• Psychologists to help with social and emotional aspects of eating

Free exercise program to treat childhood obesity

Get Up & Go is a free, 10-week program designed by our doctors and dieticians. We offer it at several local YMCAs. This means you can find the schedule and location that works best for your family. The classes provide tips and tools to make healthy eating and physical activity more enjoyable for the whole family. You, your child and other family members or caregivers are welcome to participate.

Bariatric surgery for childhood and teenage obesity

Bariatric surgery can be a very effective way to reach a healthier weight for teens ages 14 to 18 with high BMIs. Surgery is always combined with a lot of support from our team to help teens also eat healthier and move more.

Teens in our program who have surgery and follow our guidelines lose 25% to 50% of their body weight the year after surgery. This is a much higher percentage than they can lose by only changing their diet and activity level. Having surgery can also improve a teen’s self-esteem and overall well-being.

The Children’s Health Bariatric Surgical Center is the only program in North Texas to offer weight loss surgery for teens. Our childhood obesity experts will first fully evaluate your teen. If surgery is a good fit, we’ll educate you about the entire process. We make sure you know exactly what to expect before, during and after surgery. Then we support you and your teen at every step.