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Weight Issues in Early Childhood and Steps to Combat Them

All of us have heard at some point or the other that world over, childhood obesity is on the rise. According to estimates by the Centers for Disease Control and Prevention (CDC), in the last 30 years, the number of young children with obesity has nearly doubled.(1) Childhood obesity is a serious issue, one that is not talked about enough. It should be treated as a serious medical condition that affects children and adolescents. The issue of obesity in early childhood is especially problematic because the extra pounds put young children on the path to heart problems from an early age. Conditions like high blood pressure, diabetes and high cholesterol were once considered to be adult problems but now are showing up in children as well. And not to forget, childhood obesity can cause poor self-esteem and depression. Here is a complete guide to weight issues in early childhood and how to combat them.

Defining Obesity and Overweight

In order to say that a child has weight issues or is obese/overweight, it is essential to look at their body mass index (BMI). A person’s BMI is the measurement of their weight in relation to their height. These numbers serve as an estimate of body fat, and it is used to classify people into categories such as underweight, overweight, and obese.(2, 3)

Since children are constantly growing, and that too at different rates, the BMI measures differ between adults and children. Furthermore, male and female children also have natural differences in body fat distribution, taken within a range of normal body sizes and shapes. So instead of just using the calculated BMI number as is done in the case of adults, BMI percentiles for children also take into consideration their growth and development to understand if they are within the healthy weight range.

To calculate your child’s BMI, your pediatrician will measure your child’s weight and height after taking off any heavy clothes and shoes and then calculate the BMI. The number is then compared to other children of the same age and gender in that country and called a BMI percentile. For example, the BMI-for-age percentile of 65 means that the child’s weight is higher than that of 65 percent of other children of that same age group and gender. Pediatricians will plot this number on a standardized growth chart to show you a visual comparison to help you understand and keep track of your child’s growth trends over a period of time.(4, 5)

Weight Issues in Early Childhood

Weight Issues in Early Childhood

As a parent, it is important for you to realize that not all children who carry a few extra pounds are overweight or obese. Some children naturally have larger than average body frames and may appear to be large for their age but are, in fact, completely within an average range. Children also carry different amounts of body fat as they go through the various stages of development. This is why it is not always possible to determine whether a child is overweight or not just by how they look.(6, 7)

It is essential to be aware that BMI is not always the perfect measure of body fat, and it can even be misleading in some cases. For example, a muscular child might have a high BMI but not be overweight since extra muscle tends to add to the body weight but not contribute to fatness. At the same time, it may also be challenging to interpret BMI, especially during puberty when kids experience periods of fast growth. While BMI is typically a good indicator of body fat, but it is not a direct measurement of body fat.

Of course, if you are worried that your child has put on quite a bit of weight, it is best to talk to their pediatrician. Your doctor will take into account your child’s entire history of growth and development, your family’s overall weight for height history, and where your child falls on various growth charts. Your doctor will also enquire about your child’s eating and activity habits and make some suggestions on how to make certain changes to follow a healthy lifestyle. The doctor may also prescribe certain blood tests to look for any medical issues that may be linked to obesity. This will help determine for sure if your child has a weight issue and their weight falls in an unhealthy range.(8, 9)

Depending on your child’s BMI and overall health, the doctor may refer you to a dietitian or even a weight management program.

Why Do Children Become Obese or Overweight?

There are several factors that contribute to a child becoming overweight or obese, including poor dietary habits, a sedentary lifestyle, genetics, or even a combination of these. Lack of access to healthy food along with safe places to exercise or be active is a challenge for many families. In some rare cases, excessive weight gain might be due to an endocrine problem, certain medications, or some genetic syndrome.(10, 11)

Let us look at some of the causes:

  1. Unhealthy Diet and Lifestyle

    In today’s busy schedules, it has become common for more and more people to choose foods that are quickly available and easy to eat. This often includes fast food, processed foods, prepackaged meals, and snacks. Portion sizes are also usually very large.

    At the same time, kids these days are inclined to live a sedentary lifestyle, preferring their electronic devices over playing outside. Kids who spend most of their time indoors in front of their screens are more likely to be overweight. Screen time also has an impact on the quality of sleep, and it has been found that children who don’t get an adequate amount of sleep are more likely to be overweight. (12, 13)

  2. Lack of Exercise and Physical Activity

    Most kids do not get enough physical activity. Ideally, older children and teenagers should get at least one hour or more of moderate or vigorous exercise every day, including muscle and bone strengthening activities and aerobic exercises. Kids between the ages of two to five years should be active for at least three to four hours every day.(14)

  3. Genetics

    In many cases, genetics can also play a significant role in determining your child’s weight. Genes determine the body type and the process in which the body stores and burns fat. However, genes alone cannot explain the current obesity crisis being observed in children. Since both genes as well as habits are passed down from one generation to the next, it is possible for multiple members of one family to struggle with weight issues.

    At the same time, people in the same family tend to have similar sedentary behaviors, eating patterns, and levels of physical activity. Taking all this into account, a child’s chances of being overweight goes up significantly if a parent is obese or overweight.(15, 16)

Steps to Combat Weight Issues in Early Childhood

Here are some steps you can take to reduce your child’s risk of becoming overweight or obese:

  1. Stop focusing on weight loss. According to the New York State Department of Health (NYSDH), it is not good to focus on traditional weight loss strategies for young children.(17) At this growing age, following a calorie-restricted diet can actually prevent them from getting the vitamins, minerals, and other macro and micronutrients they need for proper development and growth. Instead of this, you should focus on developing healthy eating behavior.
  2. Eating nutritious food and healthy, balanced, and low-fat meals should be the ideal way to go if your child is dealing with weight issues. Balanced and nutritious meals help your child develop smart and healthy eating habits. It is essential to teach children about the importance of eating balanced meals and including a variety of nutrient-rich items such as fruits and vegetables, dairy, whole grains, legumes, and lean meat.
  3. Watch portion size when eating as overeating is another contributing factor to obesity. It is important to ensure your child eats proper portions. For example, two to three ounces of cooked lean meat, poultry, or fish should make up one portion.
  4. According to the CDC, it is important to limit your children’s time on the couch to not more than two hours a day. Kids already need to spare time for quiet reading and homework, which are sedentary activities. This is why limiting their time to other sedentary activities like video games, TV, surfing the internet, and other similar activities should be strictly implemented.(18)
  5. Regular exercise is very important to keep children healthy and fit. All children should engage in at least one hour of physical activity every day. This can include aerobic activities like running, bone-strengthening exercises like jumping rope, and muscle-strengthening activities like gymnastics.(19, 20)


It is important to remember that when children have obesity, they are at a much higher risk of developing a huge number of health conditions and problems like heart disease, type 2 diabetes, asthma, and sleep disorders, amongst others. Practicing healthy eating habits, exercising regularly, and limiting their sedentary time are the best ways to prevent obesity in children. By being vigilant from early childhood, it is possible to avoid health issues and obesity in the future.


  1. 2022. [online] Available at: <https://www.cdc.gov/healthyschools/obesity/index.htm> [Accessed 19 July 2022].
  2. Kirk, S., Zeller, M., Claytor, R., Santangelo, M., Khoury, P.R. and Daniels, S.R., 2005. The relationship of health outcomes to improvement in BMI in children and adolescents. Obesity research, 13(5), pp.876-882.
  3. Freedman, D.S. and Sherry, B., 2009. The validity of BMI as an indicator of body fatness and risk among children. Pediatrics, 124(Supplement_1), pp.S23-S34.
  4. Himes, J.H., 2009. Challenges of accurately measuring and using BMI and other indicators of obesity in children. Pediatrics, 124(Supplement_1), pp.s3-s22.
  5. Tudor-Locke, C., Pangrazi, R.P., Corbin, C.B., Rutherford, W.J., Vincent, S.D., Raustorp, A., Tomson, L.M. and Cuddihy, T.F., 2004. BMI-referenced standards for recommended pedometer-determined steps/day in children. Preventive medicine, 38(6), pp.857-864.
  6. Gulati, A.K., Kaplan, D.W. and Daniels, S.R., 2012. Clinical tracking of severely obese children: a new growth chart. Pediatrics, 130(6), pp.1136-1140.
  7. Obese, H., 1998. Body mass index (BMI). Obes Res, 6(2), pp.51S-209S.
  8. Khadilkar, V. and Khadilkar, A., 2011. Growth charts: A diagnostic tool. Indian journal of endocrinology and metabolism, 15(Suppl3), p.S166.
  9. Kuczmarski, R.J., 2000. CDC growth charts: United States (No. 314). US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
  10. Diene, G., Mimoun, E., Feigerlova, E., Caula, S., Molinas, C., Grandjean, H. and Tauber, M., 2010. Endocrine disorders in children with Prader-Willi syndrome–data from 142 children of the French database. Hormone research in paediatrics, 74(2), pp.121-128.
  11. Glass, A.R., 1989. Endocrine aspects of obesity. Medical Clinics of North America, 73(1), pp.139-160.
  12. Turel, O., Romashkin, A. and Morrison, K.M., 2017. A model linking video gaming, sleep quality, sweet drinks consumption and obesity among children and youth. Clinical Obesity, 7(4), pp.191-198.
  13. Kracht, C.L., Joseph, E.D. and Staiano, A.E., 2020. Video games, obesity, and children. Current obesity reports, 9(1), pp.1-14.
  14. Goran, M.I., Reynolds, K.D. and Lindquist, C.H., 1999. Role of physical activity in the prevention of obesity in children. International journal of obesity, 23(3), pp.S18-S33.
  15. Zhao, J. and Grant, S.F., 2011. Genetics of childhood obesity. Journal of obesity, 2011.
  16. Garver, W.S., Newman, S.B., Gonzales-Pacheco, D.M., Castillo, J.J., Jelinek, D., Heidenreich, R.A. and Orlando, R.A., 2013. The genetics of childhood obesity and interaction with dietary macronutrients. Genes & nutrition, 8(3), pp.271-287.
  17. 2022. [online] Available at: <http://www.health.ny.gov/prevention/nutrition/resources/obparnts.htm> [Accessed 19 July 2022].
  18. 2022. [online] Available at: <https://www.cdc.gov/healthyweight/children/> [Accessed 19 July 2022].
  19. Paes, S.T., Marins, J.C.B. and Andreazzi, A.E., 2015. Metabolic effects of exercise on childhood obesity: a current view. Revista Paulista de Pediatria, 33, pp.122-129.
  20. Sothern, M.S., 2001. Exercise as a modality in the treatment of childhood obesity. Pediatric Clinics of North America, 48(4), pp.995-1015.
Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:October 15, 2022

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