Treatment

Treatment for childhood obesity is based on your child's age and whether he or she has other medical conditions. Treatment usually includes changes in your child's eating habits and physical activity level. In certain circumstances, treatment might include medications or weight-loss surgery.

Treatment for children with BMIs between the 85th and 94th percentiles (overweight)

The American Academy of Pediatrics recommends that children older than 2 whose weight falls in the overweight category be put on a weight-maintenance program to slow the progress of weight gain. This strategy allows the child to add inches in height but not pounds, causing the BMI to drop over time into a healthier range.

Treatment for children with BMIs at the 95th percentile or above (obesity)

Children ages 6 to 11 whose weight falls into the obesity category might be encouraged to modify their eating habits for gradual weight loss of no more than 1 pound (or about 0.5 kilogram) a month. Older children and adolescents who have obesity or severe obesity might be encouraged to modify their eating habits to aim for weight loss of up to 2 pounds (or about 1 kilogram) a week.

The methods for maintaining your child's current weight or losing weight are the same: Your child needs to eat a healthy diet — both in terms of type and amount of food — and increase physical activity. Success depends largely on your commitment to helping your child make these changes.

Healthy eating

Parents are the ones who buy groceries, cook meals and decide where the food is eaten. Even small changes can make a big difference in your child's health.

• Prioritize fruits and vegetables. When food shopping, cut back on convenience foods — such as cookies, crackers and prepared meals — which are often high in sugar, fat and calories.
• Limit sweetened beverages. This includes beverages that contain fruit juice. These drinks provide little nutritional value in exchange for their high calories. They can also make your child feel too full to eat healthier foods.
• Avoid fast food. Most of the menu options are high in fat and calories.
• Sit down together for family meals. Make it an event — a time to share news and tell stories. Discourage eating in front of a TV, computer or video game screen, which can lead to fast eating and lowered awareness of the amount eaten.
• Serve appropriate portion sizes. Children don't need as much food as adults do. Start with a small portion and your child can ask for more if they're still hungry. Allow your child to eat only until full, even if that means leaving food on the plate. And remember, when you eat out, restaurant portion sizes are often way too large.

Physical activity

A critical part of achieving and maintaining a healthy weight, especially for children, is physical activity. It burns calories, strengthens bones and muscles, and helps children sleep well at night and stay alert during the day.

Good habits established in childhood help adolescents maintain healthy weights And active children are more likely to become fit adults.

To increase your child's activity level:

• Limit TV time. Recreational screen time — in front of a TV, computer, tablet or smart phone — should be limited to no more than two hours a day for children older than 2. Children younger than 2 should have no screen time at all.
• Emphasize activity, not exercise. Children should be moderately to vigorously active for at least an hour a day. Your child's activity doesn't have to be a structured exercise program — the object is to get him or her moving. Free-play activities — such as playing hide-and-seek, tag or jump-rope — can be great for burning calories and improving fitness.
• Find activities your child likes. For instance, if your child is artistically inclined, go on a nature hike to collect leaves and rocks that your child can use to make a collage. If your child likes to climb, head for the nearest neighborhood jungle gym or climbing wall. If your child likes to read, then walk or bike to the neighborhood library for a book.

Medications

Medication might be prescribed for some children and adolescents as part of an overall weight-loss plan.

Weight-loss surgery

Weight-loss surgery might be an option for adolescents with severe obesity, who have been unable to lose weight through lifestyle changes. However, as with any type of surgery, there are potential risks and long-term complications. Discuss the pros and cons with your child's doctor.

Your doctor might recommend this surgery if your child's weight poses a greater health threat than do the potential risks of surgery. It's important that a child being considered for weight-loss surgery meet with a team of pediatric specialists, including an obesity medicine expert, psychologist and dietitian.

Weight-loss surgery isn't a miracle cure. It doesn't guarantee that an adolescent will lose their excess weight or be able to keep it off long term. And surgery doesn't replace the need for a healthy diet and regular physical activity.