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Excess weight in children

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A child is considered medically overweight and obese when they have too much fat in their body. Being overweight can cause health problems, especially in later life. It can also affect your child’s self-esteem and mental wellbeing.

About excess weight in children

Excess weight in children is a very common problem – it affects around one in three children by the time they leave primary school. As well as physical problems (see Complications below), being overweight can affect your child’s mental health. They may have low confidence or self-esteem, and can be bullied at school. This can potentially lead to eating disorders, and depression.

There’s a lot you can do to help your child reach a healthier weight. This includes making some healthy changes to their diet, and encouraging them to be more active. This works best if you get the whole family involved.

Is my child overweight?

Children are all different shapes and sizes. Boys are different from girls and your child will grow and develop at their own pace. This constant change and variation can make it hard to know if your child is a healthy weight. But your child may be at risk of being overweight if you notice they:

  • regularly eat the same size food portions as yourself or an older sibling or ask for more food during meals
  • wear clothes made for older children because they fit better
  • struggle to keep up with their friends when playing or at school during physical education (PE) lessons

If you’re concerned about your child’s weight, contact your GP surgery. They’ll be able to compare your child’s weight to what’s expected at that age.

How the GP works out if your child is a healthy weight

Your GP or health visitor will calculate your child’s body mass index (BMI) from their height and weight. There are online sites that calculate body mass index and tell you whether you are a healthy weight, but these are just for adults. Growing children need to be compared to other children the same age and sex. So a GP will use charts to see how your child’s BMI compares with what’s expected. You can ask them to show you the chart, and explain how they tell if your child is overweight or obese (very overweight).

The GP or health visitor will also check for other health conditions related to being overweight. They might measure your child’s waist too. If they think there’s an issue with your child’s weight, they’ll ask about their diet and how active they are. They may also ask about any problems that may be caused by their weight. Your GP will probably also ask if anyone else in the family is overweight, as it can often be an issue that affects families.

Causes of child obesity and being overweight

Different things can work together to make children overweight.

The environment we live in can make it hard to keep to a healthy weight. High-calorie foods are easily available, and often cheaper than healthy alternatives. And there are many ways to entertain ourselves with screens, which can lead to hours of sitting or lying still.

Children, like adults, will tend to put on weight if they take in more energy (calories) than they use up. If your child is overweight, they may:

  • eat a diet with large amounts of carbohydrates and high-fat foods
  • drink sugary drinks
  • have portion sizes that are larger than they need
  • not getting enough exercise
  • spend a lot of time watching television, playing video games or using a computer

Being overweight also runs in families. If a child is overweight it’s likely their parents are too. This is partly genetic, but may also be due to sharing the same eating and activity patterns within the family.

Other things can affect whether a child becomes overweight. For instance, it may be linked to how much sleep they get. Children who have short sleep times may be more likely to become overweight.

Some medical conditions and medicines will make a child put on weight. A doctor can tell you more about these if they think this affects your child. And some inherited (genetic) conditions can cause obesity but they’re very rare.

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Lifestyle changes for reaching a healthier weight

If your child is overweight, take action now so you can improve their health in the future. The best way for anyone to achieve and keep to a healthy weight is to make lifestyle changes.

  • Make healthy changes to their diet
  • Encourage them to be more physically active
  • Reduce the amount of time they sit still (sedentary)

Think about changes you can make as a family to take on healthier eating habits and become more active. If you do this together, it will work better long term because it helps you all make permanent changes to your lifestyle. And don’t forget, children copy adults. If they see you eating well and exercising more, they’re more likely to join in.

You may find it helps to set goals for your child, with lots of reward and praise when they meet them. Choose rewards that aren’t based on food. Set smaller goals to start with, so that they can achieve them easily and are encouraged to carry on. And make sure your child knows that they’re loved and important, no matter what.

Food and drink

Aim for the whole family to eat a healthy balanced diet, rich in fruit and vegetables. Avoid ‘fad diets’ or diets that are very restricted.

Here are some more tips to help your child reach and keep to a healthy weight.

  • Keep an eye on portion size – start with a small portion and let your child ask for more if they’re still hungry.
  • Don’t insist that your child clears their plate at each meal.
  • Have regular meals, to help your child avoid snacking and grazing.
  • If possible, have more meals where the family eats together as a social occasion.
  • Discourage eating in front of the TV or other electronic device.
  • Replace sugary drinks with water. You can use sparkling water if your child likes fizzy drinks.
  • Choose healthy snack alternatives if your child is hungry between meals.
  • Ask your child to help you write shopping lists so you can choose healthier options together.
  • Limit fast food and takeaway food which are often high in calories.

Physical activity

Lots of children spend their time on computers or watching television and playing video games, rather than exercising. Try to limit these screen time activities. Some experts say children should have no more than two hours of screen time a day.

There are guidelines on how much physical activity children need to be healthy.

  • Children under five should be active for at least 180 minutes per day. This includes things like walking, dancing, skipping, jumping and playing in the playground.
  • Children over five need to do at least 60 minutes a day of moderate to vigorous physical activity. This includes sports and games, but also walking, running, swimming or any physical activity your child enjoys.

Again, it will help to get the whole family involved – find ways to have fun being active with your kids. Remember, exercise can bring many health benefits to your child. Getting children active from an early age can start healthy habits that may last a lifetime.

Referral to a specialist

The most important way to combat childhood obesity is to make changes to your child’s lifestyle.

A GP may suggest that you and your child join a local programme to help them reduce weight and increase their exercise. These weight management programmes are designed by a range of experts. These include dietitians, physical activity specialists and doctors and nurses who work with children. They can also help you to learn more about diet and nutrition, and to support and motivate your child.

The weight programme will come up with a tailored plan based on your child’s age and BMI. Losing weight isn’t always a good thing in children because they’re still growing. The best thing may be to aim to keep your child’s weight the same. As your child grows taller and their weight stays the same, their BMI will become lower.

In some circumstances, your GP may refer your child to see a paediatrician (a doctor who specialises in child health). This may be if there’s a medical condition linked to your child’s weight problems.

Medicines for weight loss

Medicines for weight loss aren’t recommended for children under 12, and are very rarely used in children. They can only be prescribed in a specialist clinic. A doctor will only prescribe medicines if your child is very overweight and has other health problems caused by their weight. And these will be in combination with changes to their diet and exercise.

Surgery for weight loss

Weight-loss surgery for children is very rarely done and never for younger children. It’s only considered in exceptional circumstances. Speak to your child’s specialist doctor if you would like to discuss this further.

Complications of being overweight or obese

Being overweight can cause health problems for your child, both now and in the future.

Being overweight can also make your child feel unhappy and affect the way they feel about themselves.

Like adults, children become overweight when they take in more energy (calories) than they use up. There are many reasons why this can happen. High-energy foods are easily available, and often cheaper than healthy alternatives. Children may eat too many of these, or have larger portions of food than they need. And if they don’t get enough exercise, or spend too long looking at screens, they don’t use up this energy.

For more information, see our causes of child obesity and being overweight section.

Excess weight and obesity are measured using a calculation called the body mass index (BMI). This uses the height and weight of the child. In growing children, it’s important to compare their BMI with other children of the same age and sex using charts. Plotting your child’s BMI on these charts will help your GP or practice nurse see whether your child is overweight. BMI calculators online don’t apply to growing children.

For more information, see our ‘Is my child overweight?’ section.

If your child is overweight or obese, it can have a number of effects on their development. It can affect their self-esteem and the way they feel about themselves – they may feel unhappy. It can also have physical effects and cause health conditions, such as asthma, high blood pressure, high cholesterol, fatty liver disease and diabetes.

For more information, see our complications of child obesity and being overweight section.

The best way for a child to lose weight is to make changes to their lifestyle. Eat a healthy balanced diet that includes plenty of fruit and vegetables and portion sizes appropriate for their age. And cut out sugary drinks. Encourage your child to be more active too and reduce the amount of time they sit still in front of screens. Play more games and do whatever your child enjoys, maybe dancing, skipping or jumping. Even walking helps.

For more information, see our lifestyle changes for reaching a healthier weight section.

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