Updated September 16, 2026

You want the best for your child, including a healthy body and strong self-esteem. If you think your child might be overweight, it’s important to talk with your child's pediatrician.

Sheila Ravendhran, a pediatrician with Johns Hopkins Community Physicians, has special certification in addressing obesity. Ravendhran regards parents as partners working with her to support their child’s well-being, noting, “The doctor and the parents need to be united in wanting what’s best for kids.”

What is childhood obesity?

Childhood obesity is a serious and complex condition that is typically defined as having a body mass index (BMI) at or above the 95th percentile for the same age and sex.

BMI is a number based on the ratio between a person’s weight and height.

How common is obesity in children and teens?

In the United States, close to 20% of children ages 2 to 19 are living with obesity, including nearly 13% of children under age 6. Obesity is more common in certain populations, including:

• Hispanic and Black children.
• Children from middle income families.
• Children growing up in homes headed by adults with less education.

What are the risks associated with childhood obesity?

Healthcare professionals are seeing earlier onset in children and teens of:

• Type 2 diabetes.
• Heart and blood vessel disease.
• Obesity-related depression.
• Social isolation.

The longer a person suffers with obesity, the more significant obesity-related risk factors become.

How is childhood obesity diagnosed?

Diagnosis for childhood obesity will typically start with measuring the BMI; however, that number alone may not tell the full story.

Pediatricians assess a child’s BMI in relation to age and sex and examine how the child’s growth has changed over time. BMI is a screening measure rather than a complete description of health. Evaluation also considers these factors:

• Family history
• Nutrition
• Physical activity
• Sleep habits
• Medications
• Mental health
• Social circumstances
• Physical examination findings and appropriate laboratory testing

“There are lots of different ways to define and diagnose obesity, and what works for adults may not be applicable to kids, since their body composition changes,” Ravendhran says.

What are the treatment options for childhood obesity?

Children who meet the criteria for obesity should receive a comprehensive, family-centered evaluation and be offered appropriate treatment. 

It should be noted that there are reasons to proceed cautiously when helping children and teens lose weight. Underlying mental health issues can spark an eating disorder in vulnerable kids, and rapid weight loss can cause changes in metabolism, with an impact on a child’s growth and cognitive development.

The specific goals and intensity of obesity treatment depend on the child’s age, growth pattern, health conditions, development and family circumstances. For some younger children, the initial goal may be slowing weight gain or maintaining weight while they grow taller rather than actively losing weight.

Pediatric obesity treatment has evolved substantially. Evidence-based options include:

• Intensive health behavior and lifestyle treatment.
• Weight-management medication for eligible adolescents.
• Metabolic and bariatric surgery for selected adolescents with severe obesity.

Treatment should be individualized and should support healthy growth, nutrition, mental health and the child’s relationship with food and their body.

Nutrition and Exercise Treatment for Children and Teens

Ravendhran says treating obesity in children and teens starts with addressing nutrition and exercise. For teenagers, she may prescribe a gradual weight-loss regimen aiming for loss of about 2 pounds per month.

If, despite those measures, obesity becomes worse or the child develops weight-related health problems, the doctor may recommend intensified therapy. “A comprehensive team approach may expand to include mental health support and other subspecialists as indicated,” Ravendhran says.

Once age, BMI and the presence of multiple chronic conditions increase, the options for treatment begin to include medications and bariatric surgery.

Obesity Medications for Children and Teens

The FDA has approved several medications for chronic weight management in adolescents age 12 and older who meet specific criteria. These medications include:

• Semaglutide
• Liraglutide
• Phentermine/topiramate

Medication is used together with nutrition, physical activity and behavioral support and requires discussion with a medical team of its potential benefits, adverse effects and cost. Check with your insurance provider to see if these options are covered.

Another medication that may be prescribed is orlistat, though this is often not well-tolerated due to gastrointestinal side effects. Talk with your child’s pediatrician to learn more about this medication option.

Bariatric Surgery for Children and Teens

Bariatric surgery is a weight loss procedure that changes the digestive system’s structure in ways such as making the stomach smaller.

Adolescents age 13 and older with severe obesity — generally defined as a BMI at least 120% of the 95th percentile for age and sex — may be referred to a multidisciplinary pediatric metabolic and bariatric surgery center for evaluation. Referral does not mean that surgery will be recommended. The medical team considers the degree of obesity, associated health conditions, developmental readiness, family support, and the potential risks and benefits before deciding.

How can parents support healthy weight for their children and teens?

Firstly, well-child checks should be performed as often as the pediatrician recommends. During these visits, parents can ask about their child’s health and nutrition. “It can be hard for parents to know what to do when there’s so much misinformation out there,” Ravendhran adds.

Watch Food Intake 

“Foods marketed for kids are high in refined and processed carbohydrates and sugar, which can take a toll on the body’s sensitivity to insulin over time,” Ravendhran says. “These foods act on the brain’s pleasure centers while suppressing the sensation of fullness.”

Monitor Screen Time and Exercise

Staying active is key to maintaining a healthy weight, and the sedentary time that kids spend on computers, tablets and phones should be limited.

Media viewing guidance should account for the type of content being viewed, as well as the child’s: 

• Age.
• Development.
• Sleep habits.
• Physical activity.
• Schoolwork performance.
• Relationships.

Families can establish screen-free meals and bedtimes, avoid allowing screen time to displace sleep or activity, and create a family media viewing plan that applies to adults as well.

Mild to moderate exercise and activity are essential for all children, regardless of weight. Children and teens should generally receive at least 60 minutes of moderate-to-vigorous physical activity each day. Activities should be enjoyable, developmentally appropriate, and adapted when necessary for pain, mobility limitations or other medical conditions. Obesity alone does not require medical clearance before participating in physical activity.

Sugary Drinks

Reducing sugar-sweetened beverages can be a practical way to improve nutrition. Soda, sports drinks, sweetened teas and many blended drinks can provide substantial added sugar without being very filling.

Whole fruit is generally preferable to juice because its intact fiber makes it more satisfying and slows consumption. If families serve 100% fruit juice, portions should follow age-based pediatric guidance.

How can parents support children and teens’ mental health when discussing obesity?

Mental health is an important part of the treatment plan for obesity. Relaxation and stress-reduction techniques can have a positive effect on a child’s well-being and a physiological benefit to their insulin levels.

“Positive self-care and feeling good are great interventions for children’s general health and weight control,” Ravendhran says.

Adding yoga, for example, is a good option since it combines healthy exercise with addressing stress.

“I look at yoga and mindfulness training to break down some of the barriers that keep kids from being physically active,” she says. “I like yoga because it’s not competitive, and there are no judgments or expectations. It’s about what feels good in the moment and being thankful for the body you have.”

Conversations with children and teens should focus on health, growth, behaviors and well-being rather than appearance or blame. Parents can help by supporting healthy routines for the whole family and avoiding teasing, criticism or negative comments about a child’s body.

Weight stigma can harm children’s emotional and physical health, and it may discourage them from seeking care or participating in activities. An older study of children and adolescents with severe obesity evaluated at a specialty clinic reported that health-related quality of life was comparable to that reported by a sample of children with cancer. The study did not establish that weight stigma alone caused this finding, and the results should not be generalized to every child with overweight or obesity.

What is the long-term outlook for childhood obesity?

Obesity is a chronic disease that may require long-term support, much like asthma or diabetes. Treatment needs can change as children grow, and recurrence of excess weight gain does not mean that the child or family has failed.

“That does not mean that people will have to be on medications lifelong,” Ravendhran says, “but parents and caregivers should remember that there will be the potential for triggers as children mature that could result in them experiencing a relapse.”

Medically reviewed by Sheila Ravendhran, M.D., M.P.H.