Medical considerations

"Overweight" and "at risk of overweight" are terms sometimes used when referring to children who weigh more than expected. Doctors use the U.S. Centers for Disease Control and Prevention growth charts or the body mass index (BMI) to measure a child's weight in relation to his or her height. To find out your child's BMI, use this Interactive Tool: Is Your Child at a Healthy Weight?

If you have concerns that your child is overweight or at risk of becoming so, first ask your doctor to review your child's growth charts and medical history with you.

• If your child's BMI has been high on the growth chart from birth, this may be his or her healthy size and growth rate. He or she may simply be bigger than other children of the same gender and age.
• If your child's BMI pattern has suddenly jumped from a lower range to a higher range on the growth chart, your child may be at risk of becoming overweight. Your doctor will carefully track growth over time, watching for a change in the rate of weight gain.
• If your family has a history of obesity, your child has a higher risk of becoming overweight.

Sometimes a child's BMI and weight can increase without a child being at risk of having too much body fat. For instance, before and during puberty it is normal for children to have a significant gain in weight before they begin to grow in height. Also, children who are very muscular (such as children who are very active in sports), may have a high BMI but have normal or even lower-than-normal amounts of body fat.

If your child's BMI and growth pattern suggest a weight problem, your doctor will give your child an exam that looks for health problems that can cause weight gain. This may include questions about eating and physical activity habits. Regular checkups for health problems will also be important over time.

Weight management goals for the overweight child

Use the division of responsibility. Your job is to offer nutritious food choices at meals and snack times. You decide what, where, and when your family eats. Your child's job is to choose how much he or she will eat of the foods you serve. Your child even gets to decide whether to eat.

Do not restrict food. Food restriction causes children to ignore their internal hunger gauges. Children who have their food restricted often end up heavier, because they become anxious about food and eating. Anxiety about not getting enough to eat will often lead a child to overeat whenever he or she gets a chance. This causes the child to become less in touch with how hungry or full he or she is, and the child becomes more likely to eat more than his or her body needs. This can also happen when children or teens follow weight-loss diets. It doesn't work to put a child on a diet-you get the opposite effect.