Introduction

Overweight is a fast growing health issue affecting children and adolescents today. Overweight in children and adolescents increased dramatically during the late 1990s. Results from the 1999-2000 National Health and Nutrition Examination Survey (NHANES), that used measured heights and weights, indicate that an estimated 15 percent of children and adolescents ages 6-19 years are overweight. This represents a 4 percent increase from the overweight estimates of 11 percent obtained from NHANES III (1988-94). The rate of overweight has doubled for children and adolescents in the last 20 years. For more information on the trends in childhood overweight.

Overweight in children and adolescents is generally caused by lack of physical activity, unhealthy eating patterns, or a combination of the two, with genetics and lifestyle both playing important roles in determining a child's weight. Television, computer and video games contribute to children's inactive lifestyles; 43% of adolescents watch more than 2 hours of television each day. Children, especially girls, become less active as they move through adolescence. Learn about programs that increase physical activity in children.

Health consequences related to overweight can begin in childhood or adolescence; overweight children and adolescents are at increased risk for various chronic diseases in later life. Overweight adolescents have a 70% chance of becoming overweight or obese adults. This increases to 80% if one or more parent is overweight or obese. To read more about the risks associated with overweight in children and adolescents see The Surgeon General's Call To Action To Prevent and Decrease Overweight and Obesity 2001.
Purpose

The purpose of this web site is to provides information and links to resources on the subject of overweight in childhood and adolescence that can be used to promote awareness and education, improve public health practice, and strengthen public policy.

Definition of childhood overweight and risk of overweight

Expert committees recommend the use of body mass index (BMI) to screen for overweight and risk of overweight in children and adolescents. BMI is an index of weight and height that is defined as body weight in kilograms divided by height in meters squared (kg/m²). For children, BMI is gender and age specific; therefore BMI-for-age is the measure used for children ages 2 to 20 years. Cutoff criteria are based on the 2000 Centers for Disease Control and Prevention’s BMI-for-age-growth charts for the United States. Children with BMI-for-age values at or above the 95th percentile of the gender-specific BMI growth charts are categorized as overweight and those with BMI values between the 85^th and 95^th percentiles are categorized as at risk of overweight. Click here for more information on the CDC growth charts and BMI-for-age.

Advocacy & Education

APHA Overweight Childhood Policy

Funding Resources

International Resources

Policy & Legislation

Resources

Is my child overweight? How can I help my overweight child? Be supportive Encourage healthy eating habits Healthy snack foods for your child to try Encourage daily physical activity Discourage inactive pastimes Fun things for you and your child to do besides watching TV Be a positive role model Find more help HEALTHY EATING AND PHYSICAL ACTIVITY habits are key to your child’s well-being. Eating too much and exercising too little can lead to overweight and related health problems that can follow children into adult years. You can take an active role in helping your child—and your whole family—learn healthy eating and physical activity habits that may last for a lifetime. Top
Is my child overweight?	Because children grow at different rates at different times, it is not always easy to tell if a child is overweight. If you think that your child is overweight, talk to your health care provider. Your health care provider can measure your child’s height and weight and tell you if your child is in a healthy range. Top
How can I help my overweight child? *Do not put your child on a weight-loss diet unless your health care provider tells you to. If children do not eat enough, they may not grow and learn as well as they should.*	Involve the whole family in building healthy eating and physical activity habits. It benefits everyone and does not single out the child who is overweight. Try to: Be supportive Encourage healthy eating habits Encourage daily physical activity Discourage inactive pastimes Be a positive role model. Top
Be supportive	Tell your child that he or she is loved, is special, and is important. Children’s feelings about themselves often are based on their parents’ feelings about them. Accept your child at any weight. Children will be more likely to accept and feel good about themselves when their parents accept them. Listen to your child’s concerns about his or her weight. Overweight children probably know better than anyone else that they have a weight problem. For this reason, overweight children need support, acceptance, and encouragement from parents. Top
Encourage healthy eating habits	Buy and serve more fruits and vegetables (fresh, frozen, or canned). Let your child choose them at the store. Skip buying soft drinks and high fat/high calorie snack foods like chips, cookies, and candy. If children do not see these foods at home, they will be less likely to ask for them and you will not have to say “no.” Choose healthy snack foods. Eat breakfast every day. Skipping breakfast can leave your child hungry, tired, and looking for less healthy foods later in the day. Plan healthy meals and eat together as a family. Planning the week’s meals and grocery shopping can help save you time and money. Sitting together at meal times helps children learn to enjoy a variety of foods. Eat fast food less often. When you visit a fast food restaurant, take advantage of the healthful options offered. Here are more tips to encourage healthy eating habits: Do not get discouraged if your child will not eat a new food the first time it is served. Some kids will need to have a new food served to them 10 times or more before they will eat it. Try not to use food as a reward when encouraging kids to eat. Promising dessert to a child for eating vegetables, for example, sends the message that vegetables are less valuable than dessert. Kids learn to dislike foods they think are less valuable. Do not try to control the amount of food your child eats. It is up to you to provide your child with healthy meals and snacks, but your child should be allowed to choose how much food he or she will eat. Top
Healthy snack foods for your child to try	Fresh fruit Fruit canned in juice or light syrup, such as mandarin oranges, peaches, or pineapples Small amounts of dried fruits such as raisins, apple rings, or apricots Fresh vegetables such as baby carrots, cucumber, zucchini, or tomatoes cut and served with low-fat salad dressing for dipping Reduced fat cheese served with whole-wheat crackers Low-fat yogurt with fruit Bagel spread with small amount of peanut butter Graham crackers, animal crackers, or low-fat vanilla wafers Tortilla spread with low-fat refried beans Foods that are small, round, sticky, or hard to chew, such as raisins, whole grapes, hard vegetables, hard chunks of cheese, nuts, seeds, and popcorn can cause choking. These foods are not good choices for preschool age children. Top
Encourage daily physical activity *Fun physical activities for your child to try:* *Riding a bike* *Climbing on a jungle-gym* *Swinging on a swing set* *Jumping rope* *Playing hopscotch* *Bouncing a ball*	Like adults, kids need daily physical activity. Here are some ways to help your child move every day: When appropriate and safe, let your child walk places such as to school, the store, or to friends’ houses. Encourage your child to take physical education (PE) class at school, if available. Encourage your child to join a sports team or class, such as soccer, dance, basketball, or gymnastics. Be active together as a family. Assign active chores such as making the beds, washing the car, or vacuuming. Plan active outings such as a trip to the zoo or a walk through a local park. Because his or her body is not ready yet, do not encourage your pre-adolescent child to participate in adult-style physical activity such as long jogs, using an exercise bike or treadmill, or lifting heavy weights. FUN physical activities are best for kids. Kids need a total of about 60 minutes of physical activity a day, but this does not have to be all at one time. Short 10- or even 5-minute bouts of activity throughout the day are just as good. Top
Discourage inactive pastimes	Set limits on the amount of time your family spends watching TV and videos, and playing video games. Help your child find FUN things to do besides watching TV. Your child may find that creative play is more interesting than television. Read together instead of watching TV. Read at home or volunteer to read to others. Read to adults and children at your local hospital or sign up to help people learn to read. Encourage your child to get up and move during commercials and discourage snacking when the TV is on. Top
Fun things for you and your child to do besides watching TV	Take turns acting out favorite books or stories, or singing along to favorite songs. Use old clothes for costumes. Make instruments out of kitchen items and dance to the music you make. Shake a jar filled with macaroni and beat on a plastic bowl with wooden spoons. Play schoolyard games at home. Make a hopscotch on the floor with masking tape, play follow-the-leader or “Simon says,” and toss balls into a basket. Do a family art project. Trace cookie cutters on paper, make masks out of paper bags, design a paper airplane, or cut and glue pictures to a piece of paper. Go camping at home. Make a tent by putting a sheet over a table or use a big box as a tent, make a sleeping bag from a blanket, and sing “campfire” songs. Top
Be a positive role model	Children are good learners and they learn what they see. Choose healthy foods and active pastimes for yourself. Your children will see that they can follow healthy habits that last for the rest of their lives. Top
Find more help	Your health care provider Ask your health care provider for brochures, booklets, or other informational materials about healthy eating, physical activity, and weight control. Your health care provider may be able to refer you to other health care professionals who work with overweight children, such as registered dietitians, psychologists, and exercise physiologists. Your local library Ask a librarian to help you locate books about weight control for children. Books should be written by a health professional and should encourage the whole family to build healthy eating and physical activity habits. Avoid books that promise quick results or encourage fad diets. Many libraries sponsor talks about a variety of topics, including health. Ask a librarian if any talks about healthy eating, physical activity, or weight control for children are scheduled. The Internet Look for websites about healthy eating, physical activity, and weight control for children. When searching the Internet, avoid websites that promise quick results, encourage fad diets, or ask you to buy something such as pills, food, or exercise equipment. Here are some resources that you can look at on the Internet: The Food Guide Pyramid can guide you in making healthy food choices for your family. The Food Guide Pyramid for Young Children 2 to 6 Years Old can help you teach your young child what to eat to grow and stay healthy. Healthy Eating and Physical Activity Across Your Lifespan: Helping Your Child is a helpful, in-depth brochure from the Weight-control Information Network (WIN). Kidnetic.com provides healthy eating and physical activity tips for kids and parents. KidsHealth.org provides information about nutrition and fitness for kids. Smart-mouth.org offers ideas and recipes for healthier eating. Your Child’s Weight: Help Your Child with Successful Weight Management is a useful brochure from the Children’s Nutrition Research Center at Baylor College of Medicine. County extension office Locate the cooperative extension office for your county by looking in the government section of your phone book under the name of your county. Your extension office may offer free or low-cost materials or classes in cooking and nutrition. Your local recreation center or community center Sign up for physical activity classes or programs for families or children. Weight-control program You may want to think about a treatment program if: You have changed your family’s eating and physical activity habits and your child has not reached a healthy weight. Your health care provider has told you that your child’s health or emotional well-being is at risk because of his or her weight. To locate a weight-control program for your child, you may wish to contact your local hospital, university, or college. The overall goal of a treatment program should be to help your whole family adopt healthy eating and physical activity habits that you can keep up for the rest of your lives. Here are some other things a weight-control program should do: Include a variety of health care professionals on staff: doctors, RDs, psychiatrists or psychologists, and/or exercise physiologists. Evaluate your child’s weight, growth, and health before enrolling in the program and watch these factors while enrolled. Adapt to the specific age and abilities of your child. Programs for 4-year-olds should be different from those for 12-year-olds. Help your family keep up healthy eating and physical activity behaviors after the program ends. Top
	Weight-control Information Network 1 Win Way Bethesda, MD 20892-3665 Tel: (202) 828-1025 or 1-877-946-4627 Fax: (202) 828-1028 E-mail: win@info.niddk.nih.gov The Weight-control Information Network (WIN) is a national service of the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, which is the Federal Government’s lead agency responsible for biomedical research on nutrition and obesity. Authorized by Congress (Public Law 103-43), WIN provides the general public, health professionals, the media, and Congress with up-to-date, science-based health information on weight control, obesity, physical activity, and related nutritional issues. WIN answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about weight control and related issues. Publications produced by WIN are reviewed by both NIDDK scientists and outside experts. This fact sheet was also reviewed by Leonard Epstein, Ph.D., Professor of Pediatrics, Social and Preventive Medicine, and Psychology, University of Buffalo School and Medicine and Biomedical Sciences, and Gladys Gary Vaughn, Ph.D., National Program Leader, Cooperative State Research, Education, and Extension Services, U.S. Department of Agriculture (USDA). This e-text is not copyrighted. WIN encourages users of this e-pub to duplicate and distribute as many copies as desired.
	NIH Publication No. 03-4096 April 2003 e-text posted: June 2003 Web Design & Hosting by Super Star Enterprises Web Design & Hosting 1-866-478-9568 Top