how to prevent childhood obesity

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Vol. 3 No. 1 (2026)

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Submitted
September 14, 2025
Published
January 5, 2026

Copyright (c) 2026 The American Journal of Patient Health Info

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Childhood Obesity Prevention | Raising Healthy Kids

https://doi.org/10.69512/ajphi.v3i1.154
Arohi Adhikari
B & B Hospital, Gwarko, Kathmandu, Nepal
Jwala KC
Western Michigan University Homer Stryker MD School of Medicine, MI, USA
https://orcid.org/0009-0006-3860-1647
Kaveri Karki
Manmohan Memorial Community Hospital, Sinamangal, Kathmandu, Nepal
https://orcid.org/0009-0004-7001-2573
Arati Bartaula
Health Insurance Board, Babarmahal, Kathmandu, Nepal
https://orcid.org/0009-0001-6503-6034

Corresponding Author(s) : Arohi Adhikari

arohi.adhikary789@gmail.com

The American Journal of Patient Health Info, Vol. 3 No. 1 (2026)

Abstract


  1. In the U.S, about one in five children is living with obesity, and the numbers are rising quickly.

  2. A child is overweight if their BMI is higher than 85% of kids their age and sex, and obese if it is higher than 95%.

  3. Poor food choices, low physical activity, long screen time, short sleep, genetics, early life factors, family habits, and some medications can lead to extra weight.

  4. Childhood obesity affects the heart, metabolism, liver, bones, hormones, and mental health, and raises the risk of diabetes and heart disease later.

  5. Children should eat 5 fruits and vegetables, have no more than 2 hours of screen time, get 1 hour of activity, and drink 0 sugary drinks each day.

Keywords

Body Mass Index Childhood Obesity Screen Time Physical Activity Diet
Adhikari, A., KC , J., Karki, K., & Bartaula, A. (2026). Childhood Obesity Prevention | Raising Healthy Kids. The American Journal of Patient Health Info, 3(1). https://doi.org/10.69512/ajphi.v3i1.154
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References
  1. Kerr JA, Patton GC, Cini KI, et al. Global, Regional, and National Prevalence of Child and Adolescent Overweight and Obesity, 1990–2021, With Forecasts to 2050: A Forecasting Study for the Global Burden of Disease Study 2021. Lancet. 2025;405(10481). Available from: |Full Text|
  2. Centers for Disease Control and Prevention. Childhood Obesity Facts. CDC. 2024 Apr 2. Available from: |Full Text|
  3. American Academy of Pediatrics. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity [Internet]. AAP.org; 2023. Available from: |Full Text|
  4. Endocrine Society. Pediatric Obesity—Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017 Jan 31; Available from: |PubMed| |Full Text|
  5. Jebeile H, Kelly AS, O’Malley G, Baur LA, et al. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol. 2022 May;10(5):351–365. Available from: https://www.sciencedirect.com/science/article/pii/S221385872200047X
  6. Lieb DC, Snow RE, DeBoer MD. Socioeconomic Factors in the Development of Childhood Obesity and Diabetes. Clin Sports Med. 2009 Jul;28(3):349–378. Available from: |PubMed|
  7. Cardel MI, Atkinson MA, Taveras EM, et al. Obesity Treatment Among Adolescents. JAMA Pediatr. 2020 Jun 1;174(6):609–17. Available from: |PubMed|
  8. Mitchell EA, Stewart AW, Braithwaite I, et al. Factors Associated With Body Mass Index in Children and Adolescents: An International Cross-Sectional Study. PLoS One. 2018 May 2;13(5):e0196221. Available from: |PubMed| |Full Text|
  9. UF Health. Causes and Risks for Obesity in Children [Internet]. UFHealth.org; 2022. Available from: |Full Text|
  10. Han JC, Lawlor DA, Kimm SY. Childhood Obesity. Lancet [Internet]. 2010 May;375(9727):1737–48. Available from: |PubMed|
  11. Robinson TN. Screen Media Exposure and Obesity in Children and Adolescents. Pediatrics. 2017 Nov;140(Suppl 2):S97–S101. Available from: |PubMed| |Full Text|
  12. Buchanan LR, et al. Reducing Recreational Sedentary Screen Time. Am J Prev Med. 2016 Mar;50(3):402–415. Available from: |PubMed|
  13. Centers for Disease Control and Prevention. Tips to Support Healthy Routines for Children and Teens [Internet]. Healthy Weight and Growth; 2024 May 13. Available from: |Full Text|
  14. Hampl SE, Hassink SG, Skinner AC, et al. Executive Summary: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics. 2023 Jan 9;151(2). Available from: |PubMed| |Full Text|
  15. Yuksel HS, Sahin FN, Maksimovic N, et al. School-Based Intervention Programs for Preventing Obesity and Promoting Physical Activity and Fitness: A Systematic Review. Int J Environ Res Public Health. 2020 Jan;17(1):[page or article number]. Available from: |PubMed| |Full Text|
  16. American Academy of Pediatrics. ‘5-2-1-0’ Implementation Through Community Partnerships [Internet]. AAP.org; [cited 2026 Jan 6]. Available from: |Full Text|
  17. Smith JD, St George SM, Prado G. Family-Centered Positive Behavior Support Interventions in Early Childhood to Prevent Obesity. Child Dev. 2017 Feb;88(2):427–435. Available from: |PubMed| |Full Text|
  18. Khalsa AS, Kharofa R, Ollberding NJ, et al. Attainment of ‘5-2-1-0’ Obesity Recommendations in Preschool-Aged Children. Prev Med Rep. 2017 Dec;8:79–87. Available from: |PubMed| |Full Text|
  19. Christie D, Channon S. The Potential for Motivational Interviewing to Improve Outcomes in the Management of Diabetes and Obesity in Paediatric and Adult Populations: A Clinical Review. Diabetes Obes Metab. 2014 Sep;16(5):381–387. Available from: |PubMed| |Full Text|
  20. Chilman L, Kennedy-Behr A, Frakking T, et al. Picky Eating in Children: A Scoping Review to Examine Its Intrinsic and Extrinsic Features and How They Relate to Identification. Int J Environ Res Public Health. 2021 Aug 27;18(17):9067. Available from: |PubMed| |Full Text|
  21. Umekar S, Joshi A. Obesity and Preventive Intervention Among Children: A Narrative Review. Cureus. 2024 Feb;16(2):[page or article number]. Available from: |PubMed| |Full Text|
  22. City University of New York. My Child Plate Planner [Internet]. 2021 Jun [cited 2025 Aug 16]. Available from: |Full Text|
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Arohi Adhikaria, Jwala KCb, Kaveri Karkic, Arati Bartaulad

a B & B Hospital, Gwarko, Kathmandu, Nepal

b Western Michigan University Homer Stryker MD School of Medicine, MI, USA

c Manmohan Memorial Community Hospital, Sinamangal, Kathmandu, Nepal

d Health Insurance Board, Babarmahal, Kathmandu, Nepal

Introduction

Childhood obesity is becoming more common in classrooms, hospitals, and homes. It occurs when children carry more weight than is healthy for their age. Nearly one in five kids in the United States (U.S.) faces this challenge. Poor food choices and limited activity can lead to excess weight and put their health at risk. [1,2]

When Is a Child Overweight or Obese?

For children aged two to 18 years, doctors use a measurement called body mass index (BMI) to check if a child’s weight is healthy for their age and height.

  • Overweight means a child’s BMI is higher than 85% but less than 95% of children of the same age and sex.
  • Obesity means a child’s BMI is higher than what 95% of children of the same age and sex have. [3,4]

How Daily Habits Lead to Obesity in Children?

The following points explain how everyday routines affect a child’s weight:

Figure 1.

  • Diet: Frequent intake of sugary snacks, sodas and processed foods adds excess calories with little nutrition. When fruits, vegetables and other healthy foods are missing from the diet, weight gain becomes more likely.  Irregular meal times frequent snacking and fewer home cooked meals can slowly push calorie intake beyond what the body needs. [5,6]
  • Genetics and Early Life: A child’s genes play a big role in weight—about 40–70% of differences in children’s weight come from genetics. [7] Children born to mothers who are overweight, gain too much weight during pregnancy, have diabetes, or smoke are more likely to gain extra weight. [8] Exposure to certain chemicals in the womb may also increase this risk. After birth, the first months of life are especially important. Breastfeeding can offer a gentle protective effect, while introducing solid foods too early or feeding without responding to a baby’s natural hunger cues may increase risk.
  • Family and Environment: Most parents have busy work schedules and other responsibilities, so they have less time to prepare healthy and home-cooked food. Children then turn to fast food and packaged meals more often. The place where a child grows up also matters. Neighborhoods with limited parks or safe play areas reduce chances for running and active play. Less movement over time increases the risk of obesity. [9]
  • Medication and Medication-Related Factors: Most overweight children do not have a medical condition, but some medications (like insulin, steroids, certain antidepressants, anticonvulsants, and antipsychotics) can cause weight gain. Children with certain special health needs (autism, Attention-Deficit/Hyperactivity Disorder (ADHD), developmental or physical disabilities) may be more likely to gain extra weight. If a child keeps gaining weight but stops growing in height, doctors may check for hormone problems. [10]
  • Screen Time and Obesity: Long hours spent watching television or using phones, tablets and video games replace time that could be spent moving and playing. Kids often enjoy having snacks or eating larger portions while watching or using screens. This makes it easy to take in extra calories without noticing.
  • Sleep and Obesity: Too little sleep disrupts hormones that control hunger and fullness. Children may feel hungry more often and choose higher calorie foods. Short sleep also encourages late night snacking and eating outside regular meal times. [11]

Growing Up Sitting: The Health Cost of Screen Heavy Childhood

Screen media exposure is one of the important factors causing obesity in childhood. Kids today spend hours on television (TV), tablets, smartphones, and computers.

Screen time doesn’t just mean sitting still- the constant ads for chips, soda, and fast food create cravings and push kids towards unhealthy choices. That's why it’s so important for families to set healthy limits and guide what children watch.

The American Academy of Pediatrics recommends no screen-based entertainment for children under two years. For children over two, recreational screen time should stay under two hours per day. Despite these guidelines, U.S. children aged eight to 18 spent an average of 7.2 hours a day on screens in 2009. This included 4.5 hours watching TV, 1.5 hours using the computer for fun, and 1.2 hours playing video games, not counting schoolwork or phone use. [12]

How Do Early Checkups Help Your Child Stay Healthy?

Regular checkups give doctors a chance to catch concerns early, answer family questions, and guide healthier choices.

During each well-child visit, your child’s doctor measures BMI and compares it with growth charts for their age and sex. This helps identify obesity early and gives parents advice or interventions before it becomes a bigger health problem. [13]

Health Complications of Childhood Obesity

Childhood obesity can affect a child’s heart, metabolism, liver, bones, breathing, hormones, and mental health.

Figure 2.

  • Heart and Metabolism: Nearly half of children with obesity have abnormal blood lipid levels. Children with obesity often have high cholesterol and high blood pressure. One in five adolescents has prediabetes. Obesity increases the risk of type 2 diabetes.
  • Liver and Metabolic Health: Fat can build up in the liver, causing nonalcoholic fatty liver disease. Severe obesity can lead to serious liver problems. Children with obesity may have metabolic syndrome, where multiple health problems occur together.
  • Bones and Sleep: Obesity increases the risk of sleep apnea and bone problems such as Blount disease or slipped hip.
  • Hormones and Reproductive Health: Obesity can affect hormones and may cause conditions like polycystic ovarian syndrome in girls.
  • Mental Health: Children with obesity are at higher risk for stress, depression, and low self-esteem.
  • Long-Term Risks: Children with obesity are more likely to remain obese as teenagers and adults. Obesity in childhood increases the risk of heart disease, diabetes, and other health problems in adulthood. [14]

From Playtime to Mealtime: How Families Can Curb Childhood Obesity

Families have the biggest influence on a child’s health. Simple activities like cooking together, taking a walk after dinner, or involving kids in active chores—vacuuming, washing the car, or raking leaves—can make a real difference.

Children spend much of their day at school, so staying active there is important. Physical Education (PE) classes, short activity breaks, walking or biking to school, and active play during lunch or recess help children stay strong, alert, and healthy. [15]

The ‘Let’s Go! 5-2-1-0’ program has been promoted locally and nationally to help families adopt healthy habits. It focuses on four simple daily goals: [16]

Figure 3.

  • 5 → Fill your plate with five colorful fruits and veggies every day. Colorful fruits and veggies give kids the nutrients they need to grow strong and stay healthy.
  • 2 → Keep fun screen time to two hours or less so there’s more time to play, learn, and connect.
  • 1 → Get at least one hour of moderate to vigorous physical activity every day.  Encourage running, dancing, playing outside, or riding a bike every day. [17]
  • 0 → Avoid sugary drinks. Replace soda and sports drinks with water or milk to keep children hydrated and support healthy growth. [18]

Motivational interviewing is a helpful way to support children and families in making healthier choices. Instead of telling kids what they “should” do, providers gently guide them to explore their own feelings about change. By listening, reflecting, and asking thoughtful questions, providers help children and parents discover their personal reasons to take action. [19]

Parents play a key role too. They can encourage good habits by praising healthy choices, setting clear expectations, and making nutritious options easy to access. Experts call this approach positive behavior support (PBS).

Figure 4.

Figure: Influencing Factors and Effects Of Childhood Obesity [14]

5 Effective Ways to Handle Your Child’s Picky Eating

Many children go through a phase of picky eating, which can be stressful at mealtimes. Here are five effective strategies to guide your child toward better eating habits.

Figure 5.

1. Share Responsibility at Mealtime

  • Parents decide what, when, and where food is offered.
  • Children decide what and how much to eat from those options.
  • Avoid pressuring, bribing, or restricting foods.

2. Offer Foods Again and Again

  • Children may need eight to ten times to accept a new food.
  • Pair new foods with favorites or dips to make them more appealing.
  • Model enjoyment—eat the foods yourself and show curiosity.

3. Involve Your Child in Food

  • Let children help choose, grow, or prepare meals.
  • Participation increases interest and willingness to try new foods.

4. Make Family Mealtimes a Priority

  • Eat together at least 3 times per week.
  • Family meals reduce fussiness, support healthy weight, and improve food enjoyment.

5. Watch for Nutritional Gaps

  • Most picky eaters grow normally, but some may miss nutrients like iron, zinc, or fiber. [20]

Figure 6.

Figure: Different ways to control childhood obesity. [21]

Figure 7.

Figure showing types and amounts of food considered as a healthy diet. [22]

Conclusion

Childhood obesity is more than a number on a scale. It shapes the health, happiness and confidence of our children for years to come. Nearly one in five children in the U.S. faces this challenge, and every parent teacher and doctor can make a difference. Small daily choices make a big difference. More time to play outdoors, meals rich in fruits and vegetables, limits on screen time, and regular checkups help children form healthy habits that last. Families and communities working together can help kids grow strong, active, and full of energy.

Questions To Ask Your Doctor

  1. Does my child’s weight fall within a normal range for their age?
  2. How often should my child be screened for weight concerns?
  3. What are healthy growth goals for my child?
  4. How much time can we allow the screen for my child?
  5. What small changes would make the biggest difference in my child’s daily routine?

Conflicts of Interest

The authors declare no conflicts of interest related to this work.

Peer Reviewed By

Dipsal Timila, MD

Department of Pediatrics, Sparrow Hospital, Lansing, Michigan, USA

Acknowledgment

The authors utilized generative artificial intelligence(ChatGPT, Grammarly) to enhance language editing and readability. All medical information, interpretation, and conclusions were developed, verified, and approved by the authors.

References

  1. Kerr JA, Patton GC, Cini KI, et al. Global, Regional, and National Prevalence of Child and Adolescent Overweight and Obesity, 1990–2021, With Forecasts to 2050: A Forecasting Study for the Global Burden of Disease Study 2021. Lancet. 2025;405(10481). Available from: |Full Text|
  2. Centers for Disease Control and Prevention. Childhood Obesity Facts. CDC. 2024 Apr 2. Available from: |Full Text|
  3. American Academy of Pediatrics. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity [Internet]. AAP.org; 2023. Available from: |Full Text|
  4. Endocrine Society. Pediatric Obesity—Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2017 Jan 31; Available from: |PubMed| |Full Text|
  5. Jebeile H, Kelly AS, O’Malley G, Baur LA, et al. Obesity in children and adolescents: epidemiology, causes, assessment, and management. Lancet Diabetes Endocrinol. 2022 May;10(5):351–365. Available from: https://www.sciencedirect.com/science/article/pii/S221385872200047X
  6. Lieb DC, Snow RE, DeBoer MD. Socioeconomic Factors in the Development of Childhood Obesity and Diabetes. Clin Sports Med. 2009 Jul;28(3):349–378. Available from: |PubMed|
  7. Cardel MI, Atkinson MA, Taveras EM, et al. Obesity Treatment Among Adolescents. JAMA Pediatr. 2020 Jun 1;174(6):609–17. Available from: |PubMed|
  8. Mitchell EA, Stewart AW, Braithwaite I, et al. Factors Associated With Body Mass Index in Children and Adolescents: An International Cross-Sectional Study. PLoS One. 2018 May 2;13(5):e0196221. Available from: |PubMed| |Full Text|
  9. UF Health. Causes and Risks for Obesity in Children [Internet]. UFHealth.org; 2022. Available from: |Full Text|
  10. Han JC, Lawlor DA, Kimm SY. Childhood Obesity. Lancet [Internet]. 2010 May;375(9727):1737–48. Available from: |PubMed|
  11. Robinson TN. Screen Media Exposure and Obesity in Children and Adolescents. Pediatrics. 2017 Nov;140(Suppl 2):S97–S101. Available from: |PubMed| |Full Text|
  12. Buchanan LR, et al. Reducing Recreational Sedentary Screen Time. Am J Prev Med. 2016 Mar;50(3):402–415. Available from: |PubMed|
  13. Centers for Disease Control and Prevention. Tips to Support Healthy Routines for Children and Teens [Internet]. Healthy Weight and Growth; 2024 May 13. Available from: |Full Text|
  14. Hampl SE, Hassink SG, Skinner AC, et al. Executive Summary: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics. 2023 Jan 9;151(2). Available from: |PubMed| |Full Text|
  15. Yuksel HS, Sahin FN, Maksimovic N, et al. School-Based Intervention Programs for Preventing Obesity and Promoting Physical Activity and Fitness: A Systematic Review. Int J Environ Res Public Health. 2020 Jan;17(1):[page or article number]. Available from: |PubMed| |Full Text|
  16. American Academy of Pediatrics. ‘5-2-1-0’ Implementation Through Community Partnerships [Internet]. AAP.org; [cited 2026 Jan 6]. Available from: |Full Text|
  17. Smith JD, St George SM, Prado G. Family-Centered Positive Behavior Support Interventions in Early Childhood to Prevent Obesity. Child Dev. 2017 Feb;88(2):427–435.Available from: |PubMed| |Full Text|
  18. Khalsa AS, Kharofa R, Ollberding NJ, et al. Attainment of ‘5-2-1-0’ Obesity Recommendations in Preschool-Aged Children. Prev Med Rep. 2017 Dec;8:79–87. Available from: |PubMed| |Full Text|
  19. Christie D, Channon S. The Potential for Motivational Interviewing to Improve Outcomes in the Management of Diabetes and Obesity in Paediatric and Adult Populations: A Clinical Review. Diabetes Obes Metab. 2014 Sep;16(5):381–387. Available from: |PubMed| |Full Text|
  20. Chilman L, Kennedy-Behr A, Frakking T, et al. Picky Eating in Children: A Scoping Review to Examine Its Intrinsic and Extrinsic Features and How They Relate to Identification. Int J Environ Res Public Health. 2021 Aug 27;18(17):9067. Available from: |PubMed| |Full Text|
  21. Umekar S, Joshi A. Obesity and Preventive Intervention Among Children: A Narrative Review. Cureus. 2024 Feb;16(2):[page or article number].Available from: |PubMed| |Full Text|
  22. City University of New York. My Child Plate Planner [Internet]. 2021 Jun [cited 2025 Aug 16]. Available from: |Full Text|

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