Mark L Mansfield, MD

June 27th, 2014

Childhood and adolescent obesity in America is a big issue and it is getting bigger. Over the past 30 years, childhood obesity has tripled with nearly 30 percent of children age 6-11 classified as overweight and 20 percent of those as obese. These percentages are steadily and dramatically increasing. Along with such staggering statistics, we also know that being overweight or obese can have a significant effect on both the physical and emotional health of our children. Their behavior can drift towards becoming bullied or being bullies, they can develop low self-esteem, depression, a host of medical conditions and anxiety. To help combat this trend, weight management counseling is now commonplace during routine pediatric visits.

To determine if a child is at or above a healthy weight for their age, we take a body mass index (BMI) measurement. The American Academy of Family Practice recommends obtaining this measurement annually beginning at age 2 to ensure a healthy weight trend and the United States Preventative Services Task Force recommends we refer for nutritional therapy beginning at age 6. A BMI measurement is based upon the height and weight of your child; BMIs in the 85-94th percentile are considered overweight and those above the 95th percentile are considered obese.

Every parent or guardian should visit the CDC’s website,, and know their child’s BMI percentile. If, according to the CDC calculations, your child’s BMI falls in the overweight or obese range, I highly recommend you do not initially focus on your child or children. First, take an objective look at your family habits, then schedule an appointment with your primary care provider. The benefits of behavior therapy may be increased if the parents, rather than the child, are given the primary responsibility for initiating change.

In order to maintain a healthy weight at any age, energy intake needs to equal our energy expenditure – calories in; calories out. Failure or success at weight reduction will come from the balance between your diet and exercise. Current recommendations are physical activity of 1 hour a day for children and 30 minutes for adults; 5 days a week. Exercise can be as simple as a brisk walk. Add at least a step each day! Families who start counting calories are amazed at the number of calories they actually consume during any given day. As a side note, children cannot eat junk food if you do not buy it!

This year, I had the joy of witnessing the incredible transformation of two young soccer heroes. Each received counseling on the importance of maintaining a healthy diet and engaging in the recommended amount of daily exercise. Each young boy made significant changes in their daily eating and exercise habits. One increased the number of hours he played soccer each day and the other started running and eventually ran and won a 5K. As their habits and fitness levels changed, so too did their starting positions on the team.

While these two heroes took it upon themselves, realistically, most children are not likely to change their habits on their own. Change typically is initiated by the parents and/or grandparents. If your child is struggling, your primary care provider will gladly be a part of your whole family’s health and wellbeing team.