• Posted December 30, 2025

Understanding Childhood Obesity: Causes, Treatments and How to Reduce Stigma

While childhood obesity has become more common in recent years, this is a condition that is about more than just weight.

Childhood obesity reflects our modern environment of ultra-processed foods, digital devices and psychological stressors.

To address childhood obesity, clinicians and families must work together to create a more nuanced, compassionate and evidence-based approach to prevention and care.

What is childhood obesity?

Today’s pediatric obesity epidemic involves both a child’s genetics and their environment. While genetics does play a significant role in the development of obesity in children, environments full of ultra-processed foods, screen-focused forms of recreation, poor sleep and mental stress are powerful contributors.

Recent research shows that a mother’s health, how a baby is fed, and even exposure to certain chemicals during pregnancy can affect a child’s future metabolism.

Combined with aggressive food marketing and environmental and social barriers to regular physical activity across diverse communities, these factors create a “perfect storm” for early metabolic risk.

The power of early screening

The American Academy of Pediatrics (AAP) and Obesity Medicine Association (OMA) recommend that screening for obesity begin as early as age 2. In diagnosing obesity in children, clinicians look for the following:

• How their weight relative to their height (body mass index, BMI) stacks up against expectations for their age 

• How quickly a child’s height and weight change over time 

• Family risk factors (for instance, if their parents have obesity or gestational diabetes)  

Assessing all of these factors can help clinicians intervene before weight-related issues develop. 

 The goal is not to put labels on children. It’s to help them build habits early, fostering healthy eating patterns, physical activity and self-esteem during their early years. 

Tailoring treatment based on age 

For children who have not entered puberty, the main goal is to normalize growth: maintain a healthy weight so height can catch up. Success depends on parents modeling healthy habits, setting routines and encouraging activity through play. 

Teenagers need more independence and support for emotional and social issues. Effective care should assess their sleep, stress and emotional eating, and should also check for bullying, depression, disordered eating and the effects of social media.

The importance of guidance from caregivers

The most important factor in treating pediatric obesity is family and/or caregivers.

Families and caregivers need guidance on nutrition, physical activity, understanding behavior and providing emotional support. Sustainable change is possible when a family works together. Parent-led steps like cooking meals together, being active as a family and limiting certain foods can make a big difference.

Behavioral therapy reframes obesity as a chronic, relapsing condition, not a personal failure. It empowers both children and caregivers to replace shame with skills.

Both the Obesity Medicine Association and the American Academy of Pediatrics recommend intensive health behavior and lifestyle treatment (IHBLT), defined as at least 26 hours of structured, family-based counseling delivered over 6-12 months.

Higher total contact time is associated with greater and more sustained improvements in BMI and cardiometabolic risk.

Avoiding weight bias

Possibly one of the most important things clinicians can do is speak to children with obesity (and their parents) without putting the focus on weight. Using terms like “health habits” and “growth pattern” and emphasizing body positivity instead of focusing on “weight talk” can help patients feel more comfortable and committed to their treatment.

It is also crucial to train staff to use person-first language (“child with obesity,” not “obese child”) to create a welcoming and weight-inclusive environment. This includes having appropriate seating, using a nonjudgmental tone and building trust with patients.

Emerging solutions

For severe obesity, new options approved by the U.S. Food and Drug Administration have emerged, like liraglutide and semaglutide (GLP-1 receptor agonists).

These medications must accompany the changes in lifestyle (nutrition, physical activity and behavioral therapy). They should be prescribed by clinicians trained in pediatric obesity medicine.

For teenagers with severe obesity and other related health issues, metabolic bariatric surgery offers a durable solution but requires long-term nutritional and emotional support.

Building a healthier future for children

Children cannot overcome obesity on their own. Effective prevention requires collaboration from their family, health care providers, schools, policymakers and communities.

Policies like healthy school meals, walkable neighborhoods, early nutrition education and restrictions on junk food marketing can reduce pediatric obesity better than clinical care alone.

About the expert

Shagun Bindlish, MD, FACP, FOMA, DABOM, DACLM, is an internist and diabetologist with advanced expertise in obesity and lifestyle medicine. She serves as medical and scientific chair for the American Diabetes Association in Northern California and is the founder of the Golden State Obesity Society. An educator at Touro University California and University at Sea CME, she has trained providers worldwide in metabolic health. She is also a recipient of the prestigious Compassionate Physician of the Year Award by the California Medical Association. Her work focuses on advancing diabetes and obesity care through innovation, education and advocacy.