Helping Kids Begin Life on a Healthy Path

Nearly one in five children faces obesity, a condition that can impact almost every part of the body. Excess body fat may contribute to serious health concerns, such as heart disease, diabetes, and mental well-being challenges.

“Identifying and preventing childhood obesity early is essential, as prolonged obesity increases the chance of health complications,” says Dr. Stavroula Osganian, a scientific expert from the NIH focused on childhood obesity.

If you suspect your child may be dealing with obesity, speak with their doctor. They can assess your child’s body mass index (BMI), a tool that estimates whether a child's weight is suitable for their height, age, and gender. While BMI doesn’t measure fat directly, it’s an important screening method. If BMI is high, your doctor can help plan a path toward a healthier weight.

“Taking action early is crucial,” says Dr. Leonard Epstein, a psychologist at the University at Buffalo. “Young children are more adaptable to change, and it’s easier for families to make necessary adjustments early on.”

The NIH is actively conducting research to find effective ways to both prevent and treat obesity in children.

Starting Before Birth

According to Osganian, scientists are exploring ways to prevent obesity before a baby is even born. A mother’s weight, nutrition, and activity levels during pregnancy can all influence the child's risk of developing obesity. Researchers are working to understand how these prenatal habits connect to an infant’s body composition and metabolism—the processes that help the body grow, move, and function.

Babies born with a high birth weight or who gain weight rapidly are more likely to become obese during childhood. Studies also suggest early sleep patterns play a role; even sleep deprivation in infancy can raise the risk.

The INSIGHT study, supported by the NIH, explored ways to manage these factors. First-time mothers received education on healthy feeding practices and sleep habits for their babies. They learned techniques to calm a fussy child without using food, how to monitor development using growth charts, and ways to reduce inactivity. Children whose mothers took part in the program had healthier weight outcomes up to age three compared to those in the control group.

Dr. Charlotte Pratt, an expert in child nutrition at the NIH, emphasizes that obesity in childhood often continues into adulthood. Helping children establish healthy patterns early can lead to a better future. But, she adds, kids also need to build and maintain these habits as they mature.

Building Strong Habits

Obesity results from consuming more energy, or calories, than the body uses. To prevent this, kids need to eat nutritious foods in proper amounts and stay physically active. Regular movement helps balance energy intake and use.

“Families play a key role in preventing obesity by promoting healthy diets, regular activity, and good sleep habits throughout childhood,” says Pratt. When parents model these behaviors, children are more likely to follow suit. However, maintaining those patterns can become harder as children grow older.

“When they’re young, kids often love to run and play,” Epstein notes. “But around ages 9 or 10, their interest in active play tends to drop, and they may prefer more passive activities. Physical activity at that point often shifts to organized sports and structured routines.”

Once a child experiences obesity, reversing it through lifestyle adjustments can be much harder than prevention, explains Dr. Sarah Armstrong, a pediatrician at Duke University. She says effective treatment typically involves at least 26 hours of focused guidance on nutrition and exercise over three to twelve months.

This level of care is difficult for many healthcare providers to offer alone. To improve access, Armstrong’s team created a program called Fit Together that connects pediatricians with community parks and recreation centers. Doctors provide obesity screening and lifestyle advice, while the centers supply opportunities for physical activity.

The program helped participating children achieve lower BMIs, and the team is now working toward expanding similar partnerships nationwide.

Working as a Family

Both eating habits and physical activity are key in addressing obesity. Epstein’s research shows that involving the whole family in treatment may be even more effective. His team designed family-based programs that support healthier eating and movement for both parents and kids. The approach also includes parenting techniques and tips for setting a supportive home environment.

“Positive parenting strategies help create a healthier emotional atmosphere at home,” Epstein says. Studies show that when parents and children work together on these goals, they can both lose weight — and that progress may last for up to ten years. Benefits also include reduced symptoms of depression and anxiety, and even siblings not enrolled in the program sometimes lose weight because of the improved home environment.

“Children don’t typically outgrow obesity,” Armstrong points out. “In fact, the condition often worsens over time, leading to more serious health risks. That’s why it’s so important to deliver effective, research-backed treatment options as soon as possible.”

NIH-supported scientists are also investigating how a child’s biology, behaviors, surroundings, and brain development contribute to weight gain.

“If your child has a high BMI and needs support, lead by example,” says Osganian. “Create a healthy and encouraging environment at home. Have honest conversations with your child and their doctor about health and wellness.”

In cases where severe obesity is present, even extensive lifestyle changes may not be enough. These children can be referred to specialists in obesity medicine who can assess for genetic factors and suggest additional medical approaches.