What causes unhealthy weight gain?

Here are some common reasons why teens gain more weight than they should:

• They eat and drink too many high-sugar, high-fat, low-nutrient foods. Examples are soft drinks, fruit-flavored drinks, sports drinks, french fries, candy, chips, and cookies.

• They eat too much food. This is often because they eat for reasons other than hunger.

• They don’t get enough physical activity to burn off the calories from the food they eat.

• They don't get enough sleep.

• They have a family history of unhealthy weight.

Tips for helping your child lose weight

Change eating habits

• Encourage your child to eat breakfast. Children who don’t eat breakfast often eat more in a day than children who eat breakfast. This can happen because a child is too hungry to make sensible choices later in the day. It can also happen due to changes in blood sugar and the body's natural appetite control. For a quick breakfast, offer fruit, yogurt, or a snack bar. Limit fast food.

• Have sit-down family dinners every night, or as often as possible. Discourage eating fast food, grabbing snacks for meals, or eating in front of the TV.

• Teach your child to eat more slowly. Have them try putting down the fork between bites. This helps keep your child from eating beyond when they are full. It takes 20 minutes for the “full” signal to travel from the stomach to the brain.

• Serve smaller portions of food. Let your teen ask for more if they are still hungry.

• Cut down on fast food, chips, and other junk foods and soft drinks, sports drinks, and other sugary drinks. Don't have these foods and drinks in the house.

• Provide nutritious and filling food choices. Try fruits, vegetables, and whole grains. Talk with your teen about how to make healthy choices at school and other times when they aren't home.

Increase activity

• Limit the amount of time that your child spends on TV, video games, or the computer. The American Academy of Pediatrics advises creating a family media plan. In this plan, health, school, and social goals are met first. Next, media use time is considered. You can make your own family media plan .

• Encourage active pastimes like playing basketball, walking, hiking, riding a bike, or playing outside with friends. If outdoor activity isn’t possible, going to a gym or rec center may be a good choice. Physically active video games are another idea.

• Encourage your teen to join in team or individual sports activities that provide fun and exercise.

• Move more as a family. Children ages 6 through 17 need at least 60 minutes of medium to high intensity physical activity daily. Set a good example for your children by being active yourself. Make exercise a part of your daily routine. Take a family walk. Dance, bike, or play an outdoor game together as often as you can.

Get enough sleep

• Teens who don't get enough sleep are at risk for unhealthy weight gain. Good sleep helps prevent diseases. These include type 2 diabetes and obesity, injuries, and problems with attention and behavior.

• Set regular sleep routines. Follow a sleep schedule every day. This may help teens sleep better.

• Remove screens from your child's room. Stop use of screens at least 1 hour before bedtime.

How to get started

You and your teen are probably used to your routines. Change too many things at once and you’ll likely be met with resistance or rebellion. It’s best to start slowly.

• Let your child choose one change to start with. This could be exercising once a day, having smaller meals, or reducing or cutting out sugary drinks or fast food. As they get used to the change, add another.

• Be a role model for your child. Eat healthy food yourself. Cut your intake of fast foods, sweets, and sugary drinks. Have fruits, vegetables, and whole grains in the house.

• Ask your child’s healthcare provider what your child’s goal weight should be and how quickly the weight should come off.

• Focus on health, not on how they look. Blame and guilt about a body shape or size is often harmful. Focus treatment on overall health and quality of life. For example, help them set goals to improve self-esteem, miss less school, and take part in events such as a walkathon.

• Motivate your teen to make healthy lifestyle choices by listening to your teen's concerns, especially about body image issues, offline or online bullying, self-esteem, and peer pressure.

• Always keep all channels of communication open. Offer advice gently and make suggestions whenever required, but give your teenager space and time to think them through.

• Keep your goals and expectations realistic. Don't try to overreach or show disappointment when targets are not met with expected results. Be supportive and encourage the efforts that go into the process.

Working with your child’s healthcare provider

Your child should see their healthcare provider for regular follow-up visits. During these visits, the healthcare provider can monitor your child’s progress and health. They can also help you and your child set goals. Take your child to the healthcare provider as often as suggested. Depending on your child’s needs, this may be every 1 to 2 months.

Ask your child's healthcare provider if enrolling in an Intensive Health Behavior and Lifestyle Treatment (IHBLT) program would help your teen. This is a safe treatment for childhood obesity that works well. It's a family-centered program that focuses on nutrition, physical activity, and behavior change. These are designed for your family. Or you can work with your child's provider to address lifestyle and behavior topics.

What is BMI?

Healthcare providers use a calculation called BMI (body mass index) to figure whether your child is in a healthy weight range. The number is based on your child’s height, weight, sex, and age. For children and teens, BMI is age- and sex-specific and is often referred to as BMI-for-age. If your child is very muscular or athletic, this will be taken into account. This calculation is different from the one used for adults. BMI levels among children and teens are given as percentages compared with other children and teens of the same sex and age.

A single BMI-for-age calculation is not enough to evaluate long-term weight status because your teen’s height and weight will change as they grow. With individuals, healthcare providers should consider BMI along with other factors such as family history, blood pressure, blood sugar levels, and eating patterns and physical activity level.