Overweight and Obesity in Children: What Can Parents Do?

Overweight and obesity in children are assessed using the body mass index (BMI for short), which describes the ratio of body weight to height.

Formula: BMI = Weight (kg) / Height (m)²

Since children are still growing, their BMI is not evaluated in the same way as that of adults. Body weight is assessed using so-called percentile curves that take age and gender into account.

• A child is considered overweight if their BMI is above the 90th percentile
• Obesity is defined as a BMI at or above the 97th percentile.

This definition of being overweight is based on the reference values from the KIGGS study conducted by the Robert Koch Institute.

Children who are already slightly overweight may become obese in the long term if no lifestyle changes are made. Parents should therefore monitor their child’s weight regularly and consult a pediatrician early on if there is significant weight gain.

The causes of being overweight are complex and influenced by various factors. There are an increasing number of overweight children in Germany. According to cross-sectional results from the KiGGS Wave 2 study, about 15 percent of children and adolescents are affected. 

The causes can be broken down into:

• genetic predisposition (children whose parents are overweight have a significantly higher risk of being overweight)
• diet and lifestyle (e.g., a high-calorie diet rich in sugar, fat, and processed foods, as well as sugary drinks and a lack of fruits and vegetables)
• lack of physical activity (insufficient exercise and increasing media consumption contribute to overweight; according to the Journal of Health Monitoring, children and adolescents spend an average of more than 2 hours a day watching TV or using a computer)
• Psychological factors (stress, family problems, and teasing contribute to eating disorders, as many children use eating as a coping mechanism)
• Medical causes (in only about 1% of cases is there another underlying cause, such as hypothyroidism or a disorder of the adrenal glands. In these cases, a pediatric endocrinologist should be consulted.)

The Working Group on Childhood and Adolescent Obesity points out that eating habits in many families have changed in recent years: families are eating meals together less often, while snacking and fast food consumption are on the rise.

Overweight and obesity in childhood and adolescence have far-reaching consequences for both physical and mental health. Overweight children often suffer from health problems that used to occur only in adults in Germany.

• Physical consequences include, for example, high blood pressure, lipid metabolism disorders, and type 2 diabetes; joint wear and tear or other orthopedic problems; as well as sleep disorders, fatty liver disease, and breathing difficulties
• Psychological and social consequences: psychological stress, teasing or exclusion, low self-esteem, and even depression or eating disorders.

In the long term, obesity in children and adolescents can lead to health problems, eating disorders, or difficulties in school.
The earlier overweight or obesity is recognized and treated, the better we can protect the health of children and adolescents.

Successful treatment requires individualized therapy and obesity prevention tailored to the family’s lifestyle. The goal is to stabilize body weight over the long term and prevent related health conditions, analyze eating habits, and incorporate physical activity into daily routines from an early age.

Overview of treatment options:

• Dietary changes
• Increased physical activity
• Behavioral therapy 
• Family support

These elements form the basis of the recommendations of the Working Group on Childhood and Adolescent Obesity (AGA).

1. Dietary changes

A healthy diet plays a central role.
Children should learn to correctly recognize hunger and satiety and to eat more mindfully.
A balanced diet is recommended for children, with plenty of vegetables, whole-grain products, lean protein, and little sugar.
The so-called “traffic light” system helps classify foods into “green,” “yellow,” and “red” categories—depending on their nutritional value and energy content.

An example:

• Green (recommended): Water, whole-grain products, fruit, vegetables
• Yellow (in moderation): Fruit juices, bread, cheese, low-fat dairy products
• Red (rarely): Sweets, fast food, sodas

The transition is easier when parents and children work together on their diet.

2. Physical Activity and Sports

Regular physical activity is crucial for treating childhood obesity.
At least 60 minutes of physical activity per day is recommended—ideally through everyday movement, walking to school, biking, or shared leisure activities.

Even small changes can make a big difference: less screen time, more outdoor activity, and enjoying sports that are fun.
Children who are physically inactive often gain weight without realizing it—a problem that can be effectively addressed by making exercise and sports enjoyable.

3. Behavioral Therapy and Support

Many children with obesity benefit from behavioral training. This involves specifically changing eating habits, stress management, and motivation.
It is important that parents are actively involved—they play a decisive role in shaping eating habits.

Programs for the prevention of overweight and obesity are sometimes subsidized by health insurance companies. An effective approach combines nutrition, exercise, and behavioral training.

Treating overweight and obesity in children requires experience and interdisciplinary expertise.

Specialized centers for children and adolescents with obesity offer individually tailored programs to help with weight loss, in which pediatricians, nutritionists, psychologists, and physical therapists work together.

Addresses and contact information can be found, among other places, at:

• the Working Group on Obesity in Children and Adolescents (AGA)
• the Federal Institute for Public Health
• or via the Leading Medicine Guide platform.

Here, parents can find recommended specialists who focus on the treatment and prevention of overweight and obesity.