Weight loss treatments for kids

Childhood obesity is common, affecting nearly 1 in 5 kids. But as a parent or caregiver, it’s not always easy to address weight related challenges with your child or get them the help they may need.

Sowmya Krishnan, M.D., a board-certified Pediatric Endocrinologist at Children's Health℠ and Professor at UT Southwestern, helps parents understand how to talk with their children about their weight and what weight-loss treatments and medications are available for kids.

Diagnosing overweight and obesity in children

Checking your child's weight should be part of their annual well visit.

After age 2, doctors begin determining if a child's weight is in the healthy range, using a measurement called the body mass index, or BMI. BMI is the ratio of a child’s height to their weight – compared to children of their same sex and age.

When a child’s BMI is not in a healthy range, it can put them at risk for serious health problems including diabetes, high blood pressure and breathing problems during sleep.

The goal of any weight-loss treatment for children focuses on reducing their health risks – while also helping improve how they feel day-to-day.

The difference between childhood overweight and childhood obesity

When a child has a high BMI, they fall into one of two categories:

• Childhood overweight: A BMI between the 85th and 95th percentile.

• Childhood obesity: A BMI at the 95th percentile or greater.

The American Academy of Pediatrics (AAP) categorizes obesity into three different classes.

• Class 1 obesity: A BMI that’s 100 to 120 percent of the 95th percentile.

• Class 2 obesity: A BMI that’s 120 to 140 percent of the 95th percentile.

• Class 3 obesity: A BMI that’s more than 140 percent of the 95th percentile.

Use the Centers for Disease Control (CDC) BMI calculator for children and teens or learn more about what BMI means for kids.

After a child is diagnosed as having overweight or obesity

If a child's BMI falls into the overweight or obese category, your doctor may discuss next steps with you. These next steps may include:

• Seeing a dietitian or nutritionist. They can help you with meals, portions, snacks and swaps that work for your child, your lifestyle and your whole family.

• Prescribing daily activity. Your child’s doctor can help you meet the AAP’s recommendation of at least 60 minutes of daily exercise – and set up a schedule and home environment to encourage more activity.

• Testing for other health conditions that can be associated with obesity. These include tests for fatty liver disease, type 2 diabetes and high cholesterol.

Some doctors may also want to review certain medications that can be associated with a child’s weight gain. These medications include:

• Steroid medications

• Medications for psychosis

"Be sure to talk to your child’s doctor about this possibility and whether there are other substitute medications they might try," says Dr. Krishnan.

What are the treatment options for childhood obesity?

Treatment options for childhood obesity include lifestyle changes, medications and surgery.

Lifestyle changes

Changes to your day-to-day habits are usually the first line of treatment for obesity. Your child’s doctor may first talk to you about how to help your child:

• Eat healthier foods. Learn more about healthy food swaps or tips for eating healthier at home.

• Increase their amount of physical activity. Learn more about how to keep children active in winter and summer – or how to motivate kids to exercise.

Medications for childhood obesity

When lifestyle changes aren’t enough to help your child reach a healthier weight, there are four FDA-approved medications for children 12 and older who have obesity. These medications work by helping to regulate hunger and cravings.

"Choosing the right one depends on your child's preferences and family goals," says Dr. Krishnan.

Injectable weight-loss medications for kids include:

• Wegovy. Given as a weekly injection.

• Saxenda. Given as a daily injection.

Oral medications for weight loss in children include:

• Qsymia. Taken once a day in the morning.

• Orlistat. Taken three times a day with meals.

"It's important to know that for weight-loss medications to work well, they have to be used with changes to a child’s diet and an increase in their physical activity too," says Dr. Krishnan. While these medications can be effective, Dr. Krishnan notes that their long-term effects are still unknown. They can also be costly, as many insurance plans do not cover weight-loss medications for children. She also cautions against compounded versions, which are not FDA-approved, may be unsafe and often stop working once the medication is discontinued.

Surgery for childhood obesity

Weight-loss surgery can be an effective treatment option for children who have class 3 obesity – and haven’t responded well to other treatments.

"Some people think that weight loss surgery is 'cheating' or 'the easy way out' but that's not true. Weight loss surgery requires kids to change their eating and activity habits before they undergo surgery," says Dr. Krisnan. "And the support and education provided both before and after surgery – for both the child and their family – is great for long-term success."

Learn more about the process, safety and benefits of bariatric surgery for children or read about one teen’s experience with weight-loss surgery.

Tips for parents who want to help a child with their weight

Dr. Krishnan has a few important tips for parents and caregivers if their child's weight falls outside of the healthy range.

Tip #1: Avoid body shaming

Body shaming is negatively talking about the size, shape or appearance of someone else's body.

"When you talk about weight with children, the most important thing is to avoid body shaming. You can do this by focusing your messages on their health, rather than focusing on BMI or the number on the scale," says Dr. Krishnan.

You could try saying something like: The reason why we are worried about obesity is because it is associated with several serious health-related conditions. And we want you to be as healthy as possible.

Get more tips about how to talk to your child about their weight.

Tip #2: Take a family-centered approach

Dr. Krishnan recommends that any diet or lifestyle changes that your child’s doctor recommends be made as a family.

"Positive peer pressure really works. So if the whole family is trying to eat more fruits and veggies and get more activity, it's a lot more likely that your child who needs to lose weight will be able to do those things," she says.

Check out our parent's guide to a balanced diet and how to eat fewer ultraprocessed foods.

Tip #3: Decrease screen time

Research shows that children are spending more time in front of screens than ever before. But the AAP recommends limiting screen time for children to less than two hours per day.

Reducing screen time helps cut down on sedentary behavior, giving your child more opportunities to play, move and stay active. It may also lead to better sleep – an important factor in maintaining a healthy weight.

Tip #4: Work with a health care provider

"There's a lot of diet, nutrition and exercise advice out there that can do more harm than good," says Dr. Krishnan. "Because children are still growing and have unique nutritional needs, I always recommend parents talk to a doctor or dietitian before starting any weight-loss program or diet. Restrictive plans can be especially harmful."

Partnering with a compassionate, knowledgeable health care provider can give your child a better chance at long-term success – and help identify any genetic or biological factors that may contribute to weight gain.

Additional resources for parents

• American Academy of Pediatrics (healthychildren.org)

  • Healthy Food Choices for Your Family

  • Treatment for Obesity in Children & Teens

• Centers for Disease Control and Prevention (CDC)

  • Childhood Obesity Facts

  • Preventing Childhood Obesity: 6 Things Families Can Do

• National Institutes of Health

  • Healthy Habit Tips for Parents & Other Caregivers

Learn more

Interested in learning more about healthier habits for your family? Read more about our pediatric weight management programs that include Get Up & Go, COACH, bariatrics and nutrition clinics.