Weight-Loss Recommendations for Children

Current recommendations for weight loss in children have two goals: to ensure that the child grows and develops normally and to help the child reach a healthy weight.
Weight-Loss Recommendations for Children

Weight-loss recommendations for children are different from those for adults. Unlike adults, children need calories for growth and development, in addition to the calories that their body requires for daily metabolism and physical activity. Children who eat too little may not have enough calories to grow in height. For this reason, a child's calories should not be cut too much and weight-loss recommendations for children are quite modest.

Current recommendations for weight loss in children have two goals. The first is to ensure that the child grows and develops normally and the second is to help the child reach a healthy weight. Experts in the field of pediatric weight management have developed broad treatment recommendations with these two goals in mind. 1

When to Maintain Weight
Maintaining weight allows children to "grow into" a healthy weight as they get taller. Children who are encouraged to develop healthy eating and activity patterns without "dieting" can stop excess weight gain and maintain their weight while growing taller. Specific recommendations for maintaining weight in a healthy range include eating at least five daily servings of vegetables and fruits, eating breakfast daily, limiting portion sizes, minimizing or eliminating sugar-sweetened beverages, limiting screen time to no more than two hours per day, not putting a television in the child’s bedroom, and getting at least one hour of daily physical activity. 2

Weight maintenance strategies can be used with children as young as two years of age. 1 For children whose height is increasing, weight should be held steady as the child grows and until the child's Body Mass Index (BMI) drops down into the normal range, that is, below the 85th percentile.

When to Lose Weight
Weight loss may be recommended for children over two years of age if BMI continues to increase after three to six months of weight maintenance efforts and if weight-related medical conditions such as hypertension, high blood cholesterol, or high blood glucose, as well as sleep apnea, asthma, and gastrointestinal problems, persist. 1 Children at or above the 99th percentile for weight may require a comprehensive, multidisciplinary weight management program that is designed specifically for children and has a track record of lasting results. Adult-based weight-loss programs are not appropriate for most children.

Up until age 12, a child's weight loss should be limited to an average of 1 pound per month. This allows the child to continue growing taller and building muscle.3 Children can be successful at losing weight gradually, a goal that rewards parents and children with a sense of accomplishment. In addition, the type of healthy eating that promotes slow weight loss is easy to sustain over time.

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1 Spear BA, Barlow SE, Ervin C, et al. Recommendations for treatment of child and adolescent overweight and obesity. Pediatrics. 2007 Dec;120 Suppl 4:S254-88.

2 Barlow SE; Expert Committee. Expert Committee Recommendations Regarding the Prevention, Assessment, and Treatment of Child and Adolescent Overweight and Obesity: Summary Report. Pediatrics. 2007 Dec;120 Suppl 4:S164-92.