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Toddler (1–3 years) · Preschool (3–5 years) · School age (5–12 years) · Teen (12–18 years) · Nutrition, Growth & development

Healthy weight for children: how we help families, without shame

About 1 in 5 American children has obesity. It is a chronic condition shaped by genes, sleep, food environment and stress, not a character flaw. Dare2Care Pediatrics treats it the way the AAP recommends: early, as a family, and with respect.

Key takeaways

  • BMI at or above the 85th percentile for age is overweight; at or above the 95th is obesity
  • Weight is a medical topic, never a blame topic, and we do not discuss it in front of a child in a shaming way
  • Small family-wide changes to drinks, sleep, screens and movement work better than diets
  • Treatment starts early: waiting for a child to “grow out of it” rarely works
  • For teens with obesity, medication or a specialist referral can be part of the plan

How do you know if my child’s weight is a concern?

At every well visit we plot height and weight and calculate body mass index (BMI) for age. A BMI between the 85th and 95th percentile is overweight; at or above the 95th is obesity. One measurement matters less than the trend: a child whose BMI percentile is climbing year over year is the child we want to help early.

Why does it happen?

Genes set the range, and today’s environment fills it: sugary drinks, large portions, ultra-processed snacks, less outdoor play, short sleep, stress and long screen hours. Some medicines and medical conditions contribute. None of this is a child’s fault, and blaming parents does not help either. We treat it as a health condition, like asthma.

What does treatment look like at Dare2Care Pediatrics?

  1. A private conversation with parents first, using neutral words (“weight that is higher than is healthy for the body”), and a check for causes: sleep, medicines, thyroid, family history.
  2. Labs when indicated by age and BMI: cholesterol, blood sugar (A1c), liver enzymes, and blood pressure at every visit.
  3. A family plan built around four levers: drinks (water and milk only), sleep (age-appropriate hours), screens (out of bedrooms, off before bed) and movement (60 minutes a day, any kind).
  4. Frequent follow-up. The AAP guideline recommends intensive, family-based behavior support over 3 to 12 months; we schedule monthly visits or nurse check-ins and connect families with nutrition counseling.
  5. For teens 12 and older with obesity, a discussion of weight-management medication as an addition to the plan, and referral to a pediatric weight clinic for severe obesity.

What actually moves the needle at home?

  • Swap sugary drinks (juice, soda, sports drinks, sweet coffee) for water; this alone changes the trend for many children
  • Family meals at the table, screens off, with one vegetable everyone eats
  • Breakfast every day; hunger at 10 a.m. drives afternoon snacking
  • A regular bedtime: short sleep raises hunger hormones the next day
  • Movement your child enjoys: walks, bikes, a sport, dancing in the kitchen
  • The same food for everyone; a child on a separate “diet” feels singled out

What we never do

We do not put children on restrictive diets, use scales as punishment or reward, or talk about a child’s body in front of them as a problem. Restrictive dieting in childhood raises the risk of disordered eating. The goal is health and a stable trend while the child grows, not a number.

Does insurance cover this?

Well visits, follow-up visits, labs and nutrition counseling are covered by Georgia Medicaid, PeachCare for Kids and most commercial plans we participate with. Ask the front desk about weight-management medication coverage, which varies by plan.

When to call us

  • Your child’s clothes sizes are jumping faster than their height
  • Snoring, daytime sleepiness, headaches, knee or hip pain, or dark velvety skin on the neck (acanthosis nigricans)
  • Your child is being teased about weight, or is skipping meals, hiding food or talking badly about their body

Go to the emergency room or call 911 if…

  • Extreme thirst and frequent urination with weight loss, vomiting or fast breathing: possible diabetes, go to the ER

Questions parents ask

Will my child just grow out of it?

A toddler often does; a school-age child with obesity usually does not. Most children with obesity at 8 still have it as teens. Early, gentle changes are far easier than late ones.

Should we count calories?

No. Children need to eat when hungry and stop when full. We change what is in the house and the daily routine, not the amount a child is allowed.

Do you prescribe weight-loss medication for teens?

For teens 12 and older with obesity, we discuss it as one part of a family plan, following the AAP guideline, and often together with a pediatric endocrinologist. It is never the first or only step.

Not sure? Ask us

Call or text the office during hours, or send a portal message. For emergencies call 911.

(770) 615-7000

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