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Commentary by Maria Camila Espinal
Published November 2023

We are all asked about the best way to keep children healthy. One of the things we can always counsel on and check on at every well and sick visit is if the child has excess weight. As pediatricians, we need to work with children and their caregivers to prevent and mitigate the long-term negative consequences of obesity. Managing and treating obesity should be done in a compassionate way focusing on health and well-being while using weight-neutral language and being very cognizant of the terms used. Many individuals with excess weight and obesity will avoid healthcare services due to fear of being judged or blamed for their chronic condition.

Obesity is a chronic illness that is multifactorial in nature. Most recent obesity guidelines highlight how most risk factors are social determinants of health. Children with obesity are affected by many health inequities that can further promote obesity. These have a longitudinal effect that will affect their adult life, leading to an adult with obesity and other comorbidities. Obesity can lead to non-alcoholic fatty liver disease, hypertension, dyslipidemia, type 2 diabetes, sleep apnea, orthopedic problems, and problems with how our body processes energy. People with obesity also experience weight stigma, bullying, social isolation, low self-esteem, and mood disorders. Given the extensive lists of comorbidities, we must become experts in nutritional and exercise counseling that can impact children’s health.

Keywords: overweight; social determinants of health; nutrition; dyslipidemia; hypertension; depression; disordered eating; lifestyle modification; behavioral treatment

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