Patient information from BMJ

Obesidade e sobrepeso em crianças: apoio e tratamento

Last published:Jun 03, 2025

​Maintaining a healthy weight is important for your child’s overall health. If your child is overweight, your doctor will recommend various strategies to help them lose weight or gradually grow into a healthy weight.

Below are the main strategies and treatment options. The options recommended for your child will depend on their age and how much weight they need to lose. You can use this information to talk to your doctor about which options are best for your child.

Lifestyle changes

If your child needs to lose weight, the most important thing you can do is help them make healthy lifestyle choices. This includes eating healthier, being more physically active, or both. The goal is to ensure they burn more energy (calories) than they consume, which will lead to weight loss.

It’s important to remember that a healthy lifestyle involves the whole family. When parents and siblings also make better choices, children are more likely to succeed in reaching a healthy weight. Eating meals together, creating good food habits, and having a supportive home environment all play a key role in long-term weight management.

Healthy eating

There is no single best diet for helping children reach a healthy weight. As a general rule, it’s best to limit foods that are high in calories but low in nutrients, like sugary snacks and processed foods. On the other hand, high-calorie foods that are full of nutrients, like full-fat yogurt, nuts, and avocados, can still be included as part of a balanced diet.

Here are some tips that doctors recommend:

• Avoid sugary drinks. These drinks have a lot of calories and few nutrients. Research shows that removing these drinks plays a big role in helping children lose weight.

• Reduce portion sizes. Serving smaller amounts can help your child eat the right amount for their needs.

• Avoid fast food and takeaways, which are often high in calories, unhealthy fats, and salt.

• Avoid foods that contain unhealthy fats, like sweets, cakes, crisps, and fried foods. Keep them out of the house if possible.

• Don’t use food as a reward (for example, giving sweets for finishing homework).

• Eat more fruits and vegetables. They provide important nutrients and fibre, which help children feel full.

• Provide healthy snacks like apples, carrots, or unsalted nuts.

• Eat whole grains like whole-wheat bread, brown rice, and oats instead of white bread or refined grains.

• Eat lean proteins, such as chicken, fish, eggs, beans, and lentils, without added fats or sugars.

• Eat regular meals to avoid grazing or excessive snacking. Encourage your child to eat breakfast to prevent hunger later in the day.

• Have family meals whenever possible. Eating together leads to healthier food choices.

Every child is different, and some of these tips may be harder to follow depending on your child’s needs. Factors like food preferences, cultural background, sensory challenges, or medical conditions can all play a role. You can talk to your doctor about adjusting these strategies to support your child in a way that works best for them.

Physical activity

Encouraging children to be physically active is an important part of helping them reach and maintain a healthy weight. Doctors recommend that children should have at least one hour of physical activity a day. Here are some tips:

• Find an activity your child enjoys, so they learn to see physical activity as something fun. The more they enjoy it, the more likely they are to stick with it.

• Encourage them to participate in a sport or extracurricular activity. This could include joining a school sports club, or trying activities like swimming, dance classes, or gymnastics.

• Encourage them to play outside. Games like tag, climbing, or playing catch can be a fun and simple way to get your child moving.

• Suggest biking or walking to school or other places you visit regularly. You could also walk or bike together as a family on weekends. If you have a dog, try to encourage your child to join you on dog walks.

• Limit screen time, including time spent watching television, playing video games, or using tablets or smartphones. Too much screen time can lead to less physical activity and contribute to weight gain. Set daily limits and create screen-free zones, such as during meals or in the bedroom. Instead, you can encourage your child to explore activities that don’t involve screens, like arts and crafts or playing outside.

For children with obesity, physical activity may need to be changed to fit their health or mobility needs. If your child feels pain, gets tired easily, or has other health problems, you can talk to your doctor to find exercises that suit their needs.

Behavioural therapy

Behavioural therapy teaches you practical skills to help your child and family set goals, overcome challenges, and build healthy habits. It focuses on educating you and providing strategies to support your child in making lasting changes, such as eating healthier and being more physically active. It will involve you, your child and sometimes other family members.

Behavioural therapy may happen in different ways depending on your child’s needs. You might have regular appointments with your child’s doctor, or they might refer you to a dietician or a specialist in behaviour change. Some families may be referred to a children’s weight management team, who offer weekly visits to help your child stay on track and adjust the plan as needed. If your child needs more intensive support, your doctor might recommend an in-hospital or residential programme.

Behavioural therapy might include:

• Identifying triggers for eating: This means understanding if your child eats due to emotions like boredom, stress, or loneliness, or when they are distracted, such as during screen time. You will then learn healthier ways to help them to cope with these feelings.

• Setting goals: You and your child will set achievable goals, like eating more vegetables or being active for 30 minutes a day.

• Giving rewards for reaching goals: Positive rewards, like a fun family outing or extra playtime, can motivate your child to stick with their goals.

• Learning how to self-monitor behavior: Your child might keep track of their food, activity, and feelings to better understand their habits. This helps them stay mindful of their choices and make healthier ones.

• Role modelling: You will be encouraged to set an example for your child by eating healthy and being physically active. When parents follow these habits, children are more likely to copy them.

• Motivational interviewing: Your child will talk with a counsellor to explore their own motivations for making lifestyle changes. This method includes your child in decision-making, rather than them being led by the doctor.

Medicines

Medicines to reduce weight are not often used in children. They are usually only used if a child is older (at least 12 years old), and their weight is putting their health at serious risk.

If your doctor thinks your child needs medicine to help with their weight, they will discuss the available options with you. These might include medicines such as orlistat, liraglutide, and semaglutide.

Some of these medicines come as tablets, while others come as an injection. Your doctor will explain the benefits and potential risks of each medicine to help you make an informed decision. If your child is prescribed one of these medicines, it will always be alongside intensive lifestyle changes and behavioural therapy.

Surgery

Weight-loss surgery is occasionally used for children, but only if they're older (in their teens) and are extremely overweight. It is seen as a last resort and only used in exceptional cases where an older child's health is at serious risk. Weight-loss surgery reduces the size of the stomach, so the person feels full sooner and can only eat a small amount at a time.

Weight-loss surgery often works for adults, helping them lose large amounts of weight. There hasn’t been enough research to say for certain whether weight-loss surgery for children is safe and works in the long term.

Where to get more help

There are many helpful online resources and support groups for families with children who are working to improve their health. These resources can provide valuable tips on healthy eating, physical activity, and managing lifestyle changes. Support groups can also provide emotional encouragement and connect you with other families facing similar challenges. Your doctor can recommend resources that may be a good fit for you and your child.