Preventing Childhood Obesity: Healthy Habits That Start Before Kindergarten

The Physical Health Risks of Childhood Obesity

You've heard me talk about it before. Obesity is becoming a really big problem for kids. And there are a lot of things that you need to remember. Obese kids are at risk for diabetes. They have high cholesterol. I see kids already, kids that aren't even 10, and they have insulin resistance, which is pre-diabetes. They have high cholesterol, high triglycerides. I've seen kids who are barely 10, barely into double digits, and they have triglyceride levels double what an adult should have.

If your child is obese and has asthma, it's going to make their asthma worse. A lot of kids will complain that they're short of breath because they're carrying so much weight. They'll have back pain, knee pain, things like that, and they just can't keep up with other kids. So those are the physical problems that go along with obesity.

The Emotional and Social Impact of Childhood Obesity

The psychological ones, too: a lot of kids who are overweight aren't liked by many kids. They're teased by many kids, bullied, and they don't feel good about themselves. You know, it really weighs on their self-esteem.

Understanding Body Mass Index (BMI) in Children

So it's important as a parent that you pay attention to this and especially pay attention before they become kindergarteners. See your pediatrician and ask them, you know, "What is my child's weight, what is their height, and what is their body mass index?"

All kids over 2 can have their body mass index calculated, and it's just a math formula. It takes their height and their weight into consideration, and it comes up with a number. You need to look at their percentage for their body mass index, and if they're over 95 percentile, they're considered in the obese category.

Toddlers Don’t Need to Eat as Much as You Think

We usually associate healthy babies with chubby babies. And the realism is I'm seeing a lot of kids who are overweight in their toddler years, who get to just graze all the time with eating, whose parents, you know, they think that they just need to constantly be eating for growth.

And actually, kids normally go through what's called the toddler appetite slump. Between ages 1 through 5, they just don't eat that much. They're not growing like they were in the first year of life. They're not growing like they will be during their second growth spurt around the kindergarten, first grade years. So they don't need as many calories in as they did before, so they normally are going to thin out by age 4.

Weight Before Kindergarten Can Predict Future Health

For kids who are overweight before kindergarten, it's like they've already gotten their destiny predetermined. One-third of kids who are overweight in kindergarten were actually obese by eighth grade. I mean, that's when they're around 11 years old. And the concerning thing is almost every child remained that way.

So you don't want to wait until they're, you know, in later elementary years or in middle school before you start going, "Hmm, my child looks a little bit more overweight than some of these other kids." You actually want to start paying attention when they're in preschool. See how their weight is in preschool, because that's going to tell you what things are going to be like once they get older.

Once obesity is established early in life, it actually tracks through adulthood. The only time there are really exceptions is when you make a conscious effort to change the eating habits and the activity habits of the children that you're concerned about.

Can Genetics Determine Your Child’s Weight?

For a lot of kids, there is concern about, you know, what is the ethnicity? You know, everyone says, "Oh, well, I'm from this type of ethnic group, and we always are big-boned people." Or, you know, same with race or family income. A lot of people say, "Well, I don't have the family income to be able to afford all these healthy foods, so I'm going to feed them what I can because I want my children to eat." But, regardless, a lot of people say, "Well, that's how it is in my family." But the truth is, after age 5, those factors no longer affect their risk for being overweight in the later years.

Healthy Habits That Help Prevent Childhood Obesity

So what parents really need to do is focus on checking their child's growth from early on, seeing how they are on the growth curves. And again, your pediatrician will tell you what their growth is, their weight, their height, and, after age 2, their body mass index at every single well visit.

Parents also need to pay attention to what your child is eating and their eating habits. You want to make sure you're instilling healthy eating and activity habits early on before there's a problem. Genetic influences do show up early in life, but exercise and a healthy diet can actually reduce the effect of the genes. You can actually overcome your genetics, to a point. Unfortunately, you can't change your genes. You can change how you eat and how you exercise.

The 5-2-1-0 Rule for Healthy Kids

So the important thing is to prevent the problems from happening rather than reacting to the problem once they've already happened. Pay attention to 5210:

• 5 servings of fruits and vegetables a day
• 2 hours or less of screen time, television, computers, video games
• 1 hour of physical activity. And it doesn't have to be one hour all at once. You can do 20 minutes here, 10 minutes here, 5 minutes here, round off with half an hour, just being active.
• o sugary drinks. That includes juice, that includes soda. You will be shocked to find out how much sugar and how many calories are in a 20-ounce bottle of soda or a 12-ounce cup of juice. It's as much as a candy bar. So eliminating the bad stuff like that from the diet, making them treats instead of daily or weekly parts of your diet, can actually go a long way to prevent the problems of childhood obesity.

If your child can make it through their first five years at a healthy weight, the chances that they will remain at a healthy weight for the rest of their lives really improve. So it's worth making the effort early on to give them the best start in life that you can.

_{updated: July 21, 2026
originally published: March 4, 2014}