Childhood obesity has reached epidemic proportions in the United States. In the last decade, the prevalence of obesity reached 19.3% among children and adolescents aged 2 to 19 years.1 Children with obesity by the age of 3 years are more likely to be overweight when they reach adolescence.2

In a response to the rising tide of childhood obesity, the National Association of Pediatric Nurse Practitioners (NAPNAP) released an updated position statement in Journal of Pediatric Health Care.3 The statement stems from NAPNAP’s commitment to encouraging healthy lifestyles inclusive of nutritious eating and physical activity so that children and families can establish a foundation of optimal health.

“Obesity can often result in comorbidities that correlate with chronic diseases and increased morbidity into adulthood,” said the organization in a press release.4 “Additionally, obese children are more prone to trauma, low self-esteem, anxiety, and depression due to the social stigma and victimization from bullying.”

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In response to this epidemic, NAPNAP encourages pediatric health care providers to prioritize the following goals:

  • Early identification of children and adolescents at risk for overweight
  • Provision of age-specific anticipatory guidance on healthy eating and physical activity to families and their communities
  • Continuity of care for children and adolescents identified as overweight or obese

Childhood obesity can often lead to comorbidities that “correlate with the chronicity of diseases and increased morbidity into adulthood,” NAPNAP said. Comorbidities often seen in obese children and adolescents include “cardiovascular changes leading to hypertension, dyslipidemia, [and] insulin resistance.”

Social stigma and victimization by bullying commonly lead to trauma, low self-esteem, anxiety, and depression in children and adolescents with obesity. “These considerations are important when evaluating the lifetime economic costs to the patient and the health care systems when addressing the prevalence of obesity,” NAPNAP said.

NAPNAP recommends that health care providers partner with patients, parents, families, caregivers, schools, and communities to implement a series of guidelines to help curb overweight and obesity in children. Notable guidelines include:

  • Use genetic testing for children who show signs of extreme obesity before the age of 5, who show features of genetic obesity syndrome, or who have a family history of a genetic obesity syndrome
  • For women who are pregnant and lactating, a nutritious, well-balanced diet; optimal gestational weight gain; smoking cessation; and breastfeeding during the baby’s first year are encouraged
  • Additional education for pediatric health care providers should include prevention, identification, and management of overweight and obesity in children and adolescents
  • Obtain accurate measurement of length/height and weight ratio in children, BMI for children 2 years and older, blood pressure beginning at 3 years of age or in younger children who have identified risk
  • Encourage culturally sensitive, family-centered lifestyle interventions that are geared towards promoting healthy eating habits and physical activity for children with obesity

“Partnership with families to promote healthy lifestyle changes may have a lifelong impact on health outcomes,” NAPNAP concluded.


1. Centers for Disease Control and Prevention. Childhood obesity facts. Accessed July 15, 2021.

2. Ward ZJ, Long MW, Resch SC, et al. Simulation of growth trajectories of childhood obesity into adulthood. N Engl J Med. 2017;377(22):2145-2153. doi:10.1056/NEJMoa1703860

3. Position statement on the identification and prevention of overweight and obesity in the pediatric population. J Pediatr Health Care. 2021;S0891-5245. doi:10.1016/j.pedhc.2021.03.001

4. NAPNAP updates position statement on identification and prevention of overweight and obesity in the pediatric population. News Release. National Association of Pediatric Nurse Practitioners; July 15, 2021. Accessed July 15, 2021.