AAP Voices Blog

Since the early weeks of the pandemic, countless parents of patients have approached me about how they can encourage their children to be more active at home. They worry that their kids are too idle as the pandemic has dragged on and they are spending much of their time on their smartphones and laptops.

Many families rely on their children participating in physical activities and receiving nutritious hot meals at school, but COVID-19 has changed the landscape dramatically as many children take part in virtual learning.

A report released in October from the Robert Wood Johnson Foundation found that 15.5% of U.S. children ages 10 to 17 have obesity and also noted that rates of obesity are higher among children of color and kids from families with low incomes. 

It’s even more vital now to have conversations with parents about the obesity crisis.

My primary advice to parents is this: “Be an example. Why don’t you get moving inside? You get an opportunity to be a role model for your children and get in activity yourself.”

We know that physical activity leads to better physical and mental health. We must encourage exercise among our patients and their parents and model it ourselves.

“We should help our patients’ parents prioritize addressing their children’s nutrition and physical activity now, and to approach it as a family.”

COVID-19 has had a major impact on everyone. The way that we live our daily lives has changed, and there is much uncertainty of what life will look like after we conquer this horrible disease. We see that the number of people with COVID-19 and those who have died from the disease continues to climb. And we now know that obesity is a major risk factor for severe complications from COVID-19.

Why is that? Obesity can lead to:

• Difficulty with breathing
• Problems with immune function
• Exaggerated inflammation
• Dysfunction of metabolism

This is a recipe for poor outcomes in COVID-19, and it becomes even more pronounced when you add in other obesity-associated diseases, such as Type 2 diabetes, non-alcoholic fatty liver disease, and obstructive sleep apnea, among others.

Encourage patients with obesity and overweight to seek and follow up with treatment. Pediatricians are poised and ready to help treat obesity with therapies that range from lifestyle modification to medications to surgery. The key is to get treated, even in the middle of the pandemic. There are ways to do this safely, and we are here to help.

Many of us have implemented telehealth appointments that allow continuous treatment even amid juggling at-home school and an increased intensity of our own work, in which there often is less separation of job and home. We have also taken significant precautionary measures to make sure our offices are safe and sanitary to reduce the risk of transmission of COVID-19.

It’s important to let your patients’ parents know that it’s necessary to see their pediatrician now.

This is not a problem to put off until after the pandemic. Rather, we should help our patients’ parents prioritize addressing their children’s nutrition and physical activity now, and to approach it as a family. Indeed, family-based care yields the best outcomes for the treatment of overweight and obesity.

When parents ask what they can do, it is important to focus on those factors in which we often have some control:

• Diet quality: Focus on eating vegetables, whole grains, lean protein, and fruit.
• Physical activity: Adults should be active and should encourage their children to exercise at least one hour per day. If it’s too cold to be outside, try online exercise classes, invent games that involve movement, do a set of jumping jacks at the top of each hour, and practice some kid-friendly yoga stretches at the end of the day.
• Sleep quality and duration: Children and adolescents have different requirements based on their age, but at least 7-8 hours is a good starting point. If parents or children tell you that they snore, gasp, or choke for air at night, stop breathing, are sleepy during the daytime, or wake up with a headache, they may have obstructive sleep apnea and should seek appropriate care to treat it.
• Stress: This is a tough one. We are all experiencing stress right now and it’s difficult to control at times. It is important to practice techniques to help reduce stress, such as exercise, engaging in faith-based practices, and meditation -- and to reach out for help when needed.

The American Academy of Pediatrics has guidance on COVID-19 and obesity here. This is a valuable resource for parents and children. Parents looking for help can find good tips in this article at HealthyChildren.org.

We must not let this pandemic take away our opportunity to be our happiest and healthiest selves. We must prevent and treat obesity during the COVID-19 pandemic. Our lives depend on it.