An estimated 1 in 5 children is overweight or obese. This puts them at increased risk for developing cardiovascular disease. In fact, 70% of obese children have at least one risk factor for cardiovascular disease and 39% have two or more risk factors. Young children are now being treated for high blood pressure, high cholesterol and sleep apnea. According to the American Diabetes Association, 95% of children diagnosed with diabetes have type 2 diabetes which used to be called adult onset diabetes. Very often type 2 diabetes is the result of lifestyle choices and can be avoided.
Excess weight can limit a child’s physical activity and can negatively impact their health in numerous ways. Overweight kids face psychological challenges and may face social discrimination as well as employment discrimination later in life. According to the American Academy of Pediatrics the obesity rate for children has doubled over the past two decades with adolescents being most affected. 
Dietary choices play a big role in this health problem and have changed dramatically in the last 20 years. Challenges include: soft drinks (regular and diet are a problem), increased intake of pre-packaged foods, huge increases in the amount of sugar-laden foods consumed by children, and frequent consumption of inexpensive convenience foods which have limited nutritional value.
Very often people comment that kids have too much “screen time” meaning that they spend too much time being sedentary sitting in front of a computer or the TV. There is no question that physical activity has declined (both in schools and playing outside in the neighborhood) but there are more challenges associated with TV viewing than simply lack of activity.
A recent publication by Zimmerman et al (Am J Pub Health (2010)100:334) highlighted the role that television commercials play in kids food choices because a large percentage of commercials promote high sugar cereals and snack foods. TV viewing starts at an early age with 90% of 2-year olds spending time in front of the television and by the time a child is in first grade then can identify over 200 brands. The average child ages 8-17 views roughly 7,000 TV commercials each year.
What is the answer to the childhood obesity epidemic? Kids who are “coached” about a comprehensive, healthy lifestyle can be very successful.  Parents need to be involved in the educational process and must lead by example. The probability of a child being overweight or obese drops down to only 7% if both parents are normal weight.
Children don’t want to be overweight – they just need guidance and understanding to be successful.  Some experts say that this is the first generation of kids that won’t outlive their parents. Everyone needs to work together to ensure that is not the case. A family-based lifestyle program focusing on goal setting, behavior modification, exercise and nutrition education with sensible eating really does work. The focus has to be sensible eating and not diets. Kids are smart and can be hugely successful when given the appropriate tools.