October 22, 2025, 4:34 p.m.
Piyush Srivastava, MD
If your child seems to gain weight more easily than others, you may be wondering why and what you can do. As a pediatric obesity medicine specialist, I want families to understand that weight management is more complex than it may appear.
Our society often attributes weight to individual choices or a lack of self-control, particularly in children. However, scientific evidence reveals a much more complex picture, influenced by biological factors, environmental circumstances, and emotional well-being, rather than solely dietary intake and physical activity.
The complexity of weight regulation
While dietary habits and activity levels play a role, they represent only a fraction of the factors at play. Genetic predisposition, hormonal regulation, metabolic processes, sleep patterns, stress levels, and even gut microbiome composition significantly impact how our bodies manage and store energy.
Some children may have underlying medical conditions or are on medications that contribute to weight gain. Others might experience hormonal imbalances or have a family history of obesity. Often, early weight gain stems from common behaviors, such as seeking comfort in food, reduced physical activity, or living in environments with limited access to nutritious food and safe outdoor spaces.
Understanding the causes
It's important to realize that a child's weight isn't just about their choices. Many factors can play a role. To understand this better, think about these factors:
- Genetic predisposition: Individual genetic variations can influence metabolic processes and fat storage, thereby increasing susceptibility to weight gain.
- Hormonal dysregulation: Endocrine imbalances, such as those affecting appetite and satiety regulation, can significantly impact weight.
- Environmental influences: Limited access to nutritious food, restricted opportunities for physical activity, and pervasive exposure to unhealthy food marketing contribute to weight challenges.
- Socio-emotional factors: Psychological stressors, emotional eating patterns, and familial or cultural influences on dietary habits play a substantial role.
- Metabolic variability: Individual differences in metabolic rates can affect calorie utilization and weight regulation.
- Sleep disruption: Inadequate or poor-quality sleep can disrupt hormonal balance and contribute to weight gain.
Children shouldn’t be blamed for gaining weight easily. Often it reflects how their body responds, and we need a deeper, more comprehensive understanding of why.
Your child's health journey
If you're concerned about your child's weight, initiate a conversation that is free from blame, fear, or pressure. Avoid labeling foods as "good" or "bad." Instead, focus on overall health, encompassing energy levels, sleep quality, emotional well-being, and self-confidence.
If you feel overwhelmed or unsure where to begin, pediatricians can help. A trusted provider can work with families to identify the underlying causes, develop strategies, and support a child’s overall well-being, beyond just their weight.
Need help finding a pediatrician? We’re here to assist. Learn more about what factors to consider when choosing a provider.
Piyush Srivastava, MD, provides complete health care for children as a general pediatrician and holds board certification in obesity medicine. His practice is affiliated with BJC Medical Group.
