Weight Gain During Adolescence: What is Typical? What is Concerning?
About 14.7 million American children are affected by obesity(1) and, while many people with larger bodies are healthy, obesity puts children at increased risk for health problems including Type 2 diabetes, heart disease, sleep apnea, asthma, joint pain and difficulty with physical functioning, as well as depression and anxiety. With the proliferation of high-calorie, ultra-processed foods being aggressively marketed to kids, pre-adolescent and adolescent weight gains can cause parents concern. Their concerns are not wholly unjustified. However, it is helpful to know that some weight gain during adolescence is necessary and healthy.
It is not uncommon to see adolescents gain weight rapidly over a relatively short period of time during puberty. Adolescent girls tend to have their biggest growth spurt from ages 10 to 14 and on average gain 40 to 50 pounds and 10 inches in height. Girls will gain more fat tissue and will add fat stores on their thighs, hips, and breasts. Adolescent boys tend to have their biggest growth spurt between ages 12 to 16 and on average gain 50 to 60 pounds and 12 inches in height. In boys, the weight gain is mostly due to muscle. Most adolescents will double their body weight during this period of incredible growth.(2)
Be aware that your child’s appetite (along with your grocery bill) may soar in preparation for a growth spurt. If their weight soars too, try not to react with alarm, excess concern, or criticism. Proper weight gain is needed to make sure that children reach the height they are meant to be. For many children, their weight spurts happen before their height spurts, leading to temporary excess fat stores. Some parents may feel concerned that their child is becoming overweight and react by putting them on a restrictive diet but actually both weight and height spurts are part of normal growth. If children do not gain enough weight throughout adolescence, they may not reach their full genetic potential for height. Knowing that they will gain weight, where, and why can help reassure children that they are growing as they should be. Children can be very sensitive about their changing bodies and so a supportive parent who understands and normalizes their weight increase can have a positive influence on their healthy growth.
Parents can help further reduce children’s weight sensitivity by using body-positive words like “healthy,” “amazing,” “strong,” and “fast” when talking about bodies (their child’s body, their own body, other people’s body).(3) In addition, parents can focus on what healthy bodies can do instead of their weight or shape. For example, “Wow! Your strong healthy body can run right up those stairs!” or “My amazing body gave me my two wonderful children and I’m so grateful for it.” Avoid terms that convey judgments such as “chunky,” “thin,” “big-boned,” “skinny,” or “delicate.” When I was a teen, I ran cross-country and had a strong and healthy body yet people often referred to me as “big-boned” or “robust” compared me to my “small-boned” sister and mother. What no one knew is that I had subclinical hypothyroidism, meaning that mild thyroid failure was slowing down my metabolism and leading my body to burn energy more slowly than it should have been. I had a medical condition (and also just a naturally different body build); however, this kind of language made me feel like I was doing something wrong in a 1990’s Kate Moss heroin chic obsessed society. A general rule is to not comment on anyone else’s body – it’s seldom if ever necessary! But if we must, we can use more inclusive language to help our children learn that bodies naturally come in all shapes and sizes and that neither higher-weight nor lower-weight bodies (or people with larger bodies or smaller bodies) are intrinsically good or bad, better or worse.
It is also important for both parents and children to know that there is no one ideal weight for a child at any specific age. Some healthy 10-year-olds weigh 60 pounds while others’ healthiest weight will be 100 pounds. Height, build, gender, and genetics all contribute to a child’s individual ideal weight. When it comes to interpreting your child’s growth charts, it is much more important to compare your child to themselves rather than to other children. If your child is tracking along the same weight curve as they have since early childhood and their BMI-for-age is in a healthy range, then there is little cause for concern. If your child rapidly shifts two or more major percentile channels up or down, something may be disrupting their ideal growth. Be on the lookout for sudden or extreme changes. And if you have concerns about your child’s weight or wonder whether they are on their ideal developmental track, the best thing to do is to ask your child’s doctor to talk through their growth charts with you (preferably in private, not in front of your child). Most importantly, parents should never put children on a calorie/energy restricted diet or strict exercise program without medical supervision as such programs could inhibit them from reaching their full genetic potential. Most children should continue gaining weight until they reach physical maturity by age 18 to 20. (4,5)
A healthy home environment is one that offers plenty of fruits and vegetables, whole grains, proteins, dairy, and healthy fats for meals and snacks and also limits the amount of ultra-processed foods and foods with lots of added sugar.(6) Try to choose a wide variety of different foods in order to help your child get a range of nutrients (i.e., “eat the rainbow”). At the same time, it is helpful not to restrict your child from eating any particular type of food unless medically necessary (diabetes, food allergies, etc.). A certain family member of mine often tells a story about how his parents forbade any sugar in their home and then found him hiding under the coffee service at church rapidly swallowing spoonful after spoonful from the sugar bowl. Inflexible dietary rules and restriction can lead children to develop unhealthy attitudes toward foods that may develop into eating disorders for some. There is no food that is inherently fattening – it all depends on how much and how often the food is consumed. In appropriate portions, all foods have a place in a balanced diet.
In sum, remember not to panic as your child goes through normal adolescent weight and height spurts, promote a healthy body image in front of them by focusing on what their amazing bodies can do rather than discussing weight and shape, and make a plan to talk to their doctor about your concerns if you feel worried that their growth may not be on the ideal developmental track for them. Taking action is not always necessary when your adolescent starts gaining weight – their body may be growing just as it should be.
Dr. Rebecca Swenson is a licensed clinical psychologist and parent coach who works with children, adolescents, young adults, and families in Northern Michigan with anxiety, OCD, and eating disorders. If someone in your family is struggling with emotional/behavioral health issues, contact Dr. Swenson today to learn more about evidence-based treatments that can help.