Reframing physical activity in pediatric obesity care settings can improve treatment and lifelong participation 

Pediatric obesity is complex, shaped by biological, social, environmental, and psychological factors. Globally, the prevalence of children and adolescents with overweight and obesity is estimated to be 14.8% and 8.5%, respectively. There is a clear need for effective and equitable treatment approaches that are systems-focused, patient-centered, and that move beyond narrow weight-focused outcomes.  

Physical activity is a recommended component of pediatric obesity care, yet it is often framed as a strategy aimed at reducing body weight rather than improving quality of life. It is widely known that physical activity is associated with physical and psychosocial benefits for all children, regardless of weight status. However, for youth living with obesity, the experience of movement is often shaped by weight-based bullying, exclusion, and negative experiences. Therefore, when physical activity is prescribed by healthcare professionals—and framed only as a route to weight loss—the message can reinforce stigma, erode selfefficacy, and push young people with obesity away from physical activity y the care they need.  

On World Obesity Day 2026, and consistent with ISPAH’s mission to embed physical activity into healthcare and community settings, we recognize that those engaged in supporting young people with obesity have an opportunity to help change the narrative. We encourage healthcare professionals to not only promote physical activity in pediatric obesity treatment settings, but to do so in ways that are sensitive to stigma, equitable, and tailored to each child. In fact, evidence points to the value of framing messages around the benefits of physical activity beyond weight loss, with particular attention to developing confidence, strengthening social connections, identifying and overcoming barriers, and setting goals for daily movement. The aim is lifelong physical activity engagement; not participation tied to weight and/or a time-specific treatment plan. 

Why does it matter?

Low rates of physical activity among youth, alongside rising rates of pediatric obesity, highlight the importance of ensuring physical activity recommendations are a part of routine clinical care. Indeed, alongside the physical benefits of physical activity for young people with obesity are improvements in mental health outcomes, quality of life, self-concept, and emotional functioning. Despite this, there are unique challenges associated with engaging in regular physical activity for young people living in larger bodies.  

What might reframing physical activity recommendations look like in pediatric obesity care? 

• Discuss physical activity in stigma-sensitive, supportive ways; use people-first language and avoid implying blame or ‘poor choices’ for insufficient physical activity  
• Emphasize the benefits of physical activity that are no weight-related  
• Avoid overly simplistic “eat less and move more” recommendations  
• Encourage social connection as a physical activity strategy (e.g., a ‘movement buddy’ or family-based activities) 
• Ask about the child or adolescent’s lived experience with movement (e.g., “Have there been activities where you felt comfortable or connected?”) 
• Work together to set physical activity goals that are meaningful to the child/adolescent 
• Help youth and families problem-solve to reduce environmental and social barriers (e.g. transportation challenges, access to supportive and free-of-cost activity spaces) 
• Connect families with inclusive community-based physical activity opportunities  
• Celebrate participation and consistency rather than intensity or weight loss 

This World Obesity Day, let’s remember: physical activity supports the health and wellbeing of children and youth of all sizes. Whether in clinics, schools, or community programs, those who support young people with obesity play an important role in creating supportive, stigmafree environments where activity is framed not around weight loss, but around confidence, connection, enjoyment, and wellbeing. 

Mensajes para llevar a casa

• Physical activity benefits children and youth of all sizes
• Physical activity should be routinely included in pediatric obesity care, with an emphasis on its benefits beyond weight loss
• Recognizing that barriers, individual differences, and inequities can make physical activity challenging, it is our responsibility to help create supportive, accessible, and realistic opportunities that make regular participation possible for every child

Autores: Dr Shauna M. Burke,^1,2 Dr Marina Ybarra,^1,2,3,4 Balraj Gill¹

1. Faculty of Health Sciences, Western University, London, Ontario, Canada 

2. Children’s Health Research Institute, London, Ontario, Canada 

3. Children’s Hospital, London Health Sciences Centre, London, Ontario, Canada 

4. Department of Paediatrics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada