Childhood obesity is a growing public health challenge that affects children’s health, emotional well-being and long-term quality of life. According to national data, 1 in 5 children and adolescents in the U.S. have obesity, with rates significantly higher among children covered by Medicaid than among those with private insurance.1,2 The impact is especially pronounced for low-income families, who often face barriers such as the high cost of healthy food, limited access to nutritious options, screen-time habits, stress and competing household priorities.3 Families experience childhood obesity through everyday challenges tied to cost, access and routine. UnitedHealthcare Community & State is using direct insights from Medicaid families to better understand these realities- and to design approaches that connect care, nutrition support and community support through practical, family-centered ways.
The challenges facing families
Childhood obesity is shaped by a complex set of social, economic and environmental factors that influence what families can afford, what foods are available, how much time children spend being physically active, and how supported parents feel in helping their children build healthier routines. 4 UnitedHealthcare Community & State research examining insights from Medicaid families highlights the extent of these challenges. Medicaid households with children report navigating significant nutrition-related constraints, including purchasing less nutritious foods because they are more affordable, struggling to afford healthy options and relying on government food programs to meet basic needs. For many Medicaid households, concerns about having enough affordable, nutritious food can outweigh every other priority — even stable housing — because feeding their children today is the most urgent need.
At the same time, many families face confidence gaps when it comes to preparing healthy meals. Only about half report feeling confident in their ability to shop for and prepare nutritious food, citing limited knowledge, lack of access to healthy ingredients and insufficient kitchen tools or resources. Healthier foods such as fresh produce and dairy products may also spoil faster than processed, shelf-stable foods that may cost less and offer lower nutritional value. These insights reinforce that for many families, supporting a child’s health is shaped by broader systems that affect access, affordability and having the right tools and support in place to make those choices possible.
The family perspective
In addition to data, lived experiences add important context to how childhood obesity manifests in daily life. Families describe supporting healthy eating and physical activity as a delicate balancing act, shaped by picky eating, screen time, busy schedules and the difficulty of encouraging healthier habits without creating tension or negatively impacting a child’s confidence. Among families already managing childhood obesity, the experience is often described as emotionally complex, stressful and deeply personal. As one parent shared,
“I just hope my child stays healthy, confident and develops a balanced lifestyle that feels natural and sustainable for them.”
Parents want support that fits into their real-life routines and helps them create healthy habits their children can realistically sustain.
The 5-2-1-0 framework
5 servings of fruits and vegetables
2 hours or less of recreational screen time
1 hour or more of physical activity
0 sugary beverages
How we are responding
UnitedHealthcare Community & State is working to address these challenges by combining data-driven insights with practical, family-centered solutions that connect clinical care, nutrition support and community resources. In Nevada, for example, the health plan’s Healthy Kids Program includes one-on-one consultations with registered dietitians who work with families to set goals using the 5-2-1-0 framework. This approach encourages balancing nutrition, physical activity and screen time in a way that is achievable for families.
The program is paired with Farm Box support, which provides healthy snack boxes that include items such as apples, carrots and oranges. These boxes help reinforce nutrition goals while also addressing access and affordability barriers, making it easier for families to incorporate healthier options into their daily routines. By combining education with tangible support, this model supports gradual, sustainable behavior change.
What families say they need
UnitedHealthcare Community & State research also highlights strong demand for practical support that make healthy living more accessible.4 Of those interviewed, 81% expressed interest in healthy groceries delivered to the home, 75% had interest in gift cards for cooking essentials and 72% had interest in a database of local resources that provide nutritious, affordable food. In addition, families identified grocery stipends, physical activity programs for children and access to dietitians as some of the most helpful ways a health plan can support a child’s health and weight. These findings show that families are asking for tangible support to help make healthy choices more realistic and affordable.
Why this matters for Medicaid
Factors such as food access, family stress, stigma, education and safe opportunities for physical activity all impact childhood obesity outcomes. Addressing these factors early can help improve not only physical health, but also mental well-being, school performance and long-term quality of life. For Medicaid programs, this presents both a challenge and an opportunity. By bringing together clinical care, nutrition support and community-based resources, managed care organizations can help states respond earlier, more effectively and at greater scale. This is especially important for Medicaid populations, where families may face additional barriers tied to income, caregiving demands and limited access to healthy food and activity options.
Addressing childhood obesity requires recognizing the everyday pressures families face and building solutions that are practical, compassionate and connected to the realities of Medicaid communities. By combining data, member insights and coordinated support, UnitedHealthcare Community & State is helping demonstrate how a more responsive, family-centered approach can lead to more effective and scalable solutions.
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Sources
- Childhood Obesity Facts (2, April 2). CDC.
- Williams, E., et al., (2023, August 17). Obesity Rates Among Children: A Closer Look at Implications for Children Covered by Medicaid. KFF.
- Childhood Obesity (2025, January 8). Mayo Clinic.
- UnitedHealthcare Community & State. (2025). Internal Medicaid Member Study. Unpublished proprietary research.
