As more schools open for in-person learning and some organized sports resume, many children — like adults — are returning to the world after having packed on extra body weight.
While data is sparse on whether there's been a rise in children's weight over the pandemic, some health professionals have seen worrisome signs.
Suzannah Stivison, a pediatric nurse practitioner in Kensington, Md., told NPR that some of her patients put on what she calls "the other COVID-19" — as in, 19 pounds.
A loss of daily structure, in school and extracurriculars, left kids looking for a sense of control that she said many have found in eating.
"One of the ways that we regained a routine and a schedule within our families was most likely, for a lot of people, around meals," she said.
Since last March, adults joined the bread-baking craze and indulged in junk food.
Stivison herself admits slipping into an unhealthy pandemic kick.
"I never have Cheetos in my house. But all of a sudden, they appeared," she said. "And this has been a phenomenon that I have seen in lots of houses. Eating became something we could control. And it was it's also something we use for comfort."
Virtual appointments have made it difficult for health care workers to conduct their regular height and weight assessments. But research has shown that children tend to gain weight during extended sedentary periods like summer vacation, when fewer are getting regular exercise through organized sports and physical education.
Parents who are concerned about addressing their children's weight face tricky hurdles. Those unprepared can contribute to the various stigmas around eating disorders and diseases like obesity, which have their own consequences on children's physical and mental health.
But there are supportive ways parents can help get their kids to get back to a healthier lifestyle, Stivison said.
It's less about talking and more about setting an example, she said.
Talking in the abstract about risk factors such as Type 2 diabetes and heart disease, she said, doesn't really work, especially with younger kids.
"The thing is, is that kids know they're heavier than their peers. They know they get out of breath," she said.
Instead, parents can model good habits like exercising an hour a day or keeping the house stocked with healthier foods.
"It really comes down to the modeling and the opportunity we can control what food comes into the house," she said. "And so guess what? I've stopped buying Cheetos."
The good news, Stivison said, is that healthier behaviors among kids should bounce back as people start to return to their normal rhythms.
Parents who've become more lenient with screen time, for example, will likely reinforce those limits, she said.
"Screen-time rules for kids being two hours or less came from the fact that increased screen time correlated with higher weights and BMI," she said. But during the pandemic, she said, "I have even been supporting families, saying, 'OK, playing video games with friends who are, you know, in their own house playing video games — don't consider it screen time. Consider it social time.' "
But as parents start to get their kids vaccinated, she said, "that in and of itself will likely help this problem to a great degree."
Samantha Balaban and Melissa Gray produced and edited this interview for broadcast.