What diet and exercise changes may help my obese child lose weight?

The simple answer to this question is: more exercise and some diet changes. Where obese kids are concerned, people tend to focus too much on diet, and downplay the critical importance of physical activity. Not just organized "exercise", such as a team sport, but constant daily activity. Walking to school or to other destinations counts as activity. Active outdoor play also counts - running around with friends, bicycling, playing on playground equipment, digging in a sandbox, pick-up games and the like are all exercise and should be encouraged. Kids aren't likely to stick to dull regimented activities like jogging or stationary bicycles. Parents need to evaluate how much time a child spends every day on these types of activities, vs. how much time is spent sitting - in front of TV or a computer, at school or in a car. Two or more hours of active play would be great.

Diet changes depend on what the child typically eats that contributed to obesity. Lots of sugary soft drinks? Free access to chips, cookies or other snack foods? Big portions at meals? An unbalanced diet of processed foods, with few vegetables or fruits? A preference for high fat food, whether fried foods or ice cream? All of those habits can contribute to excess calorie intake. Most are easily changed, and those changes can only have a beneficial impact on nutrition. No child needs to drink soft drinks. And parents of an obese child should not be stocking up on tempting snacks and treats, expecting the child to resist eating them. Big portions, whether at home or a restaurant, should be discouraged. All meals should have some fruit and/or vegetables, as these foods are filling, but lower in calories and higher in nutrients. If your family makes dessert a habit, limit dessert to fruit, unless it's a very special occasion, such as a birthday. Finally, make sure your child eats a healthy balanced breakfast, low sugar, with a high protein food and healthy carbs like fruit or whole grain cereal or bread. A healthy breakfast helps prevent raging hunger later in the day that can lead to mindless high calorie snacking, not something an obese child should do.