What should I do if my child is overweight?

If your child is overweight, do not withhold food. Low-calorie diets often don't supply the food energy and nutrients children need to grow, develop and learn properly.

Healthful eating habits, combined with plenty of active play, can help most overweight kids grow into their healthy weight without a special diet.

Obesity in children is rising -- one in five children are clinically obese. Obesity is specifically associated with thickening of the arterial wall, a classic precursor to heart disease. The subject of weight is a touchy subject no matter what your age, but especially for children. Be aware that once you start talking about weight to your child, you are setting up a series of events, feelings, and consequences. Even with the best of intentions, you must know exactly how to approach the topic or you could make matters worse. In fact, for many adolescents, dieting to control weight is not only ineffective, it may actually promote weight gain. One study in particular followed a group of kids, some who dieted regularly and some who didn’t; after three years the dieters ended up gaining more weight than the non-dieters.

 If you determine that your child is gaining weight, don’t try to tackle the situation by yourself. Talk to your pediatrician before approaching your child and then follow up with an appointment for an assessment and recommendations. Together, you can develop an effective and long-term plan to help guide your child back to a healthy, normal weight, without causing any ill effects.

 It may sound obvious, but your pediatrician will likely follow this approach:

1. Determine cause of weight gain. Possible causes to consider are activity level decline, nutrition changes, changes due puberty, adolescent changes, stress, peer pressure, medications, and medical conditions (such as genetic syndromes and endocrinologic diseases, but only 5% or so of patients will have these).
2. Evaluate diet of family and child. Consider not only breakfast, lunch, and dinner, but also snacking habits, desserts and sweets, dining out.
3. Evaluate activity levels of family and child. Include playing actively, team and individual sports, walking to and from school, recess activities, and family activities.
4. Evaluate mental and emotional state of child. Self-esteem, body image, confidence level, stress levels, depression, willingness to make a change.

From Good Kids, Bad Habits: The RealAge Guide to Raising Healthy Children by Jennifer Trachtenberg.

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