Helping Your Overweight Child to Lose Weight

• Set goals. Just like with adult weight loss, the weight loss goals in children should be attainable, allowing for normal growth. The goals should initially be small, so that the child doesn’t become discouraged or overwhelmed. A five to 10 pound weight loss is a reasonable first goal — about 1 to 4 pounds per month.
• Food diary. Work with your child to keep a food diary. This should include not just the type and quantity of food eaten, but where it was eaten, and who else was present. The diary is not meant to help calculate calories eaten. Rather, it is useful in determining eating patterns and problem foods.
• Diet. Work with your child’s doctor to ensure that your child is receiving a balanced diet, even if the calories consumed are decreased. Consider working with a dietitian also.
• Physical activity. Exercise is an essential component for any long-term weight loss. Start small, to avoid discouraging the child and work up to 20-30 minutes of moderate activity per day in addition to what they get in school.
• Behavior modification. It’s important to help your child learn the skills to modify the behaviors that may be causing the weight problem. Consider sending your child to a nutritional counselor.
• Parental role. Help your child by limiting the amount of fattening foods in the house, eating all meals at the dinner table at designated times, and discouraging second helpings.

Should I Enroll My Child in a Weight Loss Program?

If your efforts at home are unsuccessful in helping your child reach a healthy weight and your doctor determines that your child’s health is at risk unless he or she loses weight steadily, you may want to consider a formal weight loss program. The overall goal of a weight loss program should be to help the entire family adopt healthy eating and physical activity habits.

Look for the following characteristics when choosing a weight loss program for your child. The program should:

• Be staffed with a variety of health professionals. The best programs may include registered dietitians, exercise physiologists, pediatricians or family doctors, and psychiatrists or psychologists.
• Perform a medical evaluation of the child. Before being enrolled in a program, your child’s weight, growth, and health should be reviewed by a doctor. During enrollment, your child’s weight, height, growth, and health should be monitored by a health professional at regular intervals.
• Focus on the whole family, not just the overweight child.
• Be adapted to the specific age and capabilities of the child. Programs for 4-year-olds are different from those developed for children 8 or 12 years of age in terms of degree of responsibility of the child and parents.
• Focus on behavioral changes. Teach the child how to select a variety of healthy foods in appropriate portions. Encourage daily activity and limit sedentary activity, such as watching TV.
• Include a weight loss maintenance program and other support and referral resources to reinforce the new behaviors and to deal with underlying issues that contributed to the child becoming overweight.

Is Drug Therapy or Weight Loss Surgery an Option for an Overweight Child?

At this time, there are no weight loss drugs approved for use in children although clinical trials are under way. Surgical procedures for weight loss are being used, but their safety and effectiveness have not been widely studied in children. Talk to your child’s doctor to determine if weight loss surgery for your child should be considered.