When you and your child's doctor have determined that your child
needs to lose weight, a serious attempt to treat the problem should
be undertaken. Here are some tips to get you started.

Set goals. Just like with adult weight loss, the 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 1-4 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 treatment program.

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

Be staffed with a variety of health professionals. The best programs
may include registered dieticians, 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 foods in appropriate
portions.

Encourage daily activity and limit sedentary activity, such as
watching TV.

Include a 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