By DR. LEWIS FIRST

Parents have been feeding me lots of questions as to what they can do to help their child deal with being overweight or obese.  Let me weigh in and provide some information on this topic.

Twenty-five percent of US children are overweight and half to three quarters of overweight children will go on to become overweight or obese adults, increasing their risk of high blood pressure, heart disease, bone and joint problems, liver disease, and even depression.

What is contributing to this obesity problem?  Obesity can be largely a function of heredity, overeating, and lack of exercise – all of which revolve around, but are not caused by, the overweight child. 

In fact, a child has no motivation to lose weight until they become self-conscious about it, usually in adolescence.  Therefore the focus should be on the family of the overweight child and the role the family can play in preventing excess weight gain while maintaining a child’s healthy growth.  And I’ve got a few suggestions that may help.

First, don’t put your child on an individualized, strict diet that will be unpleasant for your child.  And and don’t deprive your child of food or regularly scheduled meals.  Withholding food only leads to overeating.  Instead, serve everyone average portions, limit seconds, and serve less-than-average-sized desserts.  Avoid sugar-sweetened beverages, and focus on a family diet that is low in calories.  Your child’s health care professional or a nutritionist can identify foods your child likes that will do this.  Weight loss medications, by the way, are not recommended for children because the risks outweigh the benefits.

Second, engage the entire family in an exercise program that consists of simple activities the family can do together, such as walks, biking, or helping to do active chores that will provide everyone with 60 minutes a day of moderate to vigorous physical activity.  Reducing the amount of recreational TV or internet time to less than two hours a day will help to encourage more physical activity and less snacking.

Third, and most importantly, please do not refer to your child as fat.  As a parent, you have a role to play in protecting your child’s self-esteem.  Focus on the positives of what your child does well rather than constantly remind them of the weight problem.  Feeling good about oneself may be the motivation needed for your child to want to start to work on not putting on the excess pounds.

Hopefully tips like these will give you something to chew on and reduce your concerns the next time you are worried about your child gaining too much weight. 

Lewis First, MD, is chief of Pediatrics at The University of Vermont Children’s Hospital and chair of the Department of Pediatrics at the University of Vermont College of Medicine.