How Much Time Is She Outdoors?
The flip side of not watching TV is what your child does instead. And just about any outside activity -- playing tag, riding a bike, throwing a ball -- will help your child burn calories. "Time spent outside results in a reduced risk of obesity," Dr. Murray says. It's especially important to encourage your child to get out as she approaches adolescence, when activity levels drop. Since many schools have cut back on physical education classes, consider an intramural sports program in your community.
How Much Soda Does He Drink?
You can't pin obesity on a single food, but some researchers say that kids' surging consumption of soft drinks has become a huge problem. A Harvard study, for example, found that drinking one extra can of sugared soft drink a day raises a child's risk of becoming obese by 60 percent. "Soft drinks provide highly concentrated, fast-acting sugar that's absorbed rapidly into the blood," says study coauthor David Ludwig, M.D., Ph.D., director of the obesity program at Children's Hospital Boston. Dr. Ludwig thinks consuming large amounts of foods high on the glycemic index, a measure of how quickly sugars enter the bloodstream, causes hormonal changes that trigger hunger and lead to overeating. If true, problem foods would include not just soda, but fruit drinks and highly refined starchy foods such as white bread and sweetened cereals. The theory is unproved, but other researchers note that soft drinks often go together with other less-than-ideal fare, such as salty snacks and fast food. "In terms of diet, I would make cutting back on soda and juice drinks the first priority," says Susan Roberts, M.D., senior scientist at Tufts University's Human Nutrition Research Center on Aging and author of Feeding Your Child for Lifelong Health. "Instead, give your child milk or water."
How Often Do You Order In or Eat Out?
It's well-established that a lot of fast foods are high in calories, but it's not just the drive-thru burger joint that's putting your child at risk. Experts say that people who eat out frequently -- even at more upscale restaurants -- and those who rely on takeout food tend to consume more calories, probably because portions are bigger. "If you dine out or order in frequently, it can be difficult to prevent a child from over-eating," Dr. Murray says.
Are You a Diet Dictator?
Fact: Almost 80 percent of schoolchildren don't get the recommended five or more servings of fruits and vegetables a day. Fact: Families who eat more fruits and vegetables have fewer weight problems. Logical conclusion: You should make sure your kids eat their broccoli and oranges.
But don't go overboard in trying to dictate what your child consumes. Studies suggest that kids whose parents tell them exactly what and when to eat are more likely to gain weight, not lose it. "Children are much better at regulating food intake than adults are," Dr. Murray says. But parents can throw off a child's natural appetite controls by making him eat lunch even if he's not hungry just because it's lunchtime, for example. Bribes backfire too. "If you tell a child he can't get a brownie unless he eats his peas, that devalues the peas and makes the brownie the attractive food," Dr. Murray says. But you can help ensure that your child eats the right foods in the right amounts. "Don't push and prod," he says. "Just continue to put a variety of healthy foods in front of your child and let him decide what, when, and how much to eat." If your child doesn't like a certain food, try something else -- or prepare it a different way. "In one study, we found that just adding cheese to broccoli doubled the number of kids who ate it," Dr. Murray says.
Does She Have Asthma?
A number of studies have found that children with asthma have higher rates of obesity than other kids. That's because the two problems tend to complicate each other: If your child has trouble breathing, she's less inclined to be physically active, which makes it easier to gain weight. And being heavier makes breathing even more difficult, leading to a vicious circle. "It's important for asthma to be treated so your child can remain as active as possible," Dr. Styne says.
Overall, the sooner you take steps to control your child's weight, the better. "You need to lay a good foundation of healthy habits early on," Dr. Murray says. "That way, children will learn to start making the right choices for themselves."