For parents of the 25 million overweight or obese kids in the U.S., it's a common dilemma: If your child is fat, she probably knows it. Classmates may tease her, and she probably thinks her clothes are too tight when she looks in the mirror. So when you broach the topic, it's important to be compassionate. "How you discuss a child's weight problem can make a huge difference in helping her deal with it," says Jamie Calabrese, MD, medical director of the Children's Institute in Pittsburgh and a member of the American Academy of Pediatrics (AAP) Task Force on Obesity.
Look for a natural time to talk about your child's weight in a low-key way. After a checkup, you might say, "You heard the doctor say you're gaining weight too quickly. Do you want to talk about what we can do to help?"
If your child seems receptive, you can explain that he needs to get exercise every day so his body burns up the energy (food) he eats. Then offer some ideas, such as going to the playground three times a week or signing up for a sports class.
Let him know that being active is something you can work on together: "How about we take a bike ride together after dinner twice a week? It'll be fun, and we can both get in shape." Making fitness a group project, whether you're washing the car, playing freeze tag, or signing up for a family swim, will help your child stick to a routine. Keep the goals modest at first so he doesn't think of exercise as a chore or punishment.
Follow a similar approach toward food. If your kid eats ice cream every day, switch to a low-fat version or sorbet or limit him to three servings a week, and give him fruit on the other nights. Remind him why you're changing the family's habits: "Sweets taste good, but they're not very healthy. If we want your body to grow strong, we need to make smart choices." Encourage good eating by keeping junk food and soda out of your house and making your child feel like part of the process ("Let's go to the store and pick out some healthy foods").
"Young kids usually don't understand that their bodies look a certain way because of the foods they eat or the amount of TV they watch," says Melinda Sothern, PhD, author of Trim Kids. Help your child make the connection. Say, "I know you don't like being heavier than your friends. But you can change that by spending less time sitting around and more time moving your body."
Likewise, a 6-year-old can't relate to long-term health threats caused by obesity, such as diabetes and heart disease. Keep it simple: "If you eat lots of fruit and vegetables and play outside more, you'll be able to run around the bases without getting tired."
Girls may be more interested in hearing how lifestyle changes will improve their appearance. Tell your daughter how shiny her hair will look if she eats more fruits and vegetables. Or say, "If you keep playing soccer, you'll get into better shape and we'll probably need to go shopping for some new clothes."
If you want your child to live in a healthier way, you need to set a good example. Mention how much fun it is to play in your tennis league, or let him know how satisfied (not stuffed!) you feel when you eat an apple instead of a fattening dessert. "Role-modeling a healthy lifestyle is no different from role-modeling kindness or honesty," says Don W. Morgan, PhD, director of the Center for Physical Activity and Health in Youth at Middle Tennessee State University, in Murfreesboro. "Once kids see that daily physical activity is important to you, they'll want to be more physically active too."
That's what happened with the Hernandez family of Irvine, California. When her 7-year-old son, Willy, gained 20 pounds in one year -- and went from wearing slim- to husky-size clothing -- his mother, Martha Hernandez (who has struggled with weight most of her life) took a hard look at her family's eating habits and attitudes. "We piled too much food, a lot of it fried, onto our plates and encouraged our son to finish it all," she says. Willy also snacked incessantly on store-bought cookies and other processed treats.
Martha began broiling or baking foods, monitoring everyone's portion size, and packing Willy a healthy school lunch (fresh fruit and a sandwich made on whole wheat bread). She stopped buying soda, chips, and sweets, switching his snack choices to fruit yogurt or hummus and whole-grain crackers.
But Martha knew her son needed more exercise too. So she convinced him to sign up for a year-round swim team, and she joined a gym and started running herself. "I thought it was only fair that I practice what I preach," she says. Today Willy, now 12, is at a healthy weight and swims competitively.
Overweight kids tend to have low self-esteem. Just one "fatty" comment from a classmate can reduce your child to tears. That's why it's crucial to empathize with her ("I know that must have hurt -- it's not nice for anyone to make fun of your weight") and to find creative ways to boost her ego.
When Kathryn Roe remarked about her "thunder thighs" one day, her mom, Valerie, figured that other kids had teased the 7-year-old. "We don't say things like that at home," Roe says. So she turned the negative remark into a positive one: Since Kathryn is passionate about ballet, her mom pointed out that professional dancers have big, muscular legs. "Now when we're bouncing on an exercise ball, she'll ask, 'Mom, will this make my legs get stronger?'"
You shouldn't lie to your child about her weight ("No, you're not fat!"), but you should talk about it honestly -- without letting it become an obsession. Don't forget to focus on how pretty her smile is or how much fun she is to be around. And regardless of her size, remind your child every day that you love her.
When she has a setback (such as bingeing at a birthday party), give her a pep talk ("Everyone slips now and then. I'm proud of how you've cut down on junk food!"). Agree on a plan for next time ("You can have either one piece of cake or two cookies"). And celebrate small victories, such as when your child eats a piece of fruit and a serving of vegetables every day for a week. Choose your rewards carefully, though: Make the incentive a visit to the zoo or a game of mini golf, not an ice cream sundae.
Your overweight child needs a wake-up call to get more exercise and eat better. But don't put her on a diet and don't put her on the scale regularly. "Even young girls can become obsessed with losing weight," says Cynthia M. Bulik, PhD, distinguished professor of eating disorders at the University of North Carolina at Chapel Hill. "We're seeing classic anorexia starting as young as age 6."
These tips will help your child feel good about her body as she gets fit: