Family cooking together Obesity is a critical and growing health problem in the U.S., and it starts at a young age. One in every 6 children and teenagers is obese (18.5 percent). That’s more than three times the rate found in the early 1970s.

Most of us are aware of the health risks that come with obesity — high blood pressure, high cholesterol levels, and an increased risk of heart disease. Obesity is also associated with sleep problems, asthma and type 2 diabetes. And being overweight can lead to children being bullied and suffering from depression.

With all of those health and emotional concerns, it can be upsetting to be told by a doctor that your child is overweight or obese. What should you do? How should you talk with your child?

We spoke with Saba Khan, MD, attending physician in the Healthy Weight Program at Children's Hospital of Philadelphia (CHOP), the CHOP Care Network, and Director of CHOP’s Food Pharmacy, to learn what works and what doesn’t in helping overweight children make changes to reach a healthy weight.

Make healthy lifestyle changes as a family

When parents ask “How do I help my child lose weight?” Dr. Khan emphasizes healthy lifestyles. She doesn’t talk about diet or exercise. The goal is to build a foundation of heathy eating and activity that lasts forever, that’s enjoyable and becomes part of how we live.

“The first thing to be aware of is that children are still growing,” says Dr. Khan. “They have height and healthy weight to gain, so simple lifestyle changes can allow their bodies to catch up with their weight.”

She also presents these lifestyle changes as a challenge and an opportunity for the whole family. “You can’t see it as just the child’s issue,” she says. “When you respond as a family, it gives everyone a chance to become healthier together. When everyone commits to making changes, it can be a very positive thing.”

Keep the message positive

Positive emotions are critical to success when it comes to dealing with weight. Eating is a social habit. When we find that we are doing solitary eating, it’s almost always because we’re compensating for emotional needs. We’re not eating from hunger. We’re eating because we’re tired, angry, sad or anxious. So it’s very important not to isolate or stigmatize the child. That would be counter-productive.

In fact, Dr. Khan encourages parents not to weigh their child. “You don’t want the child to feel judged by their weight. You want them to feel the positive changes in other ways. They’ll feel it in their energy level, in how they can run on a playing field.”

When parents ask how to talk to their kids about weight, Dr. Khan steers them toward different ways to discuss the topic.

“Don’t talk about their weight,” she says. “Instead let them know that you will be helping them make changes to feel stronger, to have more energy. I tell them, ‘Your outsides are healthy the way you are. We want to make you feel better on the inside.’ And never comment on the child’s eating — or anyone else’s. Just start making healthy changes as a family, with the adults modeling those changes for the children.”

Make changes in small steps

Dr. Khan encourages small steps that families can build on, rather than big changes they can’t sustain.

“What do you do well together?” she asks. “How are you spending time together? Start with those positive aspects of your family life and build on them in small ways.”

If you eat together with the TV on, turn it off and talk to each other. Ask everyone in the family to share one interesting thing about their day. Having a conversation will slow down your eating and make you pay more attention to your food.

If you watch movies together, take 20 or 30 minutes you might spend doing that and instead put on some happy music and dance together. Be silly and have fun. Get glow sticks and dance in the dark.

“The key is to make these changes in small, progressive steps together,” Dr. Khan says. “Once you’ve got one step down, don’t lose it. Commit to it. Then take another.”

As a next step, consider the food you eat, and what’s available in the house for meals and snacks. If you’re buying sweetened beverages and packaged foods, start replacing some of that with fresh fruits and vegetables and unsweetened seltzer.

There’s no need to cut out fattening foods completely, but turn those into an occasional treat, not an everyday item. Instead of keeping ice cream in the freezer, you might go out for ice cream cones as a family for a special treat.

As you all start eating healthier food and becoming more active, you’ll start feeling healthier and having fun at the same time. Thank your child for inspiring those healthy changes. And tell your child how proud you are of their progress.