“Most people think overweight kids eat too much,” says Dr. Alan Greene, a California-based pediatrician and author who answers parents’ pediatric questions on his Web site, DrGreene.com. “Actually, they may not be eating more than normal-weight kids, but their metabolism can’t get away with it.”

Although certain hormonal imbalances and genetic conditions can cause a child to put on pounds, the great majority of overweight preteens are heavy because of an imbalance between activity and diet. Unfortunately, some studies show that 60 percent of overweight children carry those extra pounds into adulthood.

“The more fat cells a kid enters into adulthood with, the more he’ll struggle to lose weight as a grown-up,” says Dr. Greene.

Are You Raising an Overweight Child?
The National Institutes of Health reports that obesity in American preteens has reached epidemic proportions; an estimated one in five children is overweight. What’s more alarming, this number has increased by 50 percent in the last two decades.

Dr. Greene attributes this national problem to kids’ sedentary lifestyles and fast-food habits. But before you restrict your child’s calories or put her on an exercise program, consult your pediatrician. Your doctor will determine if your child is too heavy by calculating her Body Mass Index (BMI), the ratio of an individual’s height to weight. For children, a healthy BMI falls somewhere between 17 and 23. A child with a BMI of 24 to 30 is considered obese, and any child with a BMI of more than 30 is considered severely obese.

Unless a child is severely obese, Dr. Greene advises to avoid cutting calories. Dr. Greene says kids need to get vital nutrients because their brains and organ systems are still developing. The goal for most children is to maintain weight and grow into their size. If they’re still heavy when they reach their full height, a weight reduction plan might be necessary.

Active Play vs. Exercise
"Probably the most effective thing a parent can do is cut down on the hours kids spend in front of the TV or the computer,” Dr. Greene says, lamenting the fact that children today are more sedentary than in any other time in history.

Dr. Greene urges parents to create opportunities for physical activity that kids will enjoy. He shuns the term “exercise” because – to him – it sounds like work. Instead, he advises his patients to get 30 minutes of “active play” every day, preferably outside. “Go to the park, climb, throw the dog a ball, take walks by a creek," he says. "Kids will figure out what they like once they get outside.”

Encourage Kids to Eat Healthy Foods
Instead of putting your child on a fad diet or even decreasing fatty foods, focus on incorporating healthy foods into meal times. Dr. Greene recommends adding fiber-rich foods such as fruits, vegetables and whole grains.

But watch out for fast-food choices, such as french fries and chicken nuggets, which have high levels of fat and little nutritive value.

Kids are most likely to overeat between 4 and 6 p.m., when they’re bored and their working parents are out of the house. To help kids from piling on extra calories while they’re unattended, Dr. Greene recommends clearing junk foods out of the cabinets and replacing them with healthy snacks.

But the best way for a parent to help a child lose weight is for the parent to get in shape herself. “It’s rare for a preteen to adopt a healthy lifestyle unless the whole family does,” Dr. Greene says.

The Kempskis’ Story
Corinne Kempski, a postal worker who lives near Buffalo, New York, says her daughter Courtney was a thin child until she developed asthma at age 5. After the doctor put her on steroids to treat her asthma, Courtney experienced a common side effect of the drug: She gained weight and became chronically “chunky.”

An only child, Courtney didn’t have siblings with whom to run around. To make matters worse, the Kempskis lived in a neighborhood with few children Courtney’s age. Instead of playing tag outside after school, Courtney sat in front of the television, becoming what her mother jokingly calls a “couch potato.” Corinne knew she should try to plan activities with Courtney, now 9 years old, but she was too tired and too busy getting dinner on the table after work.

Calling herself “pretty fit,” Corinne exercised to programs on television, but couldn’t rouse Courtney. One day at work, Corinne ran across an article in a local newspaper about Family Fitness Matters, a fitness program developed by Mary Jean Taylor, associate professor of physical therapy at Daemen College in Buffalo, New York. The program helps kids shape up by involving the whole family in fun activities and educating them about healthy lifestyle choices.

“I didn’t mention weight loss,” Corinne says, referring to her strategy to pique Courtney’s interest. “I said, 'There’s this program where you and I play around on a bouncy ball, and it’s fun, and it makes you feel good … do you want to do it with me?'”

Courtney enthusiastically agreed. Twice a week, mother and daughter drove the half-hour to the program’s facility on the Daemen College campus. A doctor taught Courtney and other kids in the program how to develop sound nutritional habits, such as reading food labels – a practice Courtney has continued on her own. On the advice of the program, Corinne eliminated sugary and fatty foods from the entire family’s meal plan.

“If Courtney wanted a snack before bed, I said, 'You can have an apple instead of a bag of chips.’”

To keep Courtney from feeling deprived, the family made one day each week “Cheat Day,” on which Courtney could choose a fattening snack such as ice cream or cookies.

But the best thing about the program was that it made exercising fun. “We played music, we sang, we played on the bouncy ball. It was more than just sweat,” Corinne says.

At the end of the 10-week program, Courtney had lost 8 pounds. More important, she seemed happier and more active. Her physical education course grade went from a C to an A. Corinne bought a bouncy ball and the program’s exercise tape, which Courtney now uses at home.

Why Getting Fit is a Family Affair
According to Family Fitness Matters founder Mary Jean Taylor, overweight parents tend to have overweight children. What’s more, children commonly model the exercise patterns of the mother. What better reason could a mom have to shape up than setting her child on the right track early in life?

Taylor says her program is unique because it empowers both the child and the parents; a weight control program that enlists only the child won’t work.

“Parents have to be involved and supportive so they can carry through with the program at home, not just on days when they come to our facility,” Taylor says.

Taylor and her staff stress the importance of boosting a child’s self-esteem. Nagging a preteen about losing weight is one of the worst things family members can do; no child will respond favorably to negativity. If, for instance, Taylor sees a thin child tease her overweight sibling, Taylor will take the critical child aside and explain that this negative behavior is unacceptable. Taylor urges parents to lay these ground rules for family interaction in their own homes.

“You can’t control teasing that goes on at school, but you can control what goes on at home.”

Another benefit of Family Fitness Matters is the informal group support. Parents and kids exercise together, swap tips and cheer each other on. “They learn [getting fit is] not just an issue they have, but that lots of families are struggling with this,” Taylor says.

Want to see more?

• Media Effects on Children: Television
• Girl Power: Raising Smart, Bold Girls
• Overweight Preteens Discussion Board
• Just Go Outside and Play! Fun Ways to Stay Active With Your Kids