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Comprehensive pediatric care includes monitoring and addressing habits such as nutrition and physical activity that support a healthy body weight. But addressing weight issues with a parent, let alone a child, may not be easy, especially if the child is already significantly overweight or obese.

Parents may not realize their child is overweight because he looks like so many other kids his age. Also, parents may not be ready to accept the information for a variety of reasons: They may not be prepared to make the changes necessary to help their child achieve a healthier weight, or they may have weight issues themselves.

However, in view of the immediate and long-term medical and psychological complications associated with children being overweight, it's important to have a conversation with parents if their child is overweight or obese.

Here are some tips to help you get started:

  • Let parents know that you ask questions about diet and physical activity as part of every regularly scheduled patient visit.
  • Normalize the weight issue with statements like "One in three kids today is overweight. Until recently, many of us had no idea that juice and soft drinks and fast food have contributed so much to this problem.”
  • Show parents where the child's BMI falls on the growth chart, relative to the normal range.
  • Focus the conversation on health, not beauty. Use phrases such as "building a strong, healthy body."
  • Emphasize that even small changes, such as cutting back on soft drinks or playing outside instead of watching television, can make a big difference.
  • Explain that weight loss is not the only way to achieve a healthy body weight. With younger children, slowing down the rate of weight gain with growth in height is often enough.
  • Ask parents and patients if they have any questions or concerns about their weight. Find out if the child has been teased, bullied or harassed.
  • Make sure to give children the opportunity to speak if they want to.

Once the discussion has begun, it can open the door to identifying barriers and finding solutions. When this occurs, goals can be set and outside referrals, if warranted, can be discussed.

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