The issue of child weight loss has gotten a lot of attention recently. When Dara-Lynn Weiss wrote in Vogue magazine about the dramatic (some might say Draconian) methods she used to help her seven-year old daughter lose weight, the media and the public jumped on her. Denying her daughter “reproachfully” of dinner one night after hearing what she’d eaten during a school celebration, was one of the admissions that sparked the backlash.

Parents find themselves in a difficult and confusing position when they are told their child needs to lose weight because he or she is clinically overweight or obese... The health risks to kids, especially when considered over the course of their lives, are enormous.

When her daughter’s physician told Weiss that her daughter, at 4'4" and 93 pounds, was clinically obese at six years old, she knew she had to take action. Few readers were outraged that a mother would step in to help her daughter become a healthier weight; what sparked controversy were the methods Weiss used, such as snatching hot chocolate from her daughter and pouring it out after a barista was unable to give a calorie count for the beverage. (For the record, her daughter did achieve a healthy weight by age 8.)

The article struck a chord and not just because of the controversy it sparked. It raised an important issue. Parents find themselves in a difficult and confusing position when they are told their child needs to lose weight because he or she is clinically overweight or obese. The health risks to kids, especially when considered over the course of their lives, are enormous. Serious overweight in children contributes to the development of type 2 diabetes and high cholesterol.

Child Weight Loss Is a Delicate Issue

Weight loss in children is tricky for a number of reasons, not the least of which is that they are still growing and need to have a solid nutritional foundation to maintain that growth.

Being overweight is a psychologically loaded issue for a child (as for anyone else): Self-esteem, self-worth, and popularity can be wrapped up in it, so it’s especially important to come at the weight loss endeavor as productively and positively as possible.

Here is some of the best-supported advice for parents who are trying to help their children lose weight. The bottom line: The focus should always be on health, and on making the experience as positive and rewarding – and as anxiety-free – as possible.

Be Sure Weight Loss is Necessary

The National Institutes of Health (NIH) warns that “limiting what children eat may interfere with their growth.” So determining the right way to go about it – and whether it’s really warranted – is important.

There is no one single calculation to determine if a child needs to lose weight. Some use body mass index (BMI) to determine whether a child is overweight or obese, but “BMI is tricky because children haven’t reached peak bone mass, and this can affect the measure,” says Rebecca Solomon, Registered Dietician (RD) and Nutrition Coordinator at Mount Sinai Medical Center in New York City, who adds that “the decision is really a multi-factorial one.”

When it comes to child weight loss, it’s always best to get the go-ahead from your pediatrician. In addition to making sure you are doing the right thing, having his or her authority behind you can only help. Since some kids' BMI may be on the borderline, the first step is to talk to your child’s pediatrician to determine if weight loss plan is advised. Your child’s doctor will look at all the factors – body weight, age, height, eating habits, activity level – and tell you whether it’s time to work on developing a plan or whether watching and waiting is enough.

The Best Plan Is The One That’s Tailored to Your Child

Once it has been decided that your child would benefit from a weight loss plan, it’s important to develop one that’s specific to his or her needs. Solomon says that since our society – parents and children alike – is becoming more and more sedentary, kids are less likely than they once were to “outgrow” the baby fat as they age. That is why a specific plan to lose weight is often needed.

Don’t forget to ask your child what strategy he or she feels will be best and most successful.

One recent study found that kids had an easier time sticking to weight loss plans that included more low-glycemic foods (those that raise your blood sugar slowly over time, like fruits, veggies, and whole grains), and a harder time staying with high-protein, low-carbohydrate plans like the Atkins diet. Consulting with an expert to develop the best game plan is a good place to start, but don’t forget to ask your child what strategy he or she feels will be best and most successful.

Shift the Focus, Change the Language

Regardless of whether you are overweight or normal weight yourself (more on this below), it is incredibly important to keep the discussion in a positive light, and frame the challenge in such a way that health is the goal, rather than losing weight to “fix” a problem. There are a lot of factors tied up in weight for a child (and for adults, for that matter).

For many children, there is often a perceived value judgment associated with body weight, says Solomon. She urges parents to “avoid using negative words like ‘fat’ or ‘heavy,’ because there are too many negative connotations.” Instead, say something like, “This just means that you weigh more than you should for how tall you are.” Then focus on the health-related implications, both physically and mentally. This may mean talking to your child about the positive outcomes, like how much better they’ll feel physically, how their clothes will fit differently, even how interactions with others may change as a result.

Frame the challenge in such a way that health is the goal, rather than losing weight to ’fix’ a problem.

Showing that you empathize with a child who is struggling with his or her weight is really what it’s all about. Amy Jamieson-Petonic, MEd, RD, of the Academy of Nutrition and Dietetics and Director of Coaching at Cleveland Clinic adds that “Being overweight carries quite a stigma about it... Physicians, psychologists, registered dietitians, other healthcare providers and family members need to help the child become more comfortable with who they are as a person, and let them know that they are cared for and loved.”

Help Your Kid Stay Motivated

Part of a parent's job in weight loss and life is keeping your child motivated – without nagging or pressuring. Suggest activities that put you in it together: Try out rollerblading, bike riding, swimming, hiking, or any other physical activity that strikes your child’s fancy, always making sure your child has a voice in what activities you do together.

It’s also important to celebrate your child’s success along the way. For example, a new outfit every so often, to reflect the weight loss that your child is experiencing, can help her feel the results in a new way. Food treats are also fine. They underscore that eating isn't the enemy, just eating too much.

The goal is always to help your child understand that getting healthy and being active should be fun, not work, and that there will be lots of satisfying rewards – external and internal – throughout the process.

Parents' Weight – and Example -- Can Be a Problem or an Advantage

Though it may sound funny, overweight parents who have an overweight child may actually have somewhat of an advantage (more on normal weight parents below). This is because children pick up the habits of their parents – both the bad and the good.

Jamieson-Petonic says, “Families have a HUGE impact on whether or not the child will be successful.  When I work with kids, I tell the parents that eating healthy is a family affair, and that everyone needs to be on board, and that everyone will benefit from these strategies.”

One of the most effective methods for helping children lose weight is when the parents change their own habits. Kids learn best through observing others’ behavior. They also have excellent antennae for picking up habits and moods in the household. This is why it is so important to have healthy habits and a good relationship with food yourself. Your behavior will rub off on your child more than you may want to believe.

The ‘No Cookie’ rules almost never work, because I can guarantee you that children are finding the foods elsewhere.

When parents are normal weight and their child is overweight, it’s a little bit harder. Solomon says that there’s an “extra component of perceived judgment in these situations – and it can be so hard on struggling kids, since it can damage self-esteem, self-worth, often exacerbates the problem. Kids may often ask themselves, ‘How come I can’t maintain normal body weight, when mom and dad can?’” Kids may act out or rebel in these situations, by binging when mom or dad isn’t around.

Solomon likes to meet with children alone, in addition to parent-child meetings, precisely because “a lot of kids just don’t speak freely about what they’re going through in the company of parents.” And helping kids speak freely about what’s going on inside them is a big part of finding a solution to the problem.

Weight loss programs often actually work better when peers play the leading role and the parents are less involved. Knowing what kind of role to play – and when to step back – is important, and talking to your child to learn what would make him or her feel most comfortable in the weight loss endeavor can be a good place to begin.

Be Firm, Not Strict

Being firm about certain habits is a good, even necessary, tack to take. There are certain ways in which we can set up guidelines to encourage healthier habits in our kids. For example, the NIH recommends limiting the number of hours of TV or video games a child can play every day. In this way, at least some of the unhealthy variables that can contribute to weight gain can be reduced. (You may find yourself benefitting from this concept, too.)

On the other hand, too much restriction can backfire. For example, outlawing certain foods in the house is not likely to be a successful method, says Solomon: “Nothing should be restricted. The ‘No Cookie’ rules almost never work, because I can guarantee you that children are finding the foods elsewhere.” The NIH also urges parents avoid being too strict, and says that there can even be a place for a little fast food or sweets in a healthy diet. The key is for these foods to be the exception rather than the rule.

It's About Setting Your Child Up for the Future

The pull of the media and McDonalds are awfully hard to compete with. The clever marketing tactics that fast food outlets use, and even with the kid-friendly packaging on unhealthy grocery store items are designed to attract. But it is possible to overcome the pull of the media and help your child make better choices.

We can’t be around our kids 24 hours a day. This is why we need to give them the tools to make their own good decisions.

Here, too, studies show that parents are more effective than they realize when it comes to helping their kids make better food choices. The NIH suggests that parents help their kids be attuned to peer and media pressures by talking about making smart personal choices, rather than letting those around them or the media influence them to make poor ones.

Helping set up good relationships with food early on is the very best thing you can do for your child. We can’t be around our kids 24 hours a day, and that’s the way it should be, as Solomon reminds us. But this is why we need to give them the tools to make their own good decisions. (It’s also why too much restriction is less likely to be successful.)

Teaching healthy habits – by example – will set them up for a lifetime of healthy eating and living. And again, the ultimate focus should be on gaining something positive, not on correcting a negative. Jamieson-Petonic underlines that it’s best to “focus on the health benefits of developing a healthier lifestyle, not on weight... The rewards of becoming healthier are tremendous, and if you help kids develop healthy habits today, they will carry them through a lifetime.”