I have an 11 year old daughter who needs to lose 10-15 pounds. She is physically fit and plays basketball 3 times per week. However, she has quite a tummy. Any suggestions?

Although many children grow out of their over fatness later as they reach adolescence, being over fat as a child is thought to increase the likelihood of obesity later in life. Generally a weight loss program is not recommended unless children exceed the 95th percentile in BMI for their age. See evaluation of childhood obesity.

Instead work on practicing healthy habits she will be likely to continue for her lifetime. Set a limit on the amount of time she can watch television and play on the computer. Continue to encourage opportunities for physical activity and play, not just once or twice a day either. Generally at least one hour of physical activity each day is recommended for youth but more is optimal. Find activities or sport she enjoys and can participate in on a regular basis. Be willing to provide transportation to these activities if necessary. Provide your child with the appropriate attire appropriate to the weather and activity. Do not impose your hang ups about inclement weather to your child. Be flexible and creative. Kids will usually keep active if given the opportunity to participate in fun activities. Offer praise, interest, and encouragement. You must lead by example. Perhaps invite her walk or ride her bike while you are exercising, but make it fun for her so she will want to continue. Attend and get involved with school activities and community programs that foster the development of physical fitness, self esteem, and health. Find other activities the family can participate in regularly.

Interestingly, one of the latest longitudinal studies find physical activity as child does not directly relate to body mass achieved as an adult (Sherar, et al. 2004). This may suggest learning healthy eating habits and incorporation an active lifestyle early in life may have a larger impact on her body mass as she grows into adulthood. Again, lead by example.

Follow the dietary guidelines with including healthy snacks. Prepare healthy meals and snacks the whole family can enjoy. Ask your husband and even your extended family for support. A balanced diet with plenty of variety is very important. Try new recipes and new ways of cooking food. Have her participate in helping you select menus, shopping, and preparing the food. Give her choices but within the appropriate guidelines. Consider allowing your daughter to choose or plan a meal each week or month, choosing her favorite fruits, vegetables, main dishes, etc. From a colorful cookbook, ask her to select a recipe she can help prepare. Maybe you would like to plant a garden together? Again make it a fun experience for her yet be firm in setting limits.

Do not force her to finish her plate but also do not allow her to eat just an hour later because she did not choose to eat enough when it was offered to her. Do not get discouraged if she protests or says she does not like this or that. Periodically try to reintroduce foods even though she said she hated them 6 months ago. Kids often will change their mind about foods if they are periodically reintroduced in different ways. Serve the healthy foods early in the meal when they are hungriest. Do not reintroduce the food too often, though, since they will develop the mind set they hate this food. Kids will definitely hate foods that are forced upon them.

Be very mindful of the negative health impact of refined foods and chronic sugar consumption (see Sugar: The Bitter Truth). Only permit sweets on rare occasion. Offer alternatives to sweets and other refined snack foods: fruit or nuts instead of cookies, whole wheat crackers and cheese instead of chips, milk or other nutritious drinks instead of sweetened beverages, etc. Do not use junk food as a reward or to comfort the child.

This will obviously require a lot of planning and preparation. Don't give up on her and give into the belly aching and tantrums kids can sometimes have at this age. Remember you are the parent. You will be very likely influencing generations to come.