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Expert Q&A: Helping Your Child With Weight Loss

An interview with David S. Ludwig, MD.

Are there other changes I should make to our home environment?

You have to de-emphasize television. TV is probably the worst influence -- worse than video games -- because not only are kids inactive when they watch it, but they're also likely to be snacking and getting exposed to junk food commercials. It's a triple whammy. So you definitely need to get the TVs out of your child's bedroom, the kitchen, and preferably the living room. Make watching TV less convenient and attractive.

Instead, create an active play area -- it could be a playroom, but it could also be a corner of your living room. Set up a sound system so your kids can put on music and dance around. You can also get some activity equipment for outside -- or just put up a basketball hoop in the driveway.

How can I get my child to eat healthier foods?

First of all, don't force him to eat a food. That's terribly counterproductive. We need to feel relaxed to enjoy a food. But if a child feels forced or pressured, his body will release stress hormones. He'll start to pair the food with the unpleasant feeling, and that's a great way to create food aversions that can last a whole lifetime.

So you want to encourage gently. At dinner, you could give your child a reasonable serving of an entree he likes to eat along with a serving of vegetables. Ask him to take a bite of the vegetables. If he doesn't want to finish it, that's fine. But don't give him a second helping of the entree to compensate. Hunger can be a good motivator. If he's still hungry, he'll go back to the vegetables.

You can also try some stealth nutrition -- sneaking vegetables into your child's diet in forms that he doesn't recognize. So he could get some of his vegetables through pasta sauce, or through a puree that you put into other foods. I don't like to push this approach too far though. Kids can get wise and feel manipulated. 

Are there other mistakes parents make at the dinner table?

Yes. Another typical mistake is to say, "You can't have your dessert until you eat your vegetables." Maybe that will work a few times. But what you're doing is making dessert a reward and vegetables a punishment. That will have unfortunate long-term consequences.

Instead, just say, "First we eat our vegetables, and then we eat dessert." It's a subtle but important difference. You're just showing your child the proper order of things without placing relative value on either food.

How can I help my child deal with bullying related to his or her weight?

This can be really painful, both for the kids and for their parents. But you do have to be careful not to overreact. You don't want to make the situation worse than it actually is.

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