Behavioral Recommendations
for Overweight Children & Adolescents

• Don't try to make many changes at once; pick one or two to try first. Then, when you and your child have mastered those, choose one or two more. Parents should make all the changes that you ask your children to make, regardless of your own weight status. Your children look to you for how to be as adults and will copy your behaviors.
• Don't weigh your child daily and don't use weight loss as the sign of success or failure. Changing eating-related and activity-related behaviors is a huge success by itself and should be celebrated even if there are not imediate changes in weight.
• Don't try to change too much too fast. Make a few changes each month.
• Use intangible rewards daily AND weekly for nutrition and/or activity goals (intangible rewards can include praise, hugs, etc.).
• Use tangible rewards daily AND weekly for nutrition and/or activitiy goals (tangible rewards can be a trip to the park, a new baseball, etc.).
• Make splurges healthy ones - fruit for dessert with cool whip or low-fat/sugar-free pudding, for instance. Your child will feel like you are treating them, but it is still part of your family's new healthy lifestyle.
• Take small bites and chew slowly. Also, enjoy the smell of food. All of these can trigger the brain to feel full.
• Make a plan for the toughest time of day for splurging - afternoons and evenings. Plan snacks ahead of time and stick to it.
• Focus on health issues, nutrition, physical strength/stamina rather than weight. Focus on feeling better with more energy and strength.
• Read about cognitive-behavioral strategies or talk with a therapist about how to deal with excuses, negative thoughts regarding lifestyle changes, etc. Negative "self-talk" can diminish self-esteem and motivation to change! Positive "self-talk" can improve optimism and self-esteem.
• Use positive imagery to aid in continued motivation and behavioral change. Imagine yourself making healthy choices, doing physical activity, enjoying the new lifestyle changes.
• Read about relaxation strategies and/or stress management strategies. Helping your child cope better with their feelings will avoid overindulging in response to negative emotions. Talking with a therapist can be helpful, too.
• Some children should have a goal of maintaining weight rather than losing. As they get taller, the weight will become more and more appropriate. Some children may need to lose weight. Losing about a pound per week is optimal. Losing too much too quickly can actually make your body resist losing weight more (making losing a little harder and regaining a little easier). See your medical provider for details on which goal is most appropriate for your child.
• Put healthy foods in the front of the fridge/cabinet. Unhealthy foods should be left at the store, or if absolutely necessary, buy in small portions and place way in the back, out of sight.
• Be realistic about your child's weight, nutrition, and fitness goals - talk to professionals about what they think is realistic for your child, and discuss your preconceived notions and opinions for accuracy.
• Daily relaxation helps lower stress, which in turn lowers cortisol levels. Cortisol increases appetite and cravings for sweets, and also causes fat to be deposited in the abdominal area. Learn about deep breathing techniques, yoga, and mental imagery as relaxation strategies.
• Getting adequate sleep at night will also help, as poor sleep creates an imbalance in hormones that can increase appetite.
• Focus on goals related to exercise sessions each day, but also on non-workout activity (i.e., taking the stairs at work, parking farther from the door to the store, walking to the park, etc.).
• Work on your child's motivation - focus on an outing that your child wants to look fabulous for, treat them to something for every goal obtained. Make the treat something that is part of your new healthy lifestyle (e.g., a new outfit, new workout clothes, a hike in the park, playing longer at the playground, etc.).
• Be careful about your child's goals. You may want to focus on fitness or nutrition changes rather than a specific weight loss goal. For intance, you can lower the risk of diseases by becoming more fit even if weight does not change that quickly.
• Studies show that working out with a friend/partner can increase commitment and enjoyment. Make some, if not all, of your child's planned sessions with family members or friends.
• Be a coach, not a judge. Support your child and believe in their ability to make changes. Celebrate their strengths, build self-esteem through hobbies or activities that they enjoy.
• Help older children assume responsibility for their decisions (not blaming!), and work with them on problem-solving when barriers arise.
• Seek social support. Talk to other kids who struggle with these nutrition and activity behaviors. Group therapy or educational groups can also really help!
• Remember, it takes 4-6 weeks to change one behavior and make it a normal part of a daily routine. Don't expect too much too soon.
• Get educated about nutritional goals for your child. They are different for children of different ages and different from adults. Visit www.mypyramid.gov for more information.

Tips provided by Wendy L. Ward-Begnoch, Ph.D., Assistant Professor, UAMS College of Medicine, Department of Pediatrics. © 2005 Ward-Begnoche, Revised 6/8/05.