My 11yr. old is overweight (4ft. 10in.@120lbs.) and very unhappy about it, she gets teased by boys at school and all she wants to do is fit in. My problem is even though she is unhappy about her weight, whenever her father and I suggest a solution to her she gets upset and doesn't want to talk about it anymore. We are trying to face the problem as a family by doing activities together and watching our diets together but even then she feels singled out. I want to put the focus on her health not appearance but I'm failing because she will say we think she's fat too when we suggest anything. Any ideas? – Carol

Dear Carol,

You are right to try to intervene now with your daughter's weight problem. I would start by talking with your daughter's pediatrician. He or she is most qualified to let you know if there is reason for any kind of hormonal evaluation to rule out medical causes for excessive weight gain. Thyroid conditions and diabetes are just two of many physical disorders that can present with weight gain. In addition, a complete physical is a good idea as a baseline before beginning any exercise program. For example, if your daughter has asthma, you may want to chose an activity that doesn't involve long bursts of deep breathing such as running, or an activity in the cold. Check with your pediatrician as to what physical activities may be better suited for your daughter. (See below regarding physical exercise.)

Sometimes boys and girls can first start to gain weight when they have a bit more freedom from parents, such as buying junk food instead of healthy foods at school.

You may also try addressing your daughter's weight issue in an even larger context than her health, i.e., growing up and maturing with the freedom to make more choices on her own. Try talking to your daughter about how growing up means learning how to take good care of oneself more and more without parents around to supervise. Good health is one of several goals your daughter should strive for.

Does your daughter participate in any sport or physical activity outside of school? If not, I encourage you to get her involved in regular physical exercise. Talk to her about the importance of a sport or other physical activity. She does not have to be involved in a team sport. But, help her brainstorm some activities that will help with weight loss and be fun for her as well. Some examples are: dance, tennis, karate, swimming, rollerblading, throwing a frisbee, bowling, running, bike riding, hiking, trampoline jumping, jumping rope, walking a dog (yours or a friend's), golf and ice skating.

Try to limit your daughter's exposure to television, if she watches on a daily basis. Try taping her favorite shows to watch on special occasions or weekends, so that she does not become a couch potato. Try to spark your daughter's interest in becoming more physically active by watching such movies as: A League of Their Own (1992, PG), or National Velvet (1945, NR)

Why the emphasis on a sport? Because research has shown that girls who are involved in a sport have higher self-esteem than girls who are not physically active. Exercise must go hand in hand with learning healthier eating habits. Does your daughter ever watch sports on TV? Try to encourage her to watch sports events or, better yet, to go to games with you, her Dad or with a friend.

Honestly review the food in your kitchen. If you have snack or junk food around for one member of the family, replace it with healthier food that all can enjoy. Since kids will come home after school & reach for whatever they see first for a snack, make sure that you have good snacking food in full view for your daughter, such as raw veggies with a low-fat dip, fresh fruit, yogurt or low-fat cheeses (string cheese is a good choice). You might even go over the food pyramid with your daughter. Don't assume she knows what foods are protein, carbohydrates or fats. Teach her to read nutrition labels. Compare cereals, for example, for sugar content. Keep her involved as you also learn more about healthier ways to eat.

Try to encourage your daughter to have breakfast if she is skipping it now. She will be less likely to overeat later in the day if she starts with a good breakfast. If you are also trying to improve your eating habits, let her join with you. Keep the process of changing as much fun as possible. Try to keep your emphasis on increasing exercise and making small changes in eating style.

You can be a great role model for your daughter. Ask her to help you! Make the changes family wide & challenge your daughter to help out. Most importantly, don't expect overnight drastic changes. Go for the long haul! Keep it fun and keep learning ways to eat healthier and be more physically active with your daughter. Remember, Rome wasn't built in a day. Tiny changes that become better habits are better than sweeping changes that won't last. Be patient & allow for small treats now & then. Praise your daughter's efforts as much as possible. Keep your comments as positive as you can. Walk & talk with her. Check back with her pediatrician if after a few months you feel completely stuck. Other resources are available, but try a mom-daughter approach first, without any comments about her weight. Just talk about how good it feels to have more energy and to take the best possible care of your health.