Obesity Management

The main treatment for obesity consists of dieting and physical exercise.Diet programs may produce weight loss over the short term,but keeping this weight off can be a problem and often requires making exercise and a lower calorie diet a permanent part of a person's lifestyle.Success rates of long-term weight loss maintenance are low and range from 2–20%.In a more structured setting, however, 67% of people who lost greater than 10% of their body mass maintained or continued to lose weight one year later.An average maintained weight loss of more than 3 kg (6.6 lb) or 3% of total body mass could be sustained for five years.[128] Some studies have found significant benefits in mortality in certain populations with weight loss. In a prospective study of obese women with weight related diseases, intentional weight loss of any amount was associated with a 20% reduction in mortality. In obese women without obesity related illnesses a weight loss of greater than 9 kg (20 lb) was associated with a 25% reduction in mortality.A recent review concluded that certain subgroups such as those with type 2 diabetes and women show long term benefits in all cause mortality, while outcomes for men do not seem to be improved with weight loss.A subsequent study has found benefits in mortality from intentional weight loss in those who have severe obesity.

The most effective treatment for obesity is bariatric surgery; however, due to its cost and the risk of complications, researchers are searching for other effective yet less invasive treatments.
Dieting

Dieting

Diets to promote weight loss are generally divided into four categories: low-fat, low-carbohydrate, low-calorie, and very low calorie.[123] A meta-analysis of six randomized controlled trials found no difference between three of the main diet types (low calorie, low carbohydrate, and low fat), with a 2–4 kilogram (4.4–8.8 lb) weight loss in all studies.At two years these three methods resulted in similar weight loss irrespective of the macronutrients emphasized.

Very low calorie diets provide 200–800 kcal/day, maintaining protein intake but limiting calories from both fat and carbohydrates. They subject the body to starvation and produce an average weekly weight loss of 1.5–2.5 kilograms (3.3–5.5 lb). These diets are not recommended for general use as they are associated with adverse side effects such as loss of lean muscle mass, increased risks of gout, and electrolyte imbalances. People attempting these diets must be monitored closely by a physician to prevent complications.[123]
Exercise

Physical exercise

With use, muscles consume energy derived from both fat and glycogen. Due to the large size of leg muscles, walking, running, and cycling are the most effective means of exercise to reduce body fat.Exercise affects macronutrient balance. During moderate exercise, equivalent to a brisk walk, there is a shift to greater use of fat as a fuel.[134][135] To maintain health the American Heart Association recommends a minimum of 30 minutes of moderate exercise at least 5 days a week.

A meta-analysis of 43 randomized controlled trials by the Cochrane Collaboration found that exercising alone led to limited weight loss. In combination with diet, however, it resulted in a 1 kilogram weight loss over dieting alone. A 1.5 kilogram (3.3 lb) loss was observed with a greater degree of exercise.Even though exercise as carried out in the general population has only modest effects, a dose response curve is found, and very intense exercise can lead to substantial weight loss. During 20 weeks of basic military training with no dietary restriction, obese military recruits lost 12.5 kg (27.6 lb).[137] High levels of physical activity seem to be necessary to maintain weight loss.[138] A pedometer appears useful for motivation. Over an average of 18-weeks of use physical activity increased by 27% resulting in a 0.38 decreased in BMI.

Signs that encourage the use of stairs as well as community campaigns have been shown to be effective in increasing exercise in a population.The city of Bogota, Colombia for example blocks off 113 kilometers (70 miles) of roads every Sunday and on holidays to make it easier for its citizens to get exercise. These pedestrian zones are part of an effort to combat chronic diseases, including obesity.
Weight loss programs

Weight loss programs often promote lifestyle changes and diet modification. This may involve eating smaller meals, cutting down on certain types of food, and making a conscious effort to exercise more. These programs also enable people to connect with a group of others who are attempting to lose weight, in the hopes that participants will form mutually motivating and encouraging relationships.

A number of popular programs exist, including Weight Watchers, Overeaters Anonymous, and Jenny Craig. These appear to provide modest weight loss (2.9 kg, 6.4 lb) over dieting on one's own (0.2 kg, 0.4 lb) over a two year period.Internet-based programs appear to be ineffective.The Chinese government has introduced a number of "fat farms" where obese children go for reinforced exercise, and has passed a law which requires students to exercise or play sports for an hour a day at school.

Medication

Only two anti-obesity medications are currently approved by the FDA for long term use.One is orlistat (Xenical), which reduces intestinal fat absorption by inhibiting pancreatic lipase; the other is sibutramine (Meridia), which acts in the brain to inhibit deactivation of the neurotransmitters norepinephrine, serotonin, and dopamine (very similar to some anti-depressants), therefore decreasing appetite. Rimonabant (Acomplia), a third drug, works via a specific blockade of the endocannabinoid system. It has been developed from the knowledge that cannabis smokers often experience hunger, which is often referred to as "the munchies". It has been approved in Europe for the treatment of obesity but has not received approval in the United States or Canada due to safety concerns.[148][149] European Medicines Agency in October 2008 however recommended the suspension of the sale of rimonabant in Europe as the risk seem to be greater than the benefits.

Weight loss with these drugs is modest. Over the longer term, average weight loss on orlistat is 2.9 kg (6.4 lb), sibutramine is 4.2 kg (9.3 lb) and rimonabant is 4.7 kg (10.4 lb). Orlistat and rimonabant lead to a reduced incidence of diabetes, and all three drugs have some effect on cholesterol. However, there is little information on how these drugs affect the longer-term complications or outcomes of obesity.

There are a number of less commonly used medications. Some are only approved for short term use, others are used off-label, and still others are used illegally. Most are appetite suppressants that act on one or more neurotransmitters.[151] Phendimetrazine (Bontril), diethylpropion (Tenuate), and phentermine (Adipex-P) are approved by the FDA for short term use, while bupropion (Wellbutrin), topiramate (Topamax), and zonisamide (Zonegran) are sometimes used off-label.

The usefulness of certain drugs depends upon the comorbities present. Metformin (Glucophage) is preferred in overweight diabetics, as it may lead to mild weight loss in comparison to sulfonylureas or insulin.The thiazolidinediones, on the other hand, may cause weight gain, but decrease central obesity.Diabetics also achieve modest weight loss with fluoxetine (Prozac), orlistat and sibutramine over 12–57 weeks. Preliminary evidence has however found higher number of cardiovascular events in people taking sibutramine verses control (11.4% vs. 10.0%).The long-term health benefits of these treatments remain unclear.

Fenfluramine and dexfenfluramine were withdrawn from the market in 1997,while ephedrine (found in the traditional Chinese herbal medicine má huáng made from the Ephedra sinica) was removed from the market in 2004.Dexamphetamines are not approved by the FDA for the treatment of obesity due to concerns regarding addiction.The use of these drugs is not recommended due to potential side effects.However, people do occasionally use these drugs illegally.
Surgery

Bariatric surgery

Bariatric surgery ("weight loss surgery") is the use of surgical intervention in the treatment of obesity. As every operation may have complications, surgery is only recommended for severely obese people (BMI > 40) who have failed to lose weight following dietary modification and pharmacological treatment. Weight loss surgery relies on various principles: the two most common approaches are reducing the volume of the stomach (e.g. by adjustable gastric banding and vertical banded gastroplasty), which produces an earlier sense of satiation, and reducing the length of bowel that comes into contact with food (gastric bypass surgery), which directly reduces absorption. Band surgery is reversible, while bowel shortening operations are not. Some procedures can be performed laparoscopically. Complications from weight loss surgery are frequent.

Surgery for severe obesity is associated with long-term weight loss and decreased overall mortality. One study found a weight loss of between 14% and 25% (depending on the type of procedure performed) at 10 years, and a 29% reduction in all cause mortality when compared to standard weight loss measures.A marked decrease in the risk of diabetes mellitus, cardiovascular disease and cancer has also been found after bariatric surgery.Marked weight loss occurs during the first few months after surgery, and the loss is sustained in the long term. In one study there was an unexplained increase in deaths from accidents and suicide, but this did not outweigh the benefit in terms of disease prevention.When the two main techniques are compared, gastric bypass procedures are found to lead to 30% more weight loss than banding procedures one year after surgery.

The effects of liposuction on obesity are less well determined. Some small studies show benefits while others show none.A treatment involving the placement of an intragastric balloon via gastroscopy has shown promise. One type of balloon lead to a weight loss of 5.7 BMI units over 6 months or 14.7 kg (32.4 lb). Regaining lost weight is common after removal, however, and 4.2% of people were intolerant of the device.
Clinical protocols

Much of the Western world has created clinical practice guidelines in an attempt to address rising rates of obesity. Australia,Canada,the European Union,and the United States have all published statements since 2004.

In a clinical practice guideline by the American College of Physicians, the following five recommendations are made:

   1. People with a BMI of over 30 should be counseled on diet, exercise and other relevant behavioral interventions, and set a realistic goal for weight loss.
   2. If these goals are not achieved, pharmacotherapy can be offered. The person needs to be informed of the possibility of side-effects and the unavailability of long-term safety and efficacy data.
   3. Drug therapy may consist of sibutramine, orlistat, phentermine, diethylpropion, fluoxetine, and bupropion. For more severe cases of obesity, stronger drugs such as amphetamine and methamphetamine may be used on a selective basis. Evidence is not sufficient to recommend sertraline, topiramate, or zonisamide.
   4. In people with a BMI over 40 who fail to achieve their weight loss goals (with or without medication) and who develop obesity-related complications, referral for bariatric surgery may be indicated. The person needs to be aware of the potential complications.
   5. Those requiring bariatric surgery should be referred to high-volume referral centers, as the evidence suggests that surgeons who frequently perform these procedures have fewer complications.

A clinical practice guideline by the US Preventive Services Task Force (USPSTF) concluded that the evidence is insufficient to recommend for or against routine behavioral counseling to promote a healthy diet in unselected people in primary care settings, but that intensive behavioral dietary counseling is recommended in those with hyperlipidemia and other known risk factors for cardiovascular and diet-related chronic disease. Intensive counseling can be delivered by primary care clinicians or by referral to other specialists, such as nutritionists or dietitians.

Canada developed and published evidence-based practice guidelines in 2006. The guidelines attempt to address the prevention and management of obesity at both the individual and population levels in both children and adults.[62] The European Union published clinical practice guidelines in 2008 in an effort to address the rising rates of obesity in Europe.Australia came out with practice guidelines in 2004.

Therapeutic weight loss techniques

The least intrusive weight loss methods, and those most often recommended by physicians, are adjustments to eating patterns and increased physical activity, generally in the form of exercise. Physicians will usually recommend that their overweight patients combine a reduction of processed and caloric content of the diet with an increase in physical activity.

Other methods of losing weight include use of drugs and supplements that decrease appetite, block fat absorption, or reduce stomach volume.

Weight Loss Coaching is rapidly growing in popularity in the United States, with the number of available coaches nearly doubling since 2000. Finally, surgery (i.e. bariatric surgery) may be used in more severe cases to artificially reduce the size of the stomach, thus limiting the intake of food energy.

Crash dieting

A crash diet refers to willful nutritional restriction (except water) for more than 12 hours. The desired result is to have the body burn fat for energy with the goal of losing a significant amount of weight in a short time. However, the body reacts by preserving fat stores and burning lean muscle tissue, such that this is a poor strategy for intentional weight loss.[citation needed]

Crash dieting is not the same as intermittent fasting, in which the individual periodically abstains from food (e.g., every other day).

Unintentional weight loss

Poor management of type 1 diabetes mellitus, also known as insulin-dependent diabetes mellitus (IDDM), leads to an excessive amount of glucose and an insufficient amount of insulin in the bloodstream. This triggers the release of triglycerides from adipose (fat) tissue and catabolism (breakdown) of amino acids in muscle tissue. This results in a loss of both fat and lean mass, leading to a significant reduction in total body weight. Note that untreated type 1 diabetes mellitus will usually not produce weight loss, as these patients get acutely ill before they would have had time to lose weight.

Myriad additional scientific considerations are applicable to weight loss: physiological and exercise sciences, nutrition science, behavioral sciences, and other sciences.

One area involves the science of bioenergetics including biochemical and physiological energy production and utilization systems, that is frequently evidence of diabetes, and ketone bodies, acetone particles occurring in body fluids and tissues involved in acidosis, also known as ketosis, somewhat common in severe diabetes.

In addition to weight loss due to a reduction in fat and lean mass, illnesses such as diabetes, certain medications, lack of fluid intake and other factors can trigger fluid loss. And fluid loss in addition to a reduction in fat and lean mass exacerbates the risk for cachexia.

Infections such as HIV may alter metabolism, leading to weight loss.
Hormonal disruptions, such as an overactive thyroid (hyperthyroidism), may also exhibit as weight loss.

Recent research has shown fidgeting to result in significant weight loss.

What is the Ultimate Weight Loss Solution?

Here are some helpful ways you can help yourself and loved ones.

This is a very common question in the world today. Like it or not, obesity has become a problem of epidemic proportions, and as more and more health problems are connected to obesity; more and more people want to learn how to lose weight. The problem is that finding the ultimate weight loss solution can be difficult, especially because of all of the scam diets and misinformation surrounding weight loss. Most of them are just not accurate, and here are a few popular ones to steer clear of:

The Atkins Diet - you will lose weight if you start on this diet, and you will see results quickly. Then, as soon as you stop the diet, you will see your weight come right back. Not only is this not the ultimate weight loss solution; it is extremely unhealthy. You cannot simply stop having essential nutrients or carbohydrates, your body has to have them eventually. Staying on this diet too long will make you tired and fatigued, and there is a decent chance that after a while you will start to feel sick. So do yourself a favor and avoid this diet.

The 'fill in the blank' diet - again, you will lose weight if you eat just one specific food. Why? You will get so tired of eating it that you will slowly eat it less and less often, meaning you take in less calories and therefore lose weight. However, most people will finally snap and get tired of eating the same foods over and over and over again, and then will binge eat when they finally give up. They not only gain the weight back, but often gain extra on top of their original weight. Again, not our ultimate weight loss solution.

So what is the solution that we're looking for? First of all, you have to understand how your body works. Basically, you eat food, and your body processes the calories from the food. You then use the calories up as energy for whatever you do throughout the day. Whatever doesn't get used is stored as fat.

So, obviously, you want to limit the number of calories that are stored as fat, then burn the calories that have already been stored as fat. Knowing this, it seems like our ultimate weight loss solution involves reducing the number of calories that we take in, as well as increasing the number of calories that we are burning daily. By doing both of these things, it virtually guarantees success in our weight loss endeavor. So, get a small notepad and keep track of how many calories you have on average each day. Then, reduce it by 10%, and stay with this lower amount. After you've lowered it, try to exercise at least 10 minutes each day, so you are burning more calories. Just keep repeating this 10% lowering process and until you are losing weight, but you still feel energetic and healthy. Never have less than 1000 calories daily, your body needs that much to run!

Consequences of Eating Disorders

Eating disorders profoundly impact an individual's quality of life. Self-image, relationships, physical well-being and day to day living are often adversely affected. Eating disorders are also often associated with mood disorders, anxiety disorders and personality disorders. Bullimia nervosa may be particularly associated with substance abuse problems. Anorexia nervosa is often associated with obsessive-compulsive symptoms. The scope of related problems associated with eating disorders highlights the need for prompt treatment and intervention.

Medical issues:

The process of starvation associated with Anorexia Nervosa can affect most organ systems. Physical signs and symptoms include but are not limited to constipation, abnormally low heart rate, abdominal distress, dryness of skin, hypotension, fine body hair, lack of menstrual periods. Anorexia Nervosa causes anemia, cardiovascular problems, changes in brain structure, osteoporosis, and kidney dysfunction.

Self-induced vomiting can lead to swelling of salivary glands, electrolyte and mineral disturbances, and enamel erosion in teeth. Laxative abuse can lead to long lasting disruptions of normal bowel functioning. Complications such as tearing the esophagus, rupturing the stomach, and developing life-threatening irregularities of the heart rhythm may also result.

Physical Dangers:

Sometimes those suffering with Anorexia and Bulimia do not appear underweight — some may be of "average" weight, some may be slightly overweight, variations can be anywhere from extremely underweight to extremely overweight. The outward appearance of a person suffering with an eating disorder does not dictate the amount of physical danger they are in, nor does it determine the severity of emotional conflict they are enduring.

Symptoms:

Amennorrhea — loss of menstrual cycle.

Barrett's Esophagus — associated with Cancer of the esophagus and caused by Esophageal Reflux, this is a change in the cells within the esophagus.

Blood Sugar Level Disruptions:

Low Blood Sugar — can indicate problems with the liver or kidneys and can lead to neurological and mental deterioration.

Elevated Blood Sugar — can lead to diabetes, liver and kidney shut down, circulatory and immune system problems.

Callused fingers — caused by repeated use of the fingers to induce vomiting.

Chronic Fatigue Syndrome — crippling fatigue related to a weakened immune system.

Cramps, bloating, constipation, diarrhea, incontinence — increased or decreased bowel activity.

Death — caused by any of the following or any combination of the following: heart attack or heart failure, lung collapse, internal bleeding, stroke, kidney failure, liver failure, pancreatitis, gastric rupture, perforated ulcer, depression and suicide.

Dehydration — caused by lack of intake of fluids in the body.

Dental Problems — decalcification of teeth, erosion of tooth enamel, and severe decay.

Gum Disease — caused by stomach acids and enzymes from vomiting; lack of vitamin D and calcium, and hormonal imbalance.

Depression — mood swings and depression caused by physiological factors such as electrolyte imbalances, hormone and vitamin deficiencies, malnutrition and dehydration. Living with the Eating Disorder behaviors can cause depression. Depression can also lead the victim back into the cycle of the Eating Disorder (or may have initially been the problem before the onset of the ED). Stress within family, job and relationships can all be causes. There are also a percentage of people born with a pre-disposition to depression, based on family history.

Diabetes — high blood sugar as a result of low production of insulin. This can be caused by hormonal imbalances, hyperglycemia or chronic pancreatitis.

Digestive Difficulties — a deficiency in digestive enzymes will lead to the body's inability to properly digest food and absorb nutrients. This can lead to mal-absorption problems, malnutrition and electrolyte imbalances.

Dry Skin and Hair, Brittle Hair and Nails, Hair Loss — caused by Vitamin and Mineral deficiencies, malnutrition and dehydration.

Edema — swelling of the soft tissues as a result of excess water accumulation. Most common in the legs and feet of Compulsive Overeaters and in the abdominal area of Anorexics and/or Bulimics (can be caused by Laxative and Diuretic use).

Electrolyte Imbalances — electrolytes are essential to the production of the body's "natural electricity" that ensures healthy teeth, joints and bones, nerve and muscle impulses, kidneys and heart, blood sugar levels and the delivery of oxygen to the cells. Bad circulation, slowed or irregular heartbeat, arrhythmias, angina, heart attack - There are many factors associated with having an eating disorder that can lead to heart problems or a heart attack. Sudden cardiac arrest can cause permanent damage to the heart, or instant death. Electrolyte imbalances (especially potassium deficiency), dehydration, malnutrition, low blood pressure, extreme orthostatic hypotension, abnormally slow heart rate, electrolyte imbalances, and hormonal imbalances can all cause serious problems with the heart.

Esophageal Reflux — Acid Reflux Disorders — partially digested items in the stomach, mixed with acid and enzymes, regurgitates back into the esophagus. This can lead to damage to the esophagus, larynx and lungs and increases the chances of developing cancer of the esophagus and voice box.

Gastric Rupture — spontaneous stomach erosion, perforation or rupture.

High Blood Pressure, Hypertension — elevated blood pressure exceeding 140 over 90. Can cause: blood vessel changes in the back of the eye creating vision impairment; abnormal thickening of the heart muscle; kidney failure; and brain damage.

Hyperactivity — manic behavior; not being able to sit still.

Impaired Neuromuscular Function — due to vitamin and mineral deficiencies and malnutrition.

Infertility — the inability to have children; caused by loss of menstrual cycle and hormonal imbalances. Malnutrition and vitamin deficiencies can also make it impossible to succeed with a full-term pregnancy, and can increase the chances significantly of a baby born with birth defects.

Insomnia — having problems falling and/or staying asleep.

Iron Deficiency, Anemia — this makes the oxygen transporting units within the blood useless and can lead to fatigue, shortness of breath, increased infections, and heart palpitations.

Kidney Infection and Failure — kidneys cleanse the poisons from your body, regulate acid concentration and maintain water balance. Vitamin Deficiencies, dehydration, infection and low blood pressure increase the risks of and associated with kidney infection thus making permanent kidney damage and kidney failure more likely.

Lanugo — (soft downy hair on face, back and arms). This is caused due to a protective mechanism built-in to the body to help keep a person warm during periods of starvation and malnutrition, and the hormonal imbalances that result.

Liver Failure — the liver aids in removing waste from cells, and aids in digestion. Fasting and taking acetaminophen (drug found in over-the-counter painkillers) increases your risks for Liver damage and failure. Loss of menstruation and dehydration (putting women at risk for too much iron in their system), and chronic heart failure can lead to liver damage or failure.

Low Blood Pressure, Hypotension — caused by lowered body temperature, malnutrition and dehydration. Can cause heart arrythmias, shock or myocardial infarction.

Lowered body temperature — caused by loss of healthy insulating layer of fat and lowered blood pressure.

Malnutrition — caused by undereating or overeating. Malnutrition indicates deficiency for energy, protein and micronutrients (e.g. vitamin A, iodine and iron) either singularly or in combination. It can cause severe health risks including (but not limited to) respiratory infections, kidney failure, blindness, heart attack and death.

Mallory-Weiss tear — associated with vomiting, a tear of the gastroesophageal junction.

Muscle Atrophy — wasting away of muscle and decrease in muscle mass due to the body feeding off of itself.

Orthostatic Hypotension — sudden drop in blood pressure upon sitting up or standing. Symptoms include dizziness, blurred vision, passing out, heart pounding and headaches.

Osteoporosis — thinning of the bones with reduction in bone mass due to depletion of calcium and bone protein, predisposing to fractures.

Osteopenia — below normal bone mass indicating a calcium and/or vitamin D deficiency and leading to Osteoporosis. Hormone imbalance/deficiencies associated with the loss of the menstrual cycle can also increase your risks of Osteoporosis and Osteopenia.

Pancreatitis — when the digestive enzymes attack the pancreas; caused by repeated stomach trauma, alcohol consumption or the excessive use of laxatives or diet pills.

Peptic Ulcers — caused by increased stomach acids, cigarette smoking, high consumption of caffeine or alcohol.

Pregnancy problems — including potential for high-risk pregnancies, miscarriage, still born babies and death or chronic illnesses from minor to severe, in children born (all due to malnutrition, dehydration, vitamin and hormone deficiencies).

Swelling — in face and cheeks (following self-induced vomiting).

Seizures — increased risk of seizures in Anorexic and Bulimic individuals may be caused by dehydration. It is also possible that lesions on the brain caused by long-term malnutrition and lack of oxygen-carrying cells to the brain may play a role.

Tearing of Esophagus — caused by self-induced vomiting.

TMJ "Syndrome" — degenerative arthritis within the tempero-mandibular joint in the jaw (where the lower jaw hinges to the skull) creating pain in the joint area, headaches, and problems chewing and opening/closing the mouth. Vitamin deficiencies and teeth grinding (often related to stress) can both be causes.

Weakness and Fatigue — caused by generalized poor eating habits, electrolyte imbalances, vitamin and mineral deficiencies, depression, malnutrition, heart problems.

Five Steps to Your Weight Loss Goal

1. Program yourself for success: Set a very specific goal.

• Remember that losing weight requires a change in thought and behavior, so set goals for your emotions and weight.
  
  
• Don't just set vague goals like, "I want to lose some weight." Be specific: How much weight do you want to lose? How do you want to feel? Close your eyes and visualize yourself after you've reached those goals. Use this visualization to feel commitment and inner strength.

2. Get a plan.

• Work out a detailed strategy because willpower doesn't work! To lose weight and keep it off, you must have a strategy.
  
  
• Plan ahead: Get rid of your expandable clothes, stay away from fast food, and keep healthy food in your pantry.

3. Identify small, measurable steps.

• Implement steps that will fit your lifestyle, not somebody else's.
  
  
• Be sure to move toward a positive goal, not just away from being fat. Every step you take will bring you closer to being who you want to be.

4. Create a healthy, realistic timeline.

• Where will you be in a month? Six months? A year? Fit your goals to your calendar, and stick to it.
  
  
• Don't expect to see huge results overnight; take the time to change your lifestyle, and you'll change your weight.

5. Create meaningful monitoring and accountability.

• If you know you have to report your progress to someone, you'll be more likely to stick with your plan.
  
  
• "Go public" with somebody you trust. Find support when you need it, and celebrate your victories!
  

Helping Your Overweight Child

Approximately 14 percent of children in the United States are obese. This is a disturbing and dangerous statistic. As a parent, there are things you can to do help your overweight child.

Avoid Verbal Abuse
If you think that making derogatory comments about your child's appearance will shame him/her into losing weight, you're wrong. You will cause anger, hurt and resentment. Worse than that, you'll condition your child to develop negative labels ("I'm just a pig," "I'll never be good at sports," or "Nobody will want to date me when I grow up,") that could be lasting.

Introduce Positive Labels
Don't you think your child wants to feel better, get back energy, vitality and self-esteem? Instead of providing criticism and judgment, you can provide help and encouragement. Start offering positive labels: "I can achieve whatever I set out to do," or "I am loved and valued."

Look at Why They Eat
Instead of looking at what your child eats, look into why he/she eats. Childhood obesity can be a symptom of stress. If your child is self-medicating with food, what is being medicated? Adults often turn to drugs and/or alcohol to self-medicate when they are looking to fill a void or cope with stress. Children often turn to food.

Look at Your Lifestyle
If your lifestyle is contributing to your child's obesity, change it. If you keep junk food in the house, stop. If your schedule is so hectic that your family is forced to eat high-fat, low-nutrition meals like fast food, you need to slow down. If your family life is centered around sedentary activities like watching TV, make an effort to include some form of physical activity in your child's life.