Hinting to your son about his extra weight (or hurling insults) will only backfire, because it chips away at self-esteem. Boys and girls do much better with weight loss when parents play to a child’s strengths, rather than his weaknesses. A child who feels empowered, rather than defeated, will be in a better frame of mind to work toward and maintain an active and healthy lifestyle. Even if your child is drastically overweight, pointing that out will not change his behavior. This doesn’t mean, however, that you shouldn’t highlight the importance of healthy eating and exercise for feeling good.

The first step in helping a child lose weight is to get him to start feeling better about himself. Great ways to build up self-esteem: Find opportunities to highlight good behavior or accomplishments. Remark on how helpful he was with tidying up before company came over, or how happy you were to see that he hung up his jacket and backpack or spent some time riding his bike. When it comes to food comments, however, proceed with caution. The first time he chooses an apple instead of a doughnut, giving credit for a healthy choice is useful. Avoid exaggerated praise (kids can sniff that out faster than you can say shrinking waistline), as well as negative comments on food choices, couch sitting, etc. The key: Catch your child doing something right, and encourage him to do more of that.

The second area to focus on: lifestyle changes the whole family can start to make. This is important both for allowing optimal growth in the younger child and for a cessation of ongoing weight gain for the early teen who is about to hit a growth spurt. I recommend the 5 to GO! Program.

• Cut out the diet talk. That means no discussions about your own diet, Dad’s recent weight loss or high cholesterol, etc.

• Play more as a family. Go for a hike, take a family bike ride, toss a Frisbee, set up a badminton net in your backyard. Anything that gets your child (and you!) moving 30 minutes (or more) five days a week is great.

• Limit screen time. Get the TV out of the bedroom, and limit combined TV/screen time to no more than two hours a day.

• Cook more family dinners. Unlike restaurants or fast food places, you control the portions and how the food is prepared. Don’t put too much emphasise on portions, but do explain at first why you’re changing the dinner plates to smaller salad size plates. Get in the habit of filling half the plate with veggies, reserving a quarter for protein (chicken, fish, tofu, etc.) and saving the last quarter for starch (whole-grain bread or pasta or brown rice, for instance). If your child wants seconds, ask him to wait 15 minutes to see if he’s still hungry. If it turns out he wants another serving because he loves this particular food, tell him he can have more tomorrow.

• Eat dinner together. Family meals provide the perfect opportunity to focus on positive conversation, which happens to be one of the best ways to boost children’s self esteem. Since kids who feel a connection to school also have higher self-esteem and fewer risk behaviors, try to promote excitement about any element of school (You love recess? Great! What is your favorite part?).

• Serve smart drinks. Only beverages with no calories (water) or low-fat milk.

• Junk the junk food. Replace it with tasty, healthy options (air-popped popcorn with a sprinkle of garlic powder, apple slices with a teaspoon of peanut butter, low-fat vanilla yogurt with fresh blueberries).

• Create healthy house rules. Such as no food in front of the TV (we tend to eat more while watching) and fast food only once per week.

• Build your village. Do your best to recruit grandparents, aunts, uncles, friends, the sitter, etc. to get on board with encouraging these same healthy habits.

Ellen Rome, M.D.