When parents are involved, children lose more weight and maintain the weight reduction longer even if the parents are overweight and don't lose any weight themselves. Positive reinforcement for parents has also been shown to improve children's outcomes. Self-monitoring is usually the first behavior change required. The child or parents of a young child keep records of the child's food intake and activity. Even if the self-reporting is inaccurate, it helps to increase awareness of eating habits, food choices, and patterns of overeating.
Nutritional education is essential for both the child and parents.
This includes information about the food pyramid, components of a healthy diet, and advice about providing opportunities for the child to make good food choices. Controlling environmental triggers that stimu- late overeating is important. Modifying eating behavior can be helpful. Suggestions include taking smaller bites, eating more slowly, and leaving food on the plate at the end of a meal. Skills to cope with the negative peer attitudes and remarks that obese children receive from other children are essential.