The decision of whether to talk to the doctor in a one-on-one consultation or with your child in attendance will depend on her age and personality. Very young children won't mind being part of the conversation and may benefit from their inclusion. (For younger children in particular, establishing an authority figure aside from the parents can sometimes make it a little easier to enforce new lifestyle changes.) Older kids who are feeling emotionally vulnerable about their weight may feel self-conscious about the discussion, and adolescents may even prefer to meet with the doctor privately.

If your teen meets with the doctor without you, be sure to get a quick recap from the physician on what you need to do to help your child succeed in a fitness plan. You might ask the doctor to take some notes on the main points of the conversation for your child to pass on to you afterwards. That way you aren't encroaching on what your teen feels is private business, but you will still have the information you need to help your child succeed and be able to follow up with the doctor on anything that is unclear to either of you.

Questions to Ask

If your child does attend the session with you, make sure to frame all questions in a positive light. It's also important to include your child in the conversation. A weight-loss plan won't achieve long-term success unless your child is invested in the process and senses that his feelings and participation matter.

Questions to ask your child's physician include the following:

• In what percentile do my child's weight and height fall on the growth charts for his age?

• What is the “ideal” weight range for his age and height, and what do you think his specific goal should be, based on his body type and medical history?

• Should weight maintenance or weight loss be his goal?

• If weight loss is a goal, what amount of weight is realistic and safe for him to lose each week/month?

• Does his current activity level seem appropriate?

• Do you have any sample meal plans and nutritional handouts, and can you provide a referral to a registered dietitian for a consultation?

These questions are general guidelines only. If your child has a chronic health condition, food allergies, or other complicating factors in his medical history, you will want to discuss a weight loss plan in the context of those issues.

What to Expect

After you've had an opportunity to discuss your child's current weight and any medical or environmental issues that may be contributing factors, your child's doctor will suggest a plan of either weight maintenance or weight loss, depending on your child's age, BMI, and the presence of any weight-related complications.

In many cases, your child's physician may recommend that your child attempt to keep his weight steady for awhile to let his height catch up with his weight growth. In the case that your child is topping out over the 95th percentile and weight-related health complications are involved, very gradual weight loss may be recommended. Each child's situation is different, and your physician will assess your child individually. Some weight-loss goals will take longer than others to achieve. In all cases, the final target for your child will be to achieve a BMI that is below the 85th percentile for other children of the same age.