Doctor Betti Dr. Betti Hertzberg Ressler is a Board Certified Pediatrician on staff at Miami Children's Hospital. Dr. Hertzberg developed the toilet training video "Let's Go Potty." She is the co-author of "The Doctor's Book of Home Remedies for Children." Overweight Child Question: My nine year old son weighs 172lbs. and is 5' tall. He has always been a robust child since birth and have been advised in the past to avoid putting him on a diet. He gets plenty of exercise outside but I don't think that it is sustained for any period of time. He moves rather sluggishly, lacks coordination, and his breathing is labored. He must be forced to eat most fruits and drink water. How can I help him to cut back on portion sizes without feeling like he is being deprived or starved? Answer: Childhood obesity may lead to complications during childhood and later on in adult life. Complications such as sleep apnea (uneven breathing patterns during sleep), heart disease, high blood pressure, etc., just to name a few. Treatment is aimed primarily at modifying eating and exercise behavior. Very low calorie diets are considered experimental in children. Medications are also not a good choice because of side effects related to growth and development. Surgery is almost never used in children. The most critical periods for the development of obesity are ages 5-7 and adolescence. Aside from health problems, other concerns include emotional upset/boredom, which leads to a further intake of food. Weight gain that is excessive and not easily labeled to food intake may have some endocrine components. A medical evaluation may be necessary. If you have not already done so, speak to your child's pediatrician about possibly referring your son to a pediatric dietician/nutritionist that specializes in children who are overweight. I'm not aware of any stress or social situation that might be a contributing factor in your son's case, however, there may be difficulties that may be worked out through psychological counseling. Only you can determine this. Your son needs lots of positive reinforcement, especially at home. Kids in school tend to be mean (the nature at this age). Making fun of other kids is the norm! A rule of thumb: If a child's height has been consistently above the 50th percentile on a growth chart, obesity is probably due to nutritional excess. Obesity due to endocrine or genetic factors will show other traits such as short stature and other family members with significant obesity. This is a family problem. Lets all work together to get it solved. Also see: Does Strep Throat lead to Scarlet's Fever? My 10 year old daughter is incredibly prone to insect bites. Even when no one else is getting bitten, they seem to go for her! Any suggestions? Ask Dr. Betti your questions This information is not intended to be a substitute for visiting your pediatrician. If you or your child has specific concerns, you should see your doctor for a diagnosis and treatment.