“Most obese children ‘graze,’” says Dr. Joel Steinberg, director of the Weight Guidance Clinic at Children’s Medical Center of Dallas. “The food diary is a good way for them to record exactly what they eat.”

The food diary includes entries for what, when and why food is eaten, as well as specifics on amounts of food and pertinent nutritional information. It’s a common behavioral modification tool used for overweight adults and can work for children, he says.

Dr. Steinberg adds that, for most children, a diet that allows for normal growth, plus exercise can help control weight. He also suggests parents encourage activities, hobbies, sports and school functions to divert a child’s attention away from food. Modifying their eating habits also can help.

“Scheduling eating and eating slowly to control weight can give them a sense of accomplishment and build self-esteem,” Dr. Steinberg says. “They should also understand there is a difference between needing food and desiring it.”

While all children need exercise, Dr. Steinberg says healthcare providers “prescribe” it for overweight children. They can do any type they enjoy, as long as it is appropriate and efficient. Walking, bicycling, in-line skating and low-impact aerobics are a few good choices.

Exercise not only uses energy and increases lean body mass, it accelerates the resting metabolic rate, which means the body is constantly burning more calories. Accelerating the metabolic rate is critical because unused calories are converted into fat.

While just a decade ago, 15 percent of U.S. children were obese, currently 22 percent are considered obese. Some of these children will face complications such as depression, sleep apnea, diabetes, hypertension, atherosclerosis and skeletal problems in the hips and legs.