The obesity rate among American children has more than tripled since 1970. Almost 20 percent of kids 6 to19 years old are obese, according to the CDC. And this doesn’t take into account the kids who are “just” overweight.

The obesity rate among American children has more than tripled since 1970. Almost 20 percent of kids 6 to19 years old are obese, according to the CDC. And this doesn’t take into account the kids who are “just” overweight.

Obesity in kids is a serious problem that can lead to physical, social and emotional struggles. Kids who are obese are more likely to be teased and bullied by other kids.

They are at real risk of bone or joint problems, diabetes, high blood pressure, and sleep problems. Plus, they are more likely to be obese adults.

As parents, we want our kids to be as healthy as possible. But helping kids to lose weight can be a bit tricky. Talking about their weight can have unintended consequences and promote an unhealthy lifetime relationship with food. Rather, you should work on some small changes to help your kids achieve a healthy weight.

First, have your child medically evaluated to rule out any problems that could cause weight issues, as well as help identify any stress, anxiety or depression that the child may have. Labs may be drawn to assess for any abnormalities. Your child’s doctor also can help you set a realistic weight goal for your child. Typically, if a child is still growing, the goal should be to stop weight gain and let growth catch up to the weight.

Never put children on a fad diet, drastically restrict calories or give them any type of supplement in an attempt to lose weight or control appetite. You also should not single them out from other kids, family members or siblings. Don’t keep a stash of food for yourself or other family members that you forbid the child to eat. Children’s brains are not yet fully developed so they will lack the impulse control to not eat these foods. You don’t want them to feel deprived or bad about themselves. So how can you help your child manage their weight?

1. Be a good role model. Involve the whole family. Children notice what you do and how you eat. The more family meals you can serve, the better. Plan meals out ahead of time so there will be less temptation to eat out or to rely on unhealthy options. Start small. Too much change all at once is overwhelming to the child and the whole family.

2. Make your home free of sugary beverages and foods. If you serve juice, dilute it 50/50 with water and limit the frequency. Milk should be limited to two to three cups a day. Any other beverages should be calorie-free; water is best.

3. Stock healthy snacks to fight hunger. Keep a bowl of fruit on the counter, and have vegetables cut and ready in the fridge. Hummus, popcorn, low-fat yogurt, whole grain tortilla chips, and salsa are all healthy snacks. Set snack times and rules, and don’t allow too many snacks during the day. A snack should have just 100 to 200 calories.

4. Get them involved. The more involved the child is, the more likely they will be on board with any diet changes you implement. Let them help with shopping, meal planning and food prep. Teach them to read labels to choose nutritious foods.

5. Don’t reward with food. Don’t withhold dessert until the plate is clean. Find other rewards for good behavior, rather than a stop at the ice cream shop.

6. Provide healthy breakfast options. Many breakfast foods, especially those marketed to kids, are really desserts. Sweetened cereals, donuts, Pop-Tarts, pancakes, waffles and the like are all high in sugar and calories and contain few nutrients. Instead, offer whole grain, unsweetened cereals; oatmeal; fruit; yogurt; or eggs. A quick breakfast might be an egg sandwich or some whole grain toast spread with peanut butter.

7. Limit fast food or restaurant meals to no than once a week. Large portion sizes plus unhealthy food options mean lots of extra calories.

8. Know correct portions. Serve the correct portions based on your child’s age, which is smaller than an adult portion. You can use the child’s fist size as a guide for WHAT or HOW. Use a portion plate to help visualize the right portions. Fill half the plate with fruits and vegetables, one-fourth with a starchy food and one-fourth with protein. If your child wants seconds, give extra servings of vegetables and fruit.

9. Increase activity. Kids should be getting at least 60 minutes of activity a day. Let them explore various sports to find one they really enjoy. Spend active time as a family, and encourage outdoor play.

10. Limit screen time. All screens, including TVs, phones, computers and electronic games, should be limited to no more than two hours per day. Try a three-to-four-week electronic break.

11. Make sure they are getting adequate sleep. Lack of sleep can lead to obesity and other health problems. Kids 5 to 11 years old need about 10 to 11 hours of sleep; teens should be getting about 8.5 hours a night. Keep screens out of bedrooms.

12. Figure out how to handle temptations, such as parties or going to Grandma’s house. You can’t eliminate treats altogether and kids need to learn how to handle them in a healthy way.

Following the “5210 rule,” endorsed by the American Academy of Pediatrics, is a good strategy: Aim for 5 servings of fruits and vegetables a day, restrict screen time to 2 hours per day, include at least 1 hour of physical activity, and aim for 0 sugar-sweetened beverages.

If you don’t see any progress after a few months or even weight gain, see your child’s doctor. There are weight management programs for children that might be appropriate or you may need a referral to see a dietitian.

Anita Marlay, R.D., L.D., is a dietitian in the Cardiopulmonary Rehab department at Lake Regional Health System in Osage Beach, Mo.