When your child is struggling with his or her size, you might be at a loss for words. But knowing exactly what to say can place your kid on a path to a healthier life.

By Linda DiProperzio

"I couldn't ignore it any longer," says Amy Barksdale of the Bronx, New York. She'd put off speaking to her 14-year-old daughter, Amada, about being overweight for nearly a year. "Amada needed to lose about 20 pounds," says Barksdale. "But she'd hang out with her friends after school eating chips and fries in front of the TV. I worried she was on her way to that kind of life." And Barksdale was right to be concerned.

One in three children in the U.S. are overweight or obese, a problem that will likely follow them into adulthood: Experts estimate 42% of Americans could be obese by 2030. Yet many moms, dads and even pediatricians put blinders on to avoid addressing the situation, not realizing that children want them to say something. Nearly 70% of kids feel their parents should talk to them about being overweight, according to a recent survey.

Barksdale discovered this when she finally sat down with her daughter. "Amada was waiting for me to bring it up," says the 46-year-old mom. "She knew she had to get healthy." Once you commit to a conversation, the difficult part is figuring out what to say. We asked experts to address your questions and concerns so you won't be left speechless.

I know I need to lose a few pounds. How can I bring up my kid's weight without sounding like a hypocrite?

Honestly, you can't. But you can make it clear you plan to lead by example from now on. "If you're not working on getting yourself healthy, your kids won't feel understood," says Lori Fishman, Psy.D., a pediatric psychologist in the Optimal Weight for Life Program at The New Balance Foundation Obesity Prevention Center, Boston Children's Hospital. "Explain that the entire family needs to eat right and exercise—and that you're no exception."

Melanie Johnson of Vancouver, British Columbia, had this conversation with her family. "It's not fair to single out one member," says the 44-year-old mother of two. At age 10, her son lost 58 pounds on The Wellspring Plan, a fitness and nutrition program for young people with camps in the U.S. and U.K.; he is now 13, confident and slim. "If the entire house is filled with healthy meals and snacks, then it becomes the norm for everyone to eat well," says Johnson, who struggled with her own weight before losing 175 pounds. "I told my kids, 'Your obesity was not your fault. You ate what I gave you as a child. Now that I'm learning more about this, I understand that there are healthy changes we can all make together.' "

What if talking about it hurts my child's self-esteem?

Not having the talk could do the same, so choose your words wisely. "Kids already feel guilty about being overweight," says Joanna Dolgoff, M.D., a pediatrician and creator of Red Light, Green Light, Eat Right, a healthy eating program for children. Tanikka Price, 38, of Columbus, Ohio, noticed how self-conscious her then-14-year-old daughter, Kaissa, had become. "Having gone from a size 11 to a 14/16 between her freshman and sophomore year, she started walking around with her shoulders hunched and head down as if she were trying to be invisible," says Price.

The key is making this about quality of life—not appearance. "Tell them: 'You'll feel better in the morning when you wake up and have more energy throughout the day,'" suggests Rovenia Brock, Ph.D., a nutritionist and creator of Dr. Ro's Fit Kidz show. "That means there'll be more time for sports and friends." Price was sure to emphasize lifestyle instead of looks after Kaissa wrote in a journal they share that she wanted to quit being a cheerleader. "I asked her to consider how her stamina at practice changed from her freshman year to this, her sophomore year. She admitted she needed help," says Price. "So I made an appointment for us at a local children's hospital's healthy weight and nutrition clinic."

Can discussing weight lead to an eating disorder?

Probably not, but parents do need to be careful, says Cynthia Bulik, Ph.D., director of the Center of Excellence for Eating Disorders at University of North Carolina School of Medicine in Chapel Hill. "If you talk about dieting, then you're venturing into dangerous territory," says Bulik, noting the difference between a quick fix and hopefully permanent lifestyle changes. "You don't want to plant that bomb in your child's head, especially since we all know diets don't work in the long run." Instead, focus on developing respect for one's body and giving it what it needs. Bulik suggests explaining it in a way your child can understand, such as "Would you feed a plant a soft drink and expect it to thrive?"

Should I get his pediatrician involved?

"Kids aren't one-size-fits-all, so speaking to your child's doctor about how much weight he should lose and how quickly is an important step," says Dr. Dolgoff. Your child is still growing, and you want to make sure he is getting the necessary nutrients. With that in mind, Brock also suggests speaking to a nutritionist to assist you in devising a healthy and well-balanced meal plan for the entire family.

How can I encourage my child to eat right on a daily basis?

It can be hard for tweens or teens to always make healthy eating choices, especially when they're around their friends. "You don't want to be the food police," says Fishman. "While you can't expect them not to want to do what their friends are doing, you can help them set realistic goals, such as eating healthy six days a week. Then one day when they're out with their buddies, they can indulge a little. One afternoon of junk food isn't going to do much harm if they're eating well most of the time." It also teaches them that they can enjoy these foods in moderation.

What if my child doesn't see results right away and gets discouraged?

Weight loss and switching to a healthy lifestyle is a process—it doesn't happen overnight. Still, for a child who is doing everything she is supposed to, it can be frustrating when there isn't instant gratification. "Remember to stay positive, because change takes time," says Stephen Pont, M.D., a pediatrician and the medical director for the Texas Center for the Prevention and Treatment of Childhood Obesity at Dell Children's Medical Center of Central Texas. "Focus more on making small, smart changes that stick as a family and results will follow. She'll likely start sleeping better, have more energy and feel more confident." If you're concerned about the lack of progress, consult a dietician or nutritionist.

My kid is being bullied about her weight. What should I do?

Listen to your child and be supportive, says Charles D'Angelo, a weight-loss coach and author of Think and Grow Thin. D'Angelo struggled with his weight as a young child and teen—at his heaviest he weighed 360 pounds—and was bullied because of it. "Parents have to not only encourage their child to become healthy, but also find where her strengths lie and what makes her feel good about herself," he says. "It can be riding horses, building websites, painting, playing piano. Help your child focus on her strengths, her passions and her ability to take charge of her life." You should also make her school aware of what's going on, have them address the issue and encourage your child to come to you at any time to talk about the bullying.

Is overeating an eating disorder?

Binge eating, where there is a loss of control leading to eating beyond the point of feeling full, is a disorder. Emotional overeating is different. It's when people use food to fill a void or seek comfort. "Unfortunately, it creates a vicious cycle," says Robert Pretlow, M.D., a pediatrician in Seattle and founder of Weigh2Rock.com, an online weight-loss system for kids. "Once a child gains weight from emotional eating, the decrease in self-esteem and the social isolation associated with being overweight cause more depression, anxiety and stress." Parents can offer support by asking their child what causes her to turn to food. Is she anxious about her grades? Is she upset about something at home? Then work with her to figure out how she can take care of her emotional needs without turning to food. And consider seeking professional assistance from your child's doctor or a therapist.

My son doesn't like to exercise. How do I get him moving?

Working out doesn't have to involve jogging around the neighborhood. The key here is making it fun, says Dr. Dolgoff. "Ask your child what activities he enjoys. If he's interested, he's more likely to stick with it." Consider martial arts, biking, skating or renting exercise DVDs from Netflix or the library. Whatever he chooses, just make sure he's really getting a good workout.

What should I do if my child resists making any changes?

"Ask if he's ready to get healthy," says Dr. Dolgoff. "Don't freak out if the answer is no, but don't let his resistance stop you from initiating healthy changes for the family. Just because he's not ready doesn't mean you have to endorse unhealthy habits. You can readdress the issue in three months. Right now, he just might require some time to process your talk and contemplate what needs to be done." Amy Barksdale remained supportive throughout her daughter's journey, which included a stay at Camp Shane, a weight-loss summer camp for tweens and teens. Amada lost 15 pounds there and has kept it off. "That talk was the best thing I did for both of us," says Barksdale. "My daughter is healthy and happy, and for a parent that's all that matters."

Originally published in the June 2013 issue of Family Circle magazine.

All content on this Web site, including medical opinion and any other health-related information, is for informational purposes only and should not be considered to be a specific diagnosis or treatment plan for any individual situation. Use of this site and the information contained herein does not create a doctor-patient relationship. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.