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When you're evaluating a particular weight-loss program, keep in mind that the most effective ones tend to be those that help children adopt behavioral strategies to counteract their weight problem. Doing so in a group setting not only provides support but helps youngsters develop their social skills too. These programs also should help a child increase her physical activity.

As children enter a program, they should be assessed by a number of health professionals. A pediatrician should document that the child has sufficient excess weight to warrant her participation and to confirm that she has no significant underlying health problems. A nutritionist or registered dietitian should determine what the child's nutritional habits are and create a personalized eating plan. A psychologist or other mental health professional should evaluate the youngster to identify any existing psychological difficulties, as well as to determine whether family problems may be interfering with the child's efforts at weight control.

Once your child begins participation in a formal weight-loss program, her success will require you to make certain aspects of the program part of your family's day-to-day life - from making sensible food choices to encouraging the entire family to become more physically active together. Also, with guidance from the program's staff, encourage your child to set reasonable, short-term (week-by-week) goals that she has a high likelihood of achieving. Changes in eating and exercising - and the accompanying improvements in weight - should be slow and gradual.

Provide your child with rewards, too, as she meets those goals. These rewards should be given immediately upon achieving the goals rather than setting them off in the distance (such as a visit to the amusement park next month, or a trip next summer). The best rewards are not monetary or material but those that provide the child with additional, enjoyable times with the family, such as outings and sports activities.

Elements of a Weight-Control program

Here are some sensible guidelines for healthy weight management:

• Have your child participate in daily vigorous physical activity, sufficient to increase his heart rate and make him sweat. He should start with at least 15 minutes daily and increase to at least 30 minutes. He can try fast walking, jogging, bicycling and skating. Team sports are fun, but not all are vigorous enough to be sufficient alone for weight management.
• Monitor your child's diet by writing down what he eats and drinks. Review this record each day, and find foods that he could eliminate by substituting healthier, lower-fat, lower-calorie choices. Do not rely on "diet foods" alone, but rather switch to leaner cuts of meat, poultry, fish, lower-fat cheeses and nonfat milk. Add more vegetables and fiber to his diet, and use fruits as desserts rather than cake, pie, cookies, pudding and ice cream. Watch the size of each serving, and avoid second helpings.
• If weight loss is the goal, set reasonable weight-loss targets (usually no more than one-half to 1 pound of lost weight per week), and monitor your child's progress. Periodically use rewards for achieving short-term goals. Do not use a long-term goal of a large amount of weight loss as the only criterion for success.
• Support your child's efforts by eliminating undesirable foods from the household. "Cleaning up" the food environment is critical. Keeping high-calorie foods in the house for special occasions or for other family members is cruel and will undermine the child's efforts. There is no acceptable reason for breaking this rule.
• As a parent, you are not the "food police," and thus you should not remind, cajole or scold. If you yourself practice healthier habits and keep undesirable foods out of the house, you need only provide praise to your child, not negative reinforcement.