It's about health, not weight

Follow-up care starts with a phone call about a month after the initial visit to check on progress, set new goals, and schedule a visit for the following month. "We may or may not weigh the child during that follow-up appointment," Bartels notes. "In a larger sense, this really isn't about weight; it's about healthy eating and healthy activity. Later, if the parent and child want to get a weight and see how things are going on that front, that's fine.

"The great thing about kids is that they're constantly growing," she adds. "Kids who are overweight usually don't need to lose weight; they just need to hold steady at their current weights for a while as they get taller and grow into healthier BMIs."

"That first follow-up visit may focus on nutrition, or on exploring ways to add more physical activity to the child's schedule," Joseph explains, "Or on activities the whole family can do together, since many parents are also trying to lose weight and be healthier."

We're all in this together

Losing weight and eating healthier has, indeed, been a collaborative effort for the Habers. "Our whole family is doing this together," Susan Haber says. "Much to my relief, the changes weren't as hard as I expected. When we cut back to one dessert and one treat a week, my kids weren't thrilled. But they've accepted it, and now it's fine.

"An hour of exercise a day is really difficult," she continues, "but we have made some small changes. Both of my children are in the same school, and we now walk to school as a family instead of driving—a 10- to 15-minute walk each way. We also make an effort to get out together on the weekends and do something active."

Over the next few years, Bartels and Joseph hope to see a decrease in the percentage of overweight and at-risk children in the practice, but they expect the emphasis on nutrition and physical activity to make a difference for all their patients. "We want to help all our families do better," says Joseph, "not just the families with an overweight or at-risk child. We want all the children in our practice to develop good habits now, so they'll all grow into healthier adults."