When Dara-Lynn Weiss's daughter Bea went for her annual checkup at age seven, the pediatrician pronounced her obese. In one year, Bea had gained 23 pounds and her blood pressure had bumped up significantly.
"This was a health crisis," Weiss said.
Weiss's solution was to put Bea on a calorie-restricted diet, an experience she chronicled first in a magazine article then in a bestselling book, "The Heavy."
Weiss said her decision to slash portion sizes, place limits on even healthy foods like fruit, and occasionally replace high calorie fare with Diet Coke and low fat Cool Whip, drew immediate judgment from other parents.
"There were parents who felt there should be no curtailing of what a child eats, while others felt Bea's problems could be solved by removing all unhealthy foods in any amount," Weiss said. "Then there were people who thought we should just wait for it to even out instead of intervening."
Weiss conceded that much of the advice she received was legitimate, if not always solicited or especially helpful to her daughter's specific circumstances.
"Everyone is entitled to their own approach, but in the end I had to do what was best for my child," she said.
And despite the backlash Weiss endured, there is some support in the medical community for her actions.
"Those who criticized her may not have been thinking through the consequences of obesity and may believe they could do it differently but so many kids need help getting on the right track," said Dr. James Marks, a pediatrician who is s senior vice president at the Robert Woods Johnson Foundation in Princeton, N.J.
Marks said that, while asking a young child to cut calories might seem a bit extreme and he doesn't give the idea blanket support, we live in a highly "obesogenic" world that sometimes called for parents to be more aggressive about ensuring their kids eat healthy foods in reasonable portion sizes. Every place from school to restaurants to birthday parties kids are faced with huge helpings of calorie-dense, low nutrition foods, he pointed out.
Sema Kumar, Assistant Professor of Pediatrics at the Mayo Clinic in Rochester, Minn., agreed that it's sometimes appropriate to place a young child struggling with weight on a diet.
"Whether you recommend weight loss or weight maintenance is determined by the age of the child, severity of obesity and any obesity-related health conditions the child has," she said.
The American Academy of Pediatrics recommends children ages 2-18 whose weight falls in the "overweight" category be put on a weight maintenance program to slow the progress of weight gain. Children ages 6-11 classified as obese can be put on a diet for gradual weight loss of no more than a pound a month. Children under 11 who are in the 99th percentile for weight and classified as severely obese, and older children who are obese or severely obese, should aim for a weight loss of up to two pounds a month.
Kumar also expressed concerns that placing children on overly restrictive diets could lead to health problems down the road such as stunted growth, delayed puberty, and osteoporosis. It might also promote negative body image and low self esteem.
On the other hand, remaining obese also has its risks. Obese and overweight children are at higher risk for heart disease, diabetes and cancer. And one recent Pediatrics study found that by the third grade, obese kids were 65 percent more likely to be bullied than their peers of normal weight, leaving them at greater risk for depression and anxiety.