A kid dealing with extra weight needs a dogged, empathetic advocate. Superparents.

Not a nag. Not a watchdog. Not even a cheerleader.

Here are 5 reasons you need to be your own family's obesity expert.

1. Obesity specialists are rare.

I live in Washington State where we have over 300 board certified dermatologists to care for the 7M people who live here.

But, during my last count, only 14 board certified obesity specialists.

That’s OK.

When it comes to getting obesity treatment you can partner with any willing pediatrician, nurse practitioner, or family medicine doctor. Whether you’re seeing a specialist or your usual clinician, go in knowing what to ask.

For example:

Do any of my child's current medications cause weight gain? Can we try substitutes?
Should we draw labs? A1C? Glucose? Glucose Tolerance Test?
What medication might help him/her lose weight?
And if you start medication, "This medication isn’t working. Is there a higher dose or different option?

2. Treatments vary.

Even among experts, treatments vary. Some recommend low carb diets, others the Mediterranean diet. Some are conservative, some more aggressive. Some do a lot of motivational interviewing and concentrate on diet and exercise. Some are focused on getting the medications right.

The more you understand what the treatment options are, the faster you can work with a pro to solve this puzzle in a way that works for your own family.

3. Kids respond differently.

Different people respond differently to treatment. If your child isn’t responding well, you’ll need to know enough to talk through the options.

There’s science behind good obesity treatment, but you and your doctor have to be willing to keep trying until you find what really works for your kid.  Some kids are insulin resistant, start taking the minimum dose of the prescription drug Metformin, and that’s it. They lose weight.

But for most kids and adults, treating obesity takes a lot of trial and error and is a long term effort. 

4. Kids' lives are rocky.

Kids' lives and bodies go through big changes.

Puberty can make losing weight harder, or easier.

But other things can improve or worsen your kid’s health too. A new school or school schedule causes stress or less sleep.  Sleep-away camp. New friends. A change in sport seasons. Illness or injury. Heading off to college. Bullying.

These things can be crazy for kids. You need to be steady and calm.

5. Blame and shame.

This was a game-changer for my family.

Blame and shame are the twin enemies of health. They cause us to hide, to avoid seeking help, to be self-destructive. They make us think we should be able to "fix" our kid's problem on our own.

The most fundamental fix you can make is to stop blaming and shaming yourself, your child’s other parent, or your child.

Question all conventional thinking when it comes to weight gain and especially weight gain and kids.

Specifically, when you see your kid on the couch, not moving for long stretches of time, or see him eating what appears to be much too much, check your reaction.  What are you thinking? Is it, “She’s so lazy. She needs to change; to move more and eat less.”

Instead, question what's going on.

What is causing my child’s stillness? What is the underlying problem that's making her body conserve energy? Why does her brain think she’s starving so much that it’s slowed her down?

And, what’s making my kid so hungry? Why did other kids eat two bites and run off, and my kid is getting seconds?

Great doctors will understand that it isn’t child sloth and gluttony that is causing the child to have excess weight.  The child’s body is pulling too much energy out of the blood and into fat storage, and then doesn’t recognize the storage. It sees that there’s too little energy in the blood, and then stores even more.

Too much hunger and too little movement isn’t your child’s moral failure, or yours. It isn’t a problem of too little willpower.

Obesity is a true physiological disorder. Keep searching until you find some help that works.