Question: I have a 10-year-old son who is about 5 foot and weighs about 130 pounds. He is active, but attempts at a healthier lifestyle have not made much improvement. Is he considered obese and should I have a full examination by his pediatrician? Are there any resources locally to turn to?

Answer, from Dr. Melissa St. Germain: What a great question! Childhood obesity has been front and center in the news over the last few weeks, as Michelle Obama has started her “Let's Move” campaign to end childhood obesity.

Obesity is calculated by looking at the body mass index, or BMI. BMI is a calculated measure of weight compared to height, and “normal” BMI in kids varies with age. For example, a 10-year-old boy should have a BMI less than 20. Your son's BMI is 25.4, which puts him into the obese category. (You can calculate your child's BMI by following the link on the Let's Move page.)

Why do we care? Well, obesity puts kids at risk for things like high blood pressure, high cholesterol, diabetes, joint problems and other “adult problems”. The incidence of type 2 diabetes (the kind associated with obesity) has dramatically increased in the last few years. Childhood obesity has become an epidemic. There are many reasons for this: increased time in front of TVs and computers, less time outside and more high-calorie convenience foods and fast foods, to name a few. Reversing the epidemic is going to take work. Children, parents, schools and doctors need to work together to come up with solutions that will work for each family.

Fortunately, in Omaha, you have many resources available. First of all, see your pediatrician. (Every child should have an exam every 1-2 years anyway.) He or she may recommend some baseline testing for cholesterol and blood sugar. You should have a basic discussion about food choices and activity at this point. If you've already made changes at home without seeing improvement, there are several classes available:
Children's Behavioral Health Clinic has nutrition classes starting in March that meet every Tuesday. Topics will change monthly. You can register by calling 955-3900.

Healthy Families classes are FREE classes for the whole family, and focus on nutrition and physical activity. Call 451-3553, ext. 282 for class times and registration.

Methodist Hospital also offers Life Shapes classes for kids and teens. Call 354-5670 for information.

One of the important parts of addressing childhood obesity is making the whole family accountable. This is difficult. Many of us are sensitive about our own weight and don't feel particularly inclined to address that with our pediatrician. However, it's really, really important that the whole family make healthy living a priority. You may have one child who's overweight and one child who's underweight, but the principles of healthy eating and activity apply to everyone.

If you're looking for a place to start, here are some basic rules:

-- Limit screen time (that's computer, TV, video games) to two hours or less per day.
Everyone needs at least one hour of physical activity every day. That can be walking, riding bikes, playing basketball or just playing tag in the backyard or the basement. Jump ropes are a good indoor option for the winter. Wii Fit is another popular one with a wide variety of games available. Make it fun.

-- Snacks should come out of the fridge, not the cupboard. Fresh fruits, vegetables with dip and yogurt will beat anything with preservatives in it, hands down.
Wait at least 20 minutes before deciding that you really want seconds.

-- No soda! It doesn't matter if it's diet or regular, kids should not be drinking the fizzy stuff. You'd be amazed at how many calories it can add up to.

I'm glad you're taking an interest in your child's health and well-being. Parental support is the most likely indicator of success in weight management in kids. Good luck!

Dr. Melissa St. Germain is a pediatrician with Children's Physicians Embassy Park office near 92nd Street and West Dodge Road.