I have also dealt with weight issues all my life and still am technically obese (though I'm not huge and have been losing weight). I did a report last semester on childhood obesity for a teaching class and while I understand your concerns for the child, at the same time you can't control what happens at home or when she is not on your watch because she is not your child. Though, there are some cases where families have had their children taken away by CPS because they were morbidly obesity.

The thing about obesity is that while yes, MOST of the time it is cause by overeating, there are millions of things that can attribute to it that they aren't legally obligated to tell you. Lower income families are more likely to have obese children than middle to higher income families (either because of access to better information or price of food). Medication for other condition can cause significant weight gain. EX: I was given prednisone for a severe asthma attack when I was only 3 months old (I was diagnosed with asthma at 1 month old, was BFed, weighed normal 7lbs at birth and my mom was at an ideal weight before I was born; it's genetic and I was a high risk pregnancy). I ballooned up and it change the chemistry in my brain permanently (long term affects in young patients can include increased appetite). Asthma in children is also on the rise and tend to correlate with weight issues. Some doctors believe that the treatment medications, as well as the symptoms of asthma (Fatigue, shortness of breathe with physical exertion, inflammation of body fluids), can be as much to blame for obesity risks as obesity is for asthma risks (inhalers have steroids; can cause weight gain). Insulin for diabetes can also cause weight gain, there is actually an eating disorder called 'diarexia' where people with diabetes stop taking their insulin to avoid gaining weight. Obviously parents are not going to risk their child's health by not treating their biggest health concern so that their children will be thin.

Also, while long term obesity can lead to many health problems, there are people who are considered "obese" but actually have more muscle mass than fat (need a special test). And also, there are some kids who are very heavy when they are young (no matter what they eat or how much they work out) and as they get older just get a growth spurt and thin out a bit (I did). Plus, there are some people who are just a bigger build than others and can still be healthier than others who are smaller. Most doctors today are ditching the traditional BMI calculations because it (by itself) isn't 100% accurate because every individual has a different body structure, different shape, different distribution of fat, muscle, fluid, and tissue. For my age and height, using BMI, my approximate ideal weight should be between 99-130lbs, my doctor told me that 130lbs would be a good weight for me (maybe even 140) but that I should not go under 130lbs because of my body frame and shape, I would look sick if I went too far under 130.

Unless you are a medical professional it's not wise to give weight loss tips to the family. Don't get me wrong- promoting healthy eating styles and activities are one thing, but any type of special diets for a child this young should be under close supervision of a doctor. At this age diets can be dangerous because they can stunt or even delay growth/development and if the parents misunderstand the information and wind up underfeeding her, they could wind up accidentally malnourishing her instead or (even more dangerous) they may start shaming her into not eating so much which could lead to a variety of eating disorders (anorexia, bulimia, guilt binging) or other self-destructive behavior when she's older (self-harm, drugs). If you do give them any advice, I would suggest it be asking their doctor about things they can do to help her and ask for a copy of that information to make sure you are consistent with what the doctor says the child's individual dietary/activity needs are.

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