For years, Libby McCormick's doctor said she probably would outgrow the "baby fat" padding her cheeks and belly.
But Libby kept gaining weight, and by her 8th birthday she wore a size 14 dress and weighed 105 pounds _ 20 pounds more than the top of the chart for her age and height.
"We talked about it, we decided we had to do something now," said Libby's mom, Karen McCormick. "I read about the statistics where (overweight children) track into obese adults, and it's not fair. It's our responsibility."
It is no secret what works: regular exercise, a balanced diet and parents who serve as good role models. But as many families can attest, implementing the solutions can be hard.
"The mother always says, "How much should she weigh? How much should she weigh?' " said Dr. Frank B. Diamond, a pediatric endocrinologist at All Children's Hospital in St. Petersburg. "Well, she should weight half of what she weighs now. But nobody's going to lose that much.
"If she weighs 100 and should be 50, then they'll give up."
But the McCormicks _ parents Karen and David and two daughters, Katie, 7, and Libby, now 9 _ are proving a family can learn new behavior to help one member control her weight. Although Libby hasn't lost a pound since the McCormicks started making changes a year ago, she hasn't gained one, either _ and she's grown about a foot.
Experts say Libby's family has taken a textbook approach.
Dr. J. Kevin Thompson is a professor of psychology at the University of South Florida in Tampa and editor of a new book, Body Image, Eating Disorders, and Obesity in Youth. He said changing one child's behavior usually requires the entire family to change its behavior.
It also requires creativity and a positive attitude. Forcing an overweight child to jog around the block is not likely to encourage a love of exercise, he said. Instead, parents should strive to make exercise fun, with activities such as family walks, playing soccer at the park, bicycling or skating.
"For parents, say "Why don't we do this today,' and not couch it in terms of you're fat or you watch too much TV," he said. "Once people start doing it and integrate it into their lifestyle, they'll continue to do it."
Mrs. McCormick and Libby attended Why Weight?, a six-week program for overweight children and their parents at St. Joseph's Hospital. It focuses not on losing weight, but on helping parents and children learn to adopt healthy eating and exercise habits. Bayfront Medical Center in St. Petersburg plans to start a similar class.
"One of the main reasons we chose this approach is because it is kind of midstream," said Jana Ludwig Butler, community health manager for St. Joseph's-Baptist Health Care. "It's safe and effective, we know that (encouraging) healthy lifestyles work well."
The McCormicks have built on what they learned. The family has virtually quit fast food, and Katie and Libby get to help shop for and cook their meals, so "they buy into it," their mom said. A glass bowl on the counter holds bell peppers, one of Libby's favorite new snacks.
"We went through a lot of experimentation to find out she liked bell peppers," Mrs. McCormick said. "You just put them all out there and see what they like."
Santa Claus brought a trampoline, and their parents try to schedule physical activities like biking, skating and swimming. "You have to plan it, or they will sit there all day and watch TV," their mom said.
Kimberly Sibille, a behavioral health instructor at Bayfront Family Practice in St. Petersburg, suggests setting goals for behavior _ time spent exercising, for instance, or food eaten _ rather than setting goals for weight loss.
"The more you do the healthy things, eventually your body is going to respond," said Sibille. "For all of us, we're talking about making changes, and it really takes persistence.
"Everyone has very busy lives, and consistency is the key. And don't get discouraged."
Libby, a rising fourth-grader at Children's House Montessori, says she feels better about herself. She is wearing clothes she hasn't worn in two years and bought a bikini this summer. "I wanted to prove to them that I could be skinny," she said.
The McCormicks still splurge on occasion, but the changes they have made in the past year have become much easier to live with. "You get into habits, and these are our new habits," Mrs. McCormick said. "Instead of reaching for candy bars and stuff, we eat healthy food.
"The thing is it all sounds so simple, and it is. But it's not a miracle cure; you need to think about what you're doing and adjust your lifestyle to it."