Julia,

My 9 year old son has been struggling with his weight for about 2 years now.  We got fairly aggressive about it last August.  According to our Pedi and our Endo they like to see kids only put on 5 - 7 lbs in a year.  My son was putting on 10 - 12 a year for two years.  He is very well controlled and is almost never sick and has only had his meds adjusted twice in his life.  He is currently on 10mg / 5 mg / 10 mg of Cortef (along with his Florinef).  Last August when he returned to school I totally stopped the lunch program for  him.  I don’t even allow him to get milk at school as I have no guarantee that it will be skim.  He’s kind of oblivious to things like that.  I now send him a yogurt, two fruits and two veggies a day.  I send a small snack either pretzels or fishies (similar to chees-its).  I have really worked and continue to teach him serving sizes.  We even use snack size plastic bags to pack everything into. He doesn’t get large portions of anything.  I also send him two small bottles of water in his lunch box.  He also has a large water bottle on his desk at school.  He gets a very balanced breakfast and we have really worked on the dinner with him.  We also take the approach with him that food decisions for things like ice cream and snacks for special "fun" times are up to him.  I find that doing that he more often than not decides against the "not so good choice".  Believe me we let himcheat plenty.  He is still a child and I don’t want to do the opposite of what I’m trying to accomplish.  He also (with the approval of the Endo) does the tread mill for 20 min in the morning and again in the evening, 5 days a week.  He is just beginning to up the evening to 30 min.  From August to December he didn’t put on one ounce.  He was also playing soccer in the fall.  We just saw the endo yesterday and he put on approx 5 lbs but he wasn’t playing any sports since December.  He will be starting baseball this week but I don’t expect as much exercise from that as he gets with soccer.  But with the nice weather he will be bike riding, roller blading and swimming so I’m sure he will have another good period of time.  I figure if he can just do no more than 2 - 3 lbs by August then he will be back on track.  His endo is really pleased with his efforts.  To be honest we are really working on the whole thing as a family.  I’ve actually lost some weight and so has my husband in trying to help him just maintain. 

Sorry to be so wordy but I want to share our experience.