Sha'Ariel Jones is not that heavy, but it's enough to get her mother's attention.
"It's getting to be a concern because she is not at the normal weight for her age," Detrice Jones said. She put the 8-year-old Augusta girl on a stricter diet, cutting out sugar and limiting portion sizes.
Unfortunately, not enough parents are following Jones' lead. A recent poll by the Trust for America's Health and the Robert Wood Johnson Foundation found that while 80 percent recognized childhood obesity as a significant problem for the U.S., 84 percent of parents polled said their child was at a healthy weight.
That appears unlikely when about a third of children are overweight and obese, said Jeffrey Levi, the executive director of the trust.
Pediatrician Dr. Reda W. Bassali sees it all the time at Medical College of Georgia Hospital and Clinics.
"There are many studies that showed that what is an ideal weight in the eyes of the parent is usually much different than reality," he said.
This was brought home to Mary Beth Arnold, a registered dietitian and certified diabetes educator at University Hospital, when she saw an 11-year-old patient who was already 200 pounds. The child had been off the growth charts for three years, she said.
"I think part (of the problem) is the medical profession," she said. "We've got to just flat out say, 'This is not good for your health,' especially with children. That is what is just really worrying me."
Even when pediatricians try to intervene, it doesn't stop the child from packing on more pounds, Bassali said.
"I see it in my notes from year to year and they still gain weight," he said. "It's not an easy intervention."
Part of the problem is no one wants to pay for an extensive, multidisciplinary approach, Bassali said.
The consequences are growing, especially in the South. Georgia has the second-highest childhood obesity rate in the country, behind only Mississippi, at 21 percent, according to the 2007 National Survey of Children's Health.
Those extra pounds could already be having an impact on children's cardiovascular systems, said Dr. Catherine L. Davis, a researcher at the Georgia Prevention Institute at MCG. In overweight children as young as 8 years old, higher body fat correlated with higher arterial stiffness, as did lower levels of fitness, she said. It can be hard for parents, who don't want to stigmatize their child with the obese or overweight label, Davis said.
"Another factor, I think, that makes it difficult for people to identify whether their child is overweight or not is that it is so common that their child doesn't look any different than the other kids in the class," she said. "At this point, in some of the schools, half the kids are overweight or obese."
Those children might already be suffering the health effects, Davis said.
"Ignoring the problem is a problem because it is not just about stigma or social status or looks, it's affecting these kids' bodies in really harmful ways,' she said.
Davis is studying children in after-school programs, some who race around in a gym and others who do activities such as board games and art, to see whether she can isolate the effects of exercise on these children and correlate it with academic performance and cognition.
"If that's a real connection, then the schools will become interested in investing in the children's health," Davis said. "I'm trying to get to their bottom line. They don't have money to throw around on things other than those achievement scores. ... But if I can show that it makes a difference in how these kids do on their achievement tests, then they'll pay attention."