My five year old niece weighs 75 pounds, and her face seems to be more puffy at some times than others. She also has a large appetite (2 regular size cheeseburgers and or high calorie and fat snack). Both of her parents are about 20 pounds overweight, but do not have diabetes. What could be the problem, diabetes or something else?

Children with large appetites that are provided with high fat/high carbohydrate foods (some call these foods junk foods), end up larger than their peers. Most of the time, this is due to poor eating/dietary habits and cannot be blamed on diabetes or other illness. I would suggest encouraging your niece’s parents to dramatically modify her dietary habits to include fresh fruits and vegetables.

It may be helpful to suggest consulting a dietitian to plan a daily intake for this youngster. You may wish also to mention to these parents that they take her to see her pediatrician to make sure this doesn’t represent an illness rather than a result of her diet. Encourage her parents to make a change now and not wait until they have an unhappy, overweight adolescent.

MSB