So if overweight children have a negative affect on each others' food choices and eating habits, should their parents allow them to continue eating together? Yes, Dr. Salvy says. "Having a friend—and even more for overweight kids who might be at risk for stigmas or prejudices—is the most important thing that a child can have," she says. Friends are also important for children to play with, share activities with and confide in, Dr. Salvy says.

Although the research seems negative, it also highlights the benefits of friendship—friends can also help each other become healthier. "Instead of seeing [the research] as overweight kids should not eat with overweight kids, we need to influence a child's behavior," she says. "Chances are that he can influence his friends. It's not about forbidding kids to eat with overweight kids, but its changing friends' habits so they're actually reinforcing each other's habits."

Dr. Salvy works with Dr. Leonard Epstein on his Traffic Light Diet program, which helps children lose weight and keep it off. The program asks families to get involved in the process of changing the children's eating habits, but Dr. Salvy says it might evolve to include the children's friends as well. "One of the reasons why we involve the family in the weight loss program is that if we change the behavior of the child and put them back in the family with the same [bad] eating behaviors, chances are the old habits will come back," Dr. Salvy says. "What we're thinking is that if it is possible to involve friends in this program, they would keep each other accountable."

What you can do to improve your child's eating habits


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