Dr. Patricia Riba sees so many overweight and obese children at the clinic she runs that she begins to lose perspective about what a healthy kid is supposed to look like.

“If I just eyeball a kid, I’m so used to seeing children who are overweight and obese, I can’t even tell anymore, because I see this so much,” says Riba, who sees families at the HOPE Clinic, based at the Newport-Mesa Unified School District headquarters.

When mothers and fathers are told their kids might be dangerously heavy, headed for the early onset of diabetes, they “don’t quite buy into it,” Riba said. Often it’s only when a blood test is done, to measure cholesterol levels and other markers, that reality sinks in for families. “Those are more eye-opening and more painful for the families than just looking at them.”

Is fat becoming the new normal for kids? It’s not just anecdotal evidence that makes it seem so. A new study out of Columbia University reveals that many mothers and their children who are overweight or obese don’t think they are. And the heavier they are, the more they underestimate their weight.

According to this story on CNN.com, 222 subjects — women and their children age 7 to 13 — were interviewed. A little less than two-thirds of the mothers, and nearly 40 percent of the kids, were overweight or obese (nationally, the proportion is two-thirds and one-third, respectively). Of the obese women, 82 percent underestimated their weight; 43 percent of the overweight women did. Among the overweight or obese children, 86 percent didn’t know their weight.

Riba says that once kids are on solid foods, parents shouldn’t use food as a reward, or to console them or keep them quiet. ” ‘Eat when you’re not hungry,’ that’s the mixed message,” Riba said.

She adds: “There’s zero reason to be offering juices and chocolate milk and desserts to infants and toddlers. If they’re used to snacking on cheese and fruits and vegetables and healthy foods, that’s going to be a healthy child.”