7 yr old DS is morbidly obese, what to do?

[Aplone]

Mums and other carers of formerly obese kids, how did you get them to a healthy size??

A few days ago I put DS's height / weight measurements into the NHS child BMI calculator and it says he's on the 98th percentile and morbidly obese. Am ashamed and really upset. Feel incredibly guilty. I thought maybe he had some "puppy fat" but never thought he was that large. How the fuck do I get his weight down??? I don't (obviously) want to shame him or tell him he's on a diet but have made a few swaps / changes. Would really appreciate ideas. Have instigated a fruit and veg chart to get him to eat 5 a day. He has a tendancy to sneak foods so had already hidden chocolates, biscuits, etc. He always has tea at 5pm, then has a supper which always includes a glass of milk at bedtime which I have switched to skimmed (these timings are pretty non-negotiable, he is being tested for ASD and routines are v important to him). He always has breakfast which is a brioche bun or two.

His dad and I have split up and it is very acrimonious; I can't discuss this with him as he will blame me, report me to the social etc. I know that when he's at his dad's (which is 50% of the time) he does eat a lot of junk food and sweets / candy. Not trying to point fingers this is just for context for anyone reading.

For further context, he doesn't drink fizzy drinks and isn't that keen on juice, has mostly water to drink so can't do a switch here. He plays sport twice a week but cub scouts which is mostly running around so he is active.

Do I need to get a dietician involved? Will he grow out of it? More water? More exercise? I was a skinny child and I feel out of my depth. He has had one child tell him he's fat and I don't want him to be bullied.

Please be nice to me if you reply... I feel fucking terrible thank you in advance xx

I empathise with you, OP. This sounds like a very difficult realisation. My youngest is verging on overweight and I need to get more proactive.

As he's aware of and understands that sugar is something to limit, my only piece of advice (if you think it would appeal to him) is to make him aware of sugar content in food and discuss together what might be better as an occasional treat versus everyday.

I find it works well with my kids when it comes to breakfast cereal. I set a threshold when they were little (can't even remember what it was now - maybe 11/12g per 100g. I must have read guidance on it) and only cereals below the threshold were for everyday. They like this threshold - makes it easy to understand why I say no. They also like to compare sugar content of foods, and have figured out that chocolatey/frosted cereals are basically like a bar of chocolate.

Similar story with yogurts. They know that some yogurts marketed to kids have crazy amounts of sugar and have them very rarely.

I think it is great that he is having school lunches every day

Please do not stop these and replace with packed lunch

Like others have said they are child portions and follow guidelines etc of the contents

They say the most effective way is for it to be impossible to eat snack bars etc.

They all have to go from the house. Anything he can just grab,, goes. You are in the great position of having 100% control over the food at meals and around him. So no crisps, no chocolate, no crackers, no big blocks of cheese, nothing in the house at all for weeks/months. No fizzy drinks, not much fruit juice.

Leave plenty of fruit, vegetables. Ignore pleas for nice food. It’s the simplest, the best and the kindest way. He will then naturally lose weight through lack of the constant reminders of snacky food. It might take a while, he’s still going to eat probably masses of toast, but it will work.

Activities they say are at most 20%, eating less 80%.

Is there a reason that he only has one glass of milk a day?

@SUBisYodrethwhenLarping

Is there a reason that he only has one glass of milk a day?

He hates it but we made a deal a while ago that he would have the one glass and it has become part of his incredibly rigid nighttime routine when he is with me.

@SUBisYodrethwhenLarping

I think it is great that he is having school lunches every day

Please do not stop these and replace with packed lunch

Like others have said they are child portions and follow guidelines etc of the contents

Fair comment. Tbh I hadn't realised how much thought goes into the school meals, but the point about portion sizes is very valid.

My son was on the 98th centile. Seemed to happen overnight. He was so skinny and then all of a sudden he had a belly and weight all over. He is autistic and likes the same things and would eat those chocolate brioche for breakfast every day too! He likes the same thing every day. Lots of white cards and chocolate. We worked out He was having nearly his daily fat in his breakfast.

He also loves a McDonalds breakfast so we started making our own pattys with low fat pork mince with a bacon medalian, slice of low fat cheese in a wholemeal sandwich thin with a side of berries and apple. He loved them and it was less calories and a huge amount less fat plus he was fuller. Sounds like you are veggie but could do similar with egg and mushrooms? Or veggie sausage patty?

Lunch we switched from school meals to packed lunch. Would have wholemeal pasta, Cucumber, carrot sticks and ham. Then light babybels, apple and a yogurt with a small bag of chocolate mini fingers/cookies.

Dinner I follow slimming world myself so used these meals, but instead of cutting portion sizes, I would cut the meal in half but the add veg so still felt like he was eating the same amount. For treats, chips would be homemade in air frier. Pizza would be pitta pizza using wholemeal pitta, tomato puree and low fat cheese. Homemade popcorn chicken or fish fingers. Pudding would be fruit and yogurt.

We got him a fitbit. I started couch to 5K with him. He would do video workouts on YouTube that were fun, minecraft yoga, kids dance along videos.

He lost over a stone fairly quickly and maintained it and now he is growing taller he has levelled out to around the 86th centile and although could lose a bit more he is getting taller so if he maintains the weight we will be happy with it. We spoke a lot about healty eating and food groups and good choices.

Does he sneak food a lot and never seem full? If so, you might have him checked for a mild form of Prader-Willi. It may very well be ASD (and I am not trying to diagnose on the internet), but it might be something worth keeping in mind, as it can be hard to diagnose when mild.

That said, I think you've made great strides in thinking about his diet in new ways. Small changes will help a ton. If you change out the brioche for two soft boiled eggs and get rid of the biscuits, you'll probably be cutting down about 400-500 calories a day. That's a pound a week, just from those changes. It means a stone in less than three months, just with those very small changes.

Try to make it fun and educational. Talk about getting healthy to feel good and full of energy (don’t talk about weight).

Let him choose one snack a day that is a small treat (quavers or fun size mars bar type thing).

Prepare food together- buy a hand blender and whiz up strawberries, a banana, milk and ice to make a smoothie, do a fill your own wrap station with sweetcorn, shredded lettuce, tuna and light mayo, get him to whisk eggs for an omelette. Buy a fine grater for cheese so a little looks like a lot.

Maybe do a meal plan with him in advance on a big chart in the kitchen so he knows what he’s getting but allow him a bit of control.

Just don’t buy the brioche, choc croissants, petite filous. Agree a healthy breakfast, write it on the chat and stick to it. Yes- he’ll kick off possibly but you just don’t have any choice in making these positive changes if you want him to be fit and healthy. Even a couple of veggie sausages in a wholemeal sandwich thin and ketchup would be better than tons of sugar for breakfast.

Other meal suggestions he might go for:

Jacket potato beans and cheese (small amount)
Scrambled eggs on toast
Home made fish cakes
Hidden veg cooked and blended into tomato sauce with pasta (peppers, onions, courgette works well)
Veggie roast dinner with cauliflower cheese
Packet rice (really handy- goes in microwave) with sweetcorn, chopped up veggie sausage and possibly a bit of soy sauce for flavour
Veggie bolognese

Easy veg to serve along side stuff
Tinned sweetcorn or corn on cob
Raw carrot batons
Chopped cucumber
Cherry tomatoes
Frozen veg quickly steamed or microwaved
Say he can choose which two veg he has with each main meal but he needs to eat them.
Reward him with something non food related maybe.

Best of luck! You’ll get there. He’s lucky to have you.

Totally agree about the brioches etc and not having chocolate etc in the house.
Instead of kids yoghurts (low fat =masses of sugar) get full fat greek yoghurt and flavour with cinnamon tastes luke something sugary but isn’t.
Also not all veg are equal! Tomatoes/carrots/sweetcorn/sweet potato loaded with sugar. Steamed veg from frozen -eg broccoli- are really quick to do (get an electric steamer) and butter - very filling. Fat (eh butter/yoghurt/cheese) is not your child’s enemy -sugar is!

@Aplone if you look at all the advice up here, a lot of it is conflicting, and thoroughly overwhelming. I would honestly get a referral to a dietician ASAP. (Seriously think this would be a great thing for you and your family, tbh…. In the meantime, I think you know how to start swapping out the sugary, chocolate treats for healthier options. Does your DS like eggs or low-sugar yoghurt? They might be a better breakfast choice. They’re cheap and more filling than a brioche. Foods that are higher in protein are more filling and satisfying than foods that are simple carbohydrates like sugar and flour-based foods. That ought to set him up for the day with more energy and might improve his mood. If you start modeling this healthy eating yourself, he may follow suit.

As you know OP the good side of his current diet is that you have loads to tweak and change. As an example - here’s what my 5 year old DS ate yesterday -

Breakfast: Oats cooked with milk and cheap frozen berries + 1 boiled egg + glass milk

School snack: Milk + piece of fruit + 1 rice cracker

School hot lunch

After school club snack: Brown bread sandwiches with cheese and apple

Dinner at home (heated up version of whatever we had yesterday for our own adult dinner): Goan Fish Curry with rice

Pudding: Plain yoghurt + massive pile of strawberries + milk.

On a weekend it would be -

Breakfast: pancakes or brioche or scones

Sports snack: fruit

Lunch: roast/curry

Dinner: again substantial curry or casserole

Pudding as weekdays

Your advantage here is that it’s so easy to swap things from current diet and make it better.

@Fiddliestofsticks

School puddings are not the same as puddings from the shop. They need to adhere to strict rules around sugar and fat content. Theyll call it a jam roll poly or a sponge cake with custard, but it's not what we would all call a sponge cake. They are made to be as low in sugar as they can be.

Banana with honey and a bit of ice cream isn't a terrible pudding either, but he still doesn't need two puddings in one day.

@Aplone

Off the top of my head food diary would be for a week when he is with me

Mon - Fri
AM Brioche w choc chips (1 or 2)
Small glass water

School - snack - 2 plain biscuits, "Bear" dried fruit spiral thingys

School - school dinners

After school snack (this is quite painful to write tbh ) - pain au chocolate or 3 biscuits - glass water - more dried fruit snacks or sometimes apple chopped up - yoghurt (2 x petit filous or similar type)

Dinner - any combination of
2 x vegetarian sausage or vegetarian nuggets or 2 x fish fingers and veg (usually carrots and sweetcorn) and 2 x potato waffles or mashed potato
Or
Oven pizza and cucumber sticks
Or (occasionally) rice and vegetarian sausage chopped up with it

Pudding
Banana with honey and ice cream usually

Bedtime
Glass milk
Toast and jam (though am giving without jam now) or brioche

Saturday/Sunday
Breakfast - brioches or occasionally cereal ("kids" cereal e.g. crunchy nut / honey cheerios) or pancakes

Lunch - sandwiches or cheese toastie or scrambled egg on toast or dippy egg and banana and yoghurt for pudding

Snacks - biscuits / kit kat.
Maybe croissant or pain au chocolate if we go for a walk (we live near lots of Costa / Cafe Nero / Starbucks etc.

More snacks mid afternoon - fruit, crackers

Dinner - varies - either same sort of oven foods as in the week or Dominos

Bedtime - glass milk and toast if he says he is hungry.

I feel horrible typing this out

Hi, OP!

Only the buns and the pain au chocolat have almost 1000 kcal, roughly.

I didn't actually do the math, but he might eat around 3000 kcal/day (pizza has around 800-1000, kitkat around 200-300).

I'd probably try to cut the sugar as much as possible.

Do you know what he chooses to eat for school lunch? It might give you some more ideas of things he will eat. Children often eat things in school that you think they wouldn't eat.

(Just want to hasten to add that I'm really not trying to diagnose or to scare. I think you have a good beginning of a plan here.)

OP I know you have said talking to ds's dad is a no go but although all the changes you implement will make your son healthier (and that is a great thing) in terms of losing weight, he simply won't lose it (or very very little) if he eats constantly (and poorly) every other week at his Dad's. Also, it will mean that he will feel more hungry at yours if he's allowed to overeat with his Dad.

If you took your ds to a nutritionist and got a more 'formal' eating plan, would your ds's Dad be more willing to accept that - so it's not coming from you as such?

You have my heartfelt sympathy OP, you definitely have your son's best interest at heart, it's very easy to slip into doing things you don't mean to, it's a really good parent who realises and makes steps to rectify it.

Is there any reason for the pescatarian diet for your DS apart from your own personal preference?

You are eliminating many sources of lean protein by sticking to it.

Apart from that comment - I agree what he is eating now is too high in empty carbs and he needs more protein and veg. A dietician with insight into autism would be very useful.

I disagree that he needs full fat milk. Skim or low fat is perfectly appropriate for a child of 7.

for your situation with your ex.
My exH started one of my DDs on a fizzy drink habit that she is having trouble kicking. He did it because it was a way to thumb his nose at me.

If you go to a dietician and a lower fat, lower carb diet is recommended but your ex refuses to comply, you might be able to change the 50-50 schedule if you think your DS would benefit.

I fully empathise, having children with ASN myself, that food can be difficult but there are things you can set as new rules. Maybe start on a Sat morn or school half term so initial meltdown doesn’t happen on a school day…changing breakfast to a far more protein/whole grain one would be a great start. I had one child who wanted runny porridge, one wanted thick and one didn’t mind - I felt like I was living in the Three Bears Story every morning 😁. It’s not difficult to do porridge, it’s very filling and great for your heart. You could begin by having a few choc chips or a teaspoon of hot choc powder mixed in. We eat porridge at least half of each week - favourite toppings include grated carrot, ginger & sultanas (like carrot cake),raspberries & coconut, stewed apple & cinnamon. We have egg & wholemeal toast on other mornings…they can all choose their favourite ie poached or scrambled or dippy.
Dinners: We are pescatarian too. At least once a week we have homemade soup, always has lentils, generally sweet potato, plenty of other veg…again one likes it blended, one likes it chunky, one doesn’t mind. I do a curry, a vegetarian chilli and a Bolognese each week, brown rice or wholemeal spaghetti, I’m happy to blitz the topping smooth for the one who prefers that. They all get one night where it is their choice what we have for dinner - one always chooses pizza but I do half the child-sized plate veg (fruit for the one who doesn’t eat veg). We don’t generally do pudding or supper, just a small bedtime milk. I eat with them even though 5pm is early.
Exercise: lots of hidden activity - most mornings we put on lively music and dance around like eejits before getting dressed for school, we have competitions to see who can do 100 star jumps fastest (I join in), how many squats we can do before falling, they mop the floor (that’s a fave), we have a trampoline, when we go for walks after dinner each night we include who can jump all the way to the next signpost/side-step to the telegraph pole etc.
Sadly you have to be on the ball when an ex allows rubbish diet choices when they are with him, and also have to accept there may be some meltdowns with any change and that’s okay, you are there to support whilst also following through with what you know to best for their health long term.

Focus should really be on maintains his current weight so that as he grows in height it evens out rather than actively trying to lose weight.

Looking at your current food diaries and the restrictions around timings it looks like convenience is really important.

I have the same problem in my eating, in that I just need food I can grab and eat quick which can mean bad choices if I don't prep.

Some suggestions that work for me.

Boil up half a dozen eggs at a time and have them cold in the fridge. Perfect for a snack or for breakfast sliced on a piece of whole grain toast.

Find the veg he likes and always have that in the house. DD loves cherry tomatoes and baby cucumbers. They are given as snacks and on the side of most meals.

DD is another fan of pasta with cheese but as she also likes peas and sweet corn we've been able to compromise and now she'll happily tuck into a portion of pasta with sweet corn, peas and Parmesan.

If he's not keen on just eating a piece of fresh fruit as a snack could you make up a fruit salad and keep it in the fridge for a couple of days then he could have a small bowl of that. Alternatively and apple sliced up with a solider of peanut butter for dipping. The peanut butter has fat and protein which is filling.

Regarding meals at 5pm and that meaning your meals are different I know the timing is a pain, could you make double what you have later in the day and keep a serving aside in the fridge then each day at 5pm you could just reheat a serving of what you had the night before for his dinner?

I'm not seeing yoghurt in your meal logs but that's a good snack or breakfast option, it has good fats, calcium and protein. I would recommend a full fat Greek yoghurt, the Lidl one is brilliant lovely and thick and creamy. One thing I do for DD is make up a very quick compote by chucking berries, small chunks of apple, nectarine, plum (whatever I have in the fruit bowl except orange) in a microwaveable tub. Squishing it a bit with a fork then blitzing in 30 second bursts until the fruit is all softened, add a little honey if it's very tart. Then if can be kept in the fridge for 3 days or frozen in ice cube trays. Use the compote on the yoghurt or porridge.

I'd cut out all the pastry's to start with. From what I read he could have 3/4 in a day.

At breakfast don't offer two but one with some fruit.

Cut out the toast before bed and offer fruit.

The dried fruit is full of sugar so maybe just normal fruit.

He seems to have an awful lot of control over his diet for a 7 year old. Listen, I'm not speaking from a place of ignorance here: I'm autistic. I have all the horrible anxiety that goes with it, need routine, can't multitask, and find unexpected change incredibly stressful. I am also anorexic. Most autistics have some kind of issue with food, based in our neurobiological differences, and because we do not interpret or understand signals from our bodies the way neurotypical people do. But here's the thing: autism is an explanation, but we still have to live in this world. The world isn't going to change for us, because most peopel aren't autistic. Its hard, and its hard for our parents. I'm afraid you need to tell him what he can and can't have, and explain why. Yes, there will be pushback. It could be loud. Now perhaps I'm underestimating how hard this will be for you, because I never had or have meltdowns in the sense of being loud or angry: I just shut down, and sometimes cry, but quietly, like my brain has been overloaded. I might panic but I never express it as anger (probably because of female socialization, but that's another story). But you have to push through it. The upside is this: if he is on the spectrum, he will understand that there is a reason for making these changes and that it is ultimately to his benefit. Once a new routine is established, that will become the routine, and it will become much much easier. I hope you'll be okay. Its a hard world for autistics but there are benefits to it too.

I work in a school, my first suggestion would be to ditch the school dinners and switch to packed lunches.
The children in my class seem to have stodgy puddings everyday, tons of cheap bread, deep pan pizza etc Do you know what he eats at school?

@iloveeverykindofcat

Best advice ever.

I think this culture of giving snacks every 2 hours throughout the day also hasn’t helped the child obesity issue at all.

I have a bowl of fruit that my kids can snack on. Apart from that they have breakfast, dinner & tea. If they want cakes they have to make themselves.

School dinners are a great way to ration food. Send him with an apple as a snack.

Search change4life / Wales healthy lunchboxes. You are over feeding your child. By all means do an oven dinner. Oven chips, cod in parsley sauce, peas. No pudding.

My dd was eating a very beige diet, but when she started school was happily eating the lunches. So I started trying to recreate them at home and we have really increased the variety of dinners we now have at home.