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

Not RTFT, but move tea earlier so he's not having all those snacks when he gets home. My DC have theirs at 4pm.

Also work on the exercise. My DC are similar ages and like bottomless pits, we do loads of exercise. Park everyday, walk everyday, long family walks at the weekend. We always found they slept better as toddlers when they were well walked everyday, so we kind of kept to that habit as they got older.

Why on earth would his dad call the social? Let him try it!

Otherwise, lots of good advice here op. All of those sugary carbs- he's at risk of developing diabetes.
Breakfast: could you make oat/ egg muffins with honey instead of sugar to grab and go? Or egg and veg mini omelettes in cake tins ? Or even boiled eggs to go? Veggie or chicken sausages in thin bagel or warburtons thins ?

Not sure if he would eat then but snacks perhaps oat cakes/ carrots and hummus, if he fancies something sweet then sliced apple with peanut butter is very tasty. You could get one of those apple slicers that he may enjoy using.

Good luck! You sound like a great mum.

I think it's fairly clear what you have to do, OP:

• Up the protein
• Up the fruit and vegetables.
• Reduce sugar
• Reduce fat
• Reduce carbohydrates to a sensible level.

I'd focus on a meal at a time until it becomes part of the new routine and then you can move onto the next stage. So that gives you (i) breakfast; (ii) dinner and (iii) snacks to work on. Then finally weekend lunches.

Breakfast - lots of protein. Try to reduce sugar. So eggs, peanut butter or avocado on wholemeal toast, porridge made with milk etc. Give him a big breakfast...if you fill him up early on, hopefully he'll be less hungry and more active later. In case it's helpful, my DC has the same breakfast every morning - a bowl of porridge, half a slice of peanut butter toast and a piece of fruit.

Dinner - I think your dinners sound ok. Just try to avoid empty carbs and too much fat and stop things like the dominoes. If he wants pizza, suggest you make your own. As well as one protein and carb, up the fruit and veg to 3 helpings at dinner.

Snacks - this is your real battle-ground and where most of the empty calories are. I think you need to have a list of 'acceptable' snacks on offer and then just don't have anything else in the house. I give my DC things like a hot cross bun or some homemade sweet potato pancakes along with fruit or carrot sticks. If they're really hungry, they might get some cheese (protein) and oatcakes, with a small glass of milk. They also love peanut butter toast and homemade fruit popsicles.

Ultimately, I think you're going to have to say something to your ex. You can't solve this by making changes 50% of the time. That's one reason why it might be useful to see a dietician. They can assess your DC and come up with a report and a plan, and then you can send this to your ex with a very short covering email, so e.g. "I have taken [DS name] to the dietician, who has recommended that his carers make some changes to his diet to ensure he can maintain a healthy weight. These are set out in the attached report." Then your ex has the information but he might be less confrontational if it doesn't come directly from you.

He's eating bread at every meal and having 4 meals a day plus snacks.

If he eats at 5 and also has a pudding afterwards surely he's going to bed not so long after? He doesn't need supper.

Cut the brioche out and the Dominos etc. Make wrap pizzas instead. Good luck

Asd kids are really hard to get to change but not impossible so as PP say cut down in portions. Switch out a waffle for peas & carrots.

Have half a brioche with yoghurt and fruit and let him know if he eats yoghurt & fruit he could have the other half if still hungry. Though I’d just stop buying them personally.

I have a SEN kid with a sugar addiction (will add sugar to everything inc milk) and now I just don’t buy sugar or honey or sweetness like that.

I agree about seeing a dietecian (nhs so might take time) or a nutritionist (private).

If one thing is clear from this thread is that things are not as easy as eating less or no treats etc…..

Btw if it was that easy because you just have to there wouldn’t be an obesity crisis in children and adults.

Ask for profesional support @Aplone

He is eating an awful lot of brioche/ pastries and beige food. Why are you giving him all those carbs and sugar?

It's good that you recognise the problem. That diet you listed out is quite shocking for a child. I get that he has autism and that makes thing difficult - perhaps you could talk to a professional about ways to introduce healthier foods.

I am wondering also what your own diet is like - is it similar to this with quite a lot of convenience foods, biscuits, pizza etc.? If so you might want to look at changing your own diet so that you can also set an example for him?

I agree about seeing a dietecian (nhs so might take time) or a nutritionist (private)

Dietician whether private or NHS.

Dietician is the protected title- only those registered with the professional body, have a degree and professional training can call themselves a dietician.

Any old idiot can set themselves up as a “nutritionist”. No qualifications or training needed.

Yeah it's a really bad diet :(

Every meal has sugar and carbs but not much else.

Also wouldn't be giving him a glass of milk before bed as it's unnecessary, also shouldn't need food if going to sleep, give him an apple or banana or some veg sticks and houmous if he's really hungry before bed

Good luck

As the others have said, it's all white carbs and sugar. If he will tolerate wholemeal bread/pasta/rice then those will be much better for him and fill him up much more. It's great that he will eat things like cucumber sticks, carrots and sweetcorn (try him on peas and broad beans too if you haven't already and try to expand his veg selection) and fruit (don't go too heavy on the fruit though).

He seems to have all processed meals as well? On top of fat, the salt content is likely to be quite high. I'd look at that as well, would he eat an oven cooked chicken thigh or a stir fry with chicken? Would he have plain yoghurt with the banana instead of honey and icecream? If not just give him the banana on it's own. I'd cut the potato waffles completely and find a healthier carb for him to have, he might as well be having chips every single day as them. You could try sweet potato mash instead of normal as that is lower GI.

I'm sure you can see there is a lot that can easily be changed OP which is really positive, it's great that he's not too limiting on foods considering he potentially may have ASD. Lot's to be positive about and I'm sure you'll start to see the difference quickly.

I have just read this thread. DS was a solid youngster but now mid teens he has discovered weight lifting and football and stretched out - not saying you should do nothing though.

I'd focus on making a few small changes. We stopped giving smoothies as felt the sugar and calories weren't worth the fruit portions. I agree with looking for an alternative for the chocolate brioches- DS likes toast and peanut butter. I'd be trying to introduce more protein - even things like cheese straws are a better option than biscuits.

Your dinners sound fine - or at least fine enough to not be the core problem. Plus I agree school dinners are likely to be fine and means he is getting a variety of food types.

I suspect the main issue is that even when you do tighten up on things DS will still be getting treats and too much at his DFs so maybe a neutral third person is the way to go, if he's likely to take advice from a dietitian.

@Reallyreallyborednow

I agree about seeing a dietecian (nhs so might take time) or a nutritionist (private)

Dietician whether private or NHS.

Dietician is the protected title- only those registered with the professional body, have a degree and professional training can call themselves a dietician.

Any old idiot can set themselves up as a “nutritionist”. No qualifications or training needed.

Or you can ask what training they have done or look on the BANT website to find a nutritionist that has been trained at degree level.

Dietician and nutritionists are actually two different profession and taught jn very different ways. I know many dieticians who have then trained as nutritionists because they felt their first training didn’t allow them to do support people right.

Having said that, it is true that nutritionists are not a protected title (nor is being a nurse btw) so you need to check their credentials.

placemarking

Thanks for all the overnight comments :) just to clarify DS doesn't eat an entire oven pizza by himself! He has about a quarter of one although this is something I have been reducing as before he would have more like a third.

Pescetarian diet is at DS's request. He feels very strongly about it and wouldn't eat fish if given the choice. Eating fish is a compromise.

You should not put children into weight loss diets without proper clinical oversight and advice. Make an appointment for him with the GP, just as you would with any other chronic health problems.

School dinners are quite beige. Pizza or chicken/ vegetarian dippers + chips but 2 types of vegetable each day. Old fashioned pudding every day or one day it is ice cream.

Life is hard if you don’t recognise when you are full and feel constantly hungry. Processed foods do make it worse, but if you struggle with this, even eating “healthier” foods will not necessarily help. Trying to explain to him that you don’t have to eat, even if you do feel hungry is hard, because all the messages we get now are to listen to your body-and sometimes it is broken!

I am NOT suggesting this for him (or other children) at all, but some of the more effective diets for some overweight adults/type 2 diabetics are semaglutide or liraglutide injections which help blood sugars and hunger. I was a fat child, and am a fat adult, yo-yoing up and down throughout the years. i can personally say that up till i started on my injections, i had never before experienced the feeling of not being ravenously hungry and out of control-i had a gastric sleeve weight loss surgery last year and after the initial shock of the op i still felt hungry and struggled. I’ve lost 27kgs and have my BMI under 35 now so it is working and I’m hopeful it can stay working-but it’s really really hard and not as easy as eat less, move more. If (and i really hope that your son is just one of the children who outgrow puppy fat and slim down naturally) that is the case for your son, then understanding all that will go a long way to help when you feel frustrated with your son about his weight and eating habits as he gets older. Its not necessarily just him being greedy and its not a character flaw.

The only other advice i can give is to try and break the habit of making food an integral part of your lives and celebrations-go for a walk without associating it with Costa/watch a film without sweets and popcorn/go to a trampoline or soft play without including meals and snacks etc.

Good luck.

DS does really like peanut butter so I give him this but the school like most schools now is nut-free.

That’s a lot of white carbs and sweet stuff - puddling every day? Ice cream plus honey is more of a weekend treat, could you replace with yogurt? Brioches are sweetened - toast or cereal instead would be healthier. Maybe just try replacing some of the sweet stuff with savoury snacks for a bit and see if he notices? Good luck.

*Pudding, not puddling! 😁

@trockodile

Life is hard if you don’t recognise when you are full and feel constantly hungry. Processed foods do make it worse, but if you struggle with this, even eating “healthier” foods will not necessarily help. Trying to explain to him that you don’t have to eat, even if you do feel hungry is hard, because all the messages we get now are to listen to your body-and sometimes it is broken!

I am NOT suggesting this for him (or other children) at all, but some of the more effective diets for some overweight adults/type 2 diabetics are semaglutide or liraglutide injections which help blood sugars and hunger. I was a fat child, and am a fat adult, yo-yoing up and down throughout the years. i can personally say that up till i started on my injections, i had never before experienced the feeling of not being ravenously hungry and out of control-i had a gastric sleeve weight loss surgery last year and after the initial shock of the op i still felt hungry and struggled. I’ve lost 27kgs and have my BMI under 35 now so it is working and I’m hopeful it can stay working-but it’s really really hard and not as easy as eat less, move more. If (and i really hope that your son is just one of the children who outgrow puppy fat and slim down naturally) that is the case for your son, then understanding all that will go a long way to help when you feel frustrated with your son about his weight and eating habits as he gets older. Its not necessarily just him being greedy and its not a character flaw.

The only other advice i can give is to try and break the habit of making food an integral part of your lives and celebrations-go for a walk without associating it with Costa/watch a film without sweets and popcorn/go to a trampoline or soft play without including meals and snacks etc.

Good luck.

Can I ask more about the injections? For me not DS! Can you get them on the NHS?

That is very good point re. not getting snacks at cinemas and soft plays as that is part of the fun.

Could you possibly switch the breakfast brioche for a piece of whole meal toast or a whole meal bagel?

Switch the pain au chocolate for a banana or a hard boiled egg.

Switch the evening pudding to yoghurt and berries.

Would he accept the above?

That would knock out about 800 calories!

I would change one thing at a time, assume this is a long game and start with finding a replacement for the brioche. It's extremely high in fat and sugar. So start with just that.

And maybe at one of his usually snack times go and do an activity, see if you can drop one of the snacks a day, no big fuss, just oh let's walk the dog or do the homework or finish up that puzzle first.

So it's not creating a big feeling of deprivation, more a distraction.