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

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

I would say this is part of the issue. You're seeing food as 'fun' and a pleasure and so you're craving more to get that joy

@Aplone -there’s a few threads on them on Mumsnet-can’t link atm but theres one about starting Saxenda running and lots of Facebook groups. As with all these things theres a postcode lottery and it depends on your doctor! I had to pay privately for my sleeve as our criteria is under age 44 and I’m 47! Because my diabetes was so bad though, i was able to get the injections prescribed-its complicated

I realise you’re upset about this and it’s great you’re taking steps to change his habits but that food diary makes me want to weep. With the exception of whatever his school dinners are, he essentially lives 100% on a diet of processed foods, white carbs and sugar.

Brioche with chocolate for breakfast is disgraceful. And when he comes down from that sugar high he gets biscuits and dried fruit at school? What kind of school does he go to or are you giving him that snack to eat when he gets there? And a 7 year old does not need crunchy nut cereals on the weekend, that is bananas. Is there a reason you give him processed food for dinner every night? Can you cook? I would advise:

Breakfast: wholemeal toast with peanut butter OR porridge OR Weetabix. Glass of milk or water.
Snack: Banana and crackers
Lunch: School Dinners
After school: Cheese and cracker or apple and peanut butter
Dinner: home cooked meals (i.e., not potato waffle and fish fingers!)
Pudding: fresh fruit and yoghurt.

I can’t believe you give him a banana split after dinner every night and jam on toast before bed?! That is frankly the oddest thing I’ve ever heard. Would you eat jam on toast then go to sleep?!

The OP wong answer questions about cooking it engage with any of the posts recommend various recipes. I think she wants to know how she can manage, but only with processed food and she doesnt seem to want to remove anything her son "really likes" because well, it's just easier that way.

@Aplone - if you turn up at your first appointment with a two week food diary, you won’t have to come back with one. That is wonderful advice!!!

@mn2022

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

I would say this is part of the issue. You're seeing food as 'fun' and a pleasure and so you're craving more to get that joy

@Aplone -yes, i realised that it is so easy for everything to revolve around food and treats (shopping-coffee and cake, theatre trip-ice creams and sweets, birthdays-a meal out, holidays-where will we eat?/character meal at Disney etc ) From the sounds of it, routine and rituals are important to your son, i think breaking the association of treat/food would be helpful-obviously if ds’s dad isn’t on board it will make it more difficult. You can only do your best though, and don’t waste time feeling guilty!

It sounds like he will actually eat quite a bit of healthy stuff, like fruit and veg, yoghurt etc. Looking at the food diary you gave the only thing that stands out to me is the amount of pastries and biscuits.

I'd potentially keep the brioche for breakfast since he likes it so much, but make the after school snack only fruit & yoghurt, and also no toast pre-bedtime either, or just one slice if he has to have it.

Even if you can't introduce anything new due to ASD, it sounds like there is enough good in his diet that if you rejig it and remove the majority of pastries and biscuits you will be cutting a good few hundred calories out of his day :)

It is so good that you are recognising this and want to fix it. I think DS needs a lot more protein. Would you consider including free-range chicken in your diet? If not, you will need to up your pescetarian/vegetarian cooking skills. Following that restricted diet in a healthy nutritious way (especially for growing kids) involves a lot more than vegetarian sausages/nuggets and filling up on beige carbs.

Also don't understand how your DS is able to eat that much between home time and bedtime, especially if the school run isn't physically demanding. I look after 7yo twin boys - we cycle home from school, they get ONE piece of toast when we get in at 4 pm, carrot/celery sticks to keep them going from 5-6, and dinner is something like a jacket potato with cheese and beans (they share a normal-sized tin) and lots of veg around 6 p.m. They can then have pudding but don't always want it - when they do, it's something like one yoghurt or one Innocent smoothie or a piece of fruit. That's it! They are the tallest boys in their year and never sit still but this still seems to be enough.

Would you be able to come home from school via the park so DS can have half an hour or running around, climbing etc, at least on days when he doesn't have an after-school activity? This would give him more exercise and also mean less time for snacking.

Could you maybe offer a small hot chocolate made with milk (reduced sugar) and a slice of wholemeal peanut butter toast as an after school snack? That might be enough of a 'sweet fix' for him and has plenty of protein to keep him going until dinner.

Too many carbs I think. Ditch the brioche and replace with brown bread toast maybe?? Lots of chopped salads - fresh lettuce cucumber tomatoes etc. Get him to help prepare it. Try toasted tortilla wraps with chicken and salad filling. Those are
Lovely. Toast In the oven. Good luck. Currently fighting my own weight loss!!

Forgot to say the 7yo DCs I look after don't have any bedtime snack, and stopped having milk at bedtime when they were 3/4 - they don't drink milk at all any more, only have it with cereal (semi-skimmed). I think most families get into the habit of bedtime milk with toddlers and then go on with it for years and years. You could definitely drop this, especially if DS doesn't even like it!

Hi OP, you have my sympathy my DS also suspected for autism & it is very easy to fall into these patterns.

We do notice our DS is insanely hungry very quickly if he has a brioche or pastry for breakfast. It's been trial & error for us - but our little boy will eat porridge - so we add flaxseed, blueberries & sugar free peanut butter to up the nutrition. He will sometimes eat scambled eggs - but we find eggy bread will always be eaten, so thats a good fall back - cooked in a tsp of olive oil, using wholemeal bread.

I also make sugar free savoury muffins - and pack loads of veg in, carrot, sweetcorn, peas etc. You can freeze these & take out as snacks. I bought a silicone mini muffin tray & it has been a godsend. Even though they are healthy muffins - they present as cupcakes, so DS will eat them.

I also make sugar free pancakes - I add sweetcorn to mine, and if you blitz in the blender the sweetcorn is indiscernible. This is a good recipe (we don't add maple syrup & bacon!) www.waitrose.com/home/recipes/recipe_directory/s/sweetcorn-pancakes.html

Dinners I find difficult - but I keep persisting with different foods & always add a small portion of 'safe food' to his plate. If he doesn't eat much dinner he can have a snack of apple with some peanut butter or banana.

Well done and trying to address this.
My kids eat similar amounts of biscuits for snacks as your son BUT they have a high fibre cereal for breakfast, fewer carbs with meals and no real
Puddings after dinner
Could you cut out the pudding or offer a small pot of yoghurt instead?
For supper give him One price of toast with only a scraping of butter or a banana and skimmed milk. Up his fruit and veg so he’s not snacking as much. Make his toast wholemeal or 50/50

One thing we have done for dinner is make our own chicken nuggets - using crushed rice crispies to coat. Good protein & not proceed like you find in the freezer aisle.

@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

I think focus on what is good here rather than what is bad. Nothing wrong with scrambled egg and toast, bananas, carrot and cucumber, yoghurt (in moderation). Your child clearly can tolerate healthy food. Try the carrot grated - you can shovel a lot of grated carrot down and it's v filling. Try eggs cooked in different ways to mix it up, cut up banana and mix with other cut fruit as snacks. Also there's a lot of water drunk there rather than squash or juice. So that's good. And the odd glass of milk is fine. Yes - focus on the good, and replicate, replacing the stuff like brioche and biscuits. Good luck!

This child is pescatarian so I’ve no idea why people keep suggesting chicken . @Aplone you need to somehow get him off the processed foods , I would invest in a simple but healthy vegetarian cookbook and get him interested in helping prepare his meals as a starting point . With regards to his dad would he accept things need to change if a dietician wrote him a letter ?

@Dazedandconfused28

One thing we have done for dinner is make our own chicken nuggets - using crushed rice crispies to coat. Good protein & not proceed like you find in the freezer aisle.

Sorry - I missed pescatarian, this could still apply to a fillet of white fish

@Aplone

So far he has been ok with the changes. I am not sure he has noticed them with the milk. I think your point about interception in autism rings true in that there is never any saitiety. He will have dinner then say he needs pudding and then wants seconds of pudding (which is always no - 1 rule I have always had, randomly!). He doesnt ever know if he is full or not, I think.

The carbs and sugar won't help with this either, it makes it worse. If I get back on the junk food, I can eat/snack pretty much continuously through the day.

To the people saying that they don’t understand how a 7 year old can eat that much, or that its as simple as cooking particular foods- it doesn’t really help. You may as well say that you don’t understand alcoholism or drug addiction-just saying i don’t need to do this, or i used to do it and i managed to kick the habit does not mean that everyone can be the same. Biology, socio economic factors, emotional well being etc are all contributing factors. I’m not saying it can’t be changed, or that there isn’t an element of personal choice and accountability in our lifestyle/health needs, but its considerably more complicated than that.

@Floralnomad

This child is pescatarian so I’ve no idea why people keep suggesting chicken . *@Aplone* you need to somehow get him off the processed foods , I would invest in a simple but healthy vegetarian cookbook and get him interested in helping prepare his meals as a starting point . With regards to his dad would he accept things need to change if a dietician wrote him a letter ?

I agree, plus the ASD factor is being ignored quite a lot too with suggestions of totally alien food for him, like veg curry etc.

Re dad, I'd say OP should try cutting out what she can from her side first before opening that can of worms. Because looking at the food diary I'd say 2 pastries, biscuits and toast every day, plus meals, is actually likely to be a big part of the culprit. Cut out the after-school pan au choc, biscuit snacks and at least one of the breakfast brioches and you've removed 500+ calories already.

@Aplone

That is depressing about the dried fruit / tooth decay. Remarkably, DS's teeth are fine at the moment (touch wood!).

My DD's teeth were fine at 7. By 9 she had 2 cavities. She doesn't eat much sweets either, nor drink a particularly large amount of juice, & it's extremely rare she's ever been allowed fizzy drinks. It was down to the dried fruit. We've now cut right back.

I see you've said you live close to the school so it's not much of a walk in the morning. Is there anywhere nearby that you can walk as a detour on the way to school, set off a bit earlier or on the way home? Just tell him you're bored of walking the same way every day. Even just an extra five or ten minutes a day would help, it's better than nothing.

Also, you say he's pescatarian & only drinks 1 cup of milk per day by his own choice. In that case I'd tell him he needs to start making some choices about alternative healthy protein in his diet, explain to him what it is & why we need it, i.e. that it will help him feel full & will build healthy muscle to help him run around more easily. You don't need to get complicated about it. And that good non animal sources of protein are beans & tofu, served with wholemeal bread, rice & pasta, etc. Nuts can be a good source which he already enjoys. If you look on the vegetarian society or vegan society website they will have lots of information to help you. Ultimately he needs to make a choice - animal or vegetable protein, it can be his choice but his current diet isn't healthy & he needs to start to take an active role in managing it. The conversation doesn't need to focus on weight, just health.

Could you try just serving normal food for breakfast? So leftovers or do some baked beans on toast with some carrot sticks. Most 'breakfast' foods (cereals, pastries, brioche) offer an appalling nutritional start to the day. I quite often just eat whatever's left from dinner the night before for breakfast.

@trockodile... I get your point about food addiction, but this is a 7 yo child. If his mother doesn't take charge of his diet now, she'll set him up for a lifetime of battling with weight, food cravings etc.

Just cutting out the processed food, focusing on protein and vegetables, and reducing food offerings to a more normal level will make a huge difference to this boy's life.

Well done for posting about this and tackling it.

A few things

Health promotion person I spoke to said that BMI calculation has been discredited, so don't take it as gospel, I haven't researched it further but I guess someone on here can enlighten us. And that doesn't mean you don't need to change things, but there is also an element of him growing out of it. He is only 7

If you are a single person the key to this I feel is as follows

You are probably (and I'm assuming) budgeting and doing stock control of your cupboards going forward.

So the rule is, what you don't buy they can't eat (as it isn't there)

So knock the following off your list right away and you will find it not only improves things but saves money

Chocolate and chocolate spread
Biscuits (right off)

Brioche
Crisps

May seem harsh, but knock them RIGHT off

He will occasionally get these as a treat at parties/sleepovers no doubt, but never, ever have them in the house.

He won't starve and neither will you.

When someone said 'replace processed foods with home cooked foods' they are quite right, however some people imagine that this involves more work and more time.

It does't always, there are lots of healthy snacks that don't involve cooking, then there is batch cooking whatever.

Sure others can come up with more tips.

And work towards a meditarranean diet. Olive oil.
Nothing wrong with beans on toast.

You have already got vegetarian things in there, the options are many. Cook together (or assemble sandwiches together wholemeal bread) it is fun and you can save money on activities that way as well

They can research veggie recipes on internet and you can take it from there.

good luck

@trockodile

But this is a 7 year old child. How in the hell does a 7 year old get two brioche with chocolate chips for breakfast? They didnt suddenly wake up at 5 or 6 years old and say "mummy, would you get me a chocolate chip brioche" because they wouldnt know it existed! The only way a child discovers that for breakfast is if they parents buy it and give it to them. That should never have happened in the first place.
It's a lot easier to feed kids well than people make out. You dont introduce them to the shit food at this age and then they dont know about it. And mum would never have even thought to give him eggs for breakfast!?! Really?