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

Hi OP,
I’m sorry you are facing this dilemma and you sound like a lovely caring mum to me.

Looking at your list of a typical days food for your son the main thing that struck me (as different to my 11 year old son) is not what your boy is eating but how much/how often. I’m not posting this to say what a great diet my kid has - quite the opposite. We are always trying to have more meat or fish and 2 veg type dinners but with both working etc often resort to quick foods. Weight wise though my child is offered/eats less frequently for sure.

My child’s typical day:

Breakfast: usually 1 slice of toast and butter/carton juice or squash
(sometimes - once or twice a week- a different breakfast such as a sausage sandwich which is 4 skinny sausages with 2 slices of bread, or 2 croissants, or a pancake or toast with nutella)

No snack sent to school as it is left but I would happily send an apple or similar if it would be eaten.

School lunch - I don’t try to control his choice of lunch. He has what he wants from their offering. He likes the school dinners.

After school: He usually has a packet of crisps. If he fetches another or biscuits (2) whatever I won’t take it off him but I will tell him “no more now - if you have anything else before dinner it’s fruit”. Sometimes he will say he’s hungry and my reply is “good - dinner will be in an hour”.

Dinner - spag bol/ curry and rice/ roast dinner/ salmon with chips and veg (I have jacket or mash but he won’t)/ tuna pasta/ pizza (he eats as much dinner as he likes/ seconds if he wants but his serving is less than the adult one. I understand you can’t allow this if the child wouldn’t choose when to stop. He will eat a whole supermarket pizza if he’s hungry).
Don’t usually have a pudding but maybe twice a week when I’ve been shopping we’ll have strawberries or cake. You mention your son has banana/honey/ice cream. If we had ice cream my son would have 2 scoops with perhaps a few mini marshmallows sprinkled on. What is his portion like? I know some kids have a cereal bowl of ice-cream. If he had this with a whole banana it would probably be 400 calories or so. If my son always insisted on a pud and liked yogurt I would go with that most of the time.

Nothing further to eat usually. You will spot no doubt a lack of dairy so I try to make him a hot chocolate made up with milk in the evening. It would be half/two thirds a mug of full fat milk/hot choc and marshmallows. He won’t drink neat milk or eat a yogurt and I think it is good that your son will.

If he says he is hungry in the evening (and assuming he has had crisps or some other junk (biscuits/sweets/choc whatever) after school I say it’s fruit or a sandwich now and he usually drops the subject because he wasn’t hungry for “food” only junk. If he had a weight problem and would readily accept the sandwich I would just say “It’s only fruit now”.

On a Friday he has sausage and chips from the chippy and probably on some other occasion a Mcdonalds meal with McFlurry (as his lunch or tea). On a Friday I also give him money to get something after school and he usually chooses an ice cream from the ice cream van or a bag of haribo from the shop (which I’m not keen on teeth wise).

Just a comparison for frequency/amount really.

@trockodile

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.

I think the point people are making (certainly the point I was making) is that a lot of the excessive and poor-quality eating here is probably down to habit, not hunger. Even a large energetic/active 7yo boy is unlikely to have a physical need for that many calories, which makes me wonder if this little boy is actually asking for so much food or just being fed as part of his routine - especially as routine is so important for a lot of autistic children.

It's good that you are being so honest about this. As you have identified, his diet is not good and will be doing him no favours.

I would honestly approach gp/dietician to get professional support, especially if you think there may be a struggle due to his needs - not knowing he is full can be signs of other things. X

My 8 Yr old ds has in a day

Breakfast
2 slices toast with butter and a banana

Lunch packed lunch
Half ham sandwich (send a full one only eats half)
Pepper sticks
Carrot sticks
Cucumber sticks
Cherry toms
Small homemade cupcake
1 piece of fruit
Jelly pot 3 times a week

Tea
Pizza with salad
Fish fingers chips
Pasta and meatballs
Sauage dinner
Chicken curry
Flat breads
All depends on what he wants icepop or yoghurt for pudding

If hungry before bed crackers and butter maybe has this once a week

Only drinks water

He was a very fussy eater he got 1 new thing on his plate a day and the rule was 1 bite thats it and after 4 weeks he started liking it it has taken 3 years but now only 4 food he won't eat beef, avocado, mushrooms courgettes only these 4 make him gag

I have an ASD child though he has always been the opposite and we had issues getting him to eat enough.

The drinks sound good and healthy and he is exercising. If he loves numbers a Fitbit might work for encouraging more exercise but I think the main issue here is he is getting far more calories than he should be getting each day. I would look up how many calories he needs and how many are in each day and that moment. I would guess around 1,000 too many.

Is the excess as you all eat far more than you should or as he is constantly seeking food? If its you are all eating way over what you should be it maybe worth changing the families diet. If its him constantly seeking food, I think it can be partly sensory.

I would stick with school dinners - they are normally sensible proportions. Mine is quite restricted on what he will eat and won't eat anything mixed so all items have to be separate and no sauces / soups etc, occasionally if very plain.

Mine just has breakfast, lunch, dinner and if he wants to snack we have apples / fruit he will eat. He eats something like toast and butter for breakfast or a crumpet or a scotch pancake then school lunch then we have an evening meal of something like sausages, long brocolli and mash or fish fingers, beans and chips. We sometimes have dessert.

I would come up with a plan that just has the calories he needs to maintain weight and try to reduce the very unhealthy parts either by cutting back to just breakfast, lunch and dinner with just fruit for snacks or reducing portion sizes and cutting out some unhealthy parts. If you are doing it as a family you could discuss it with him, mine likes to lecture on healthy eating from the talks in school.

Its great you are trying.

I really think that you can get this under control by making gradual improvements in your ds diet and increasing his activity levels. Slow and steady but consistent is the key in weight loss for children we want them to enjoy their food and activity. This is especially important for your ds with his food sensitivity and all the difficulties he has in life. The good news is if he gets used to a new healthier choice he will probably stick with it as he seems to like having a fairly predictable diet and the same might be the case for building in more activity to his day. If he gets used to having an hours exercise every day he will probably want to stick with it.

Haven't read the full thread but if he likes peanut butter, peanut butter spread on brown toast is great for breakfast. It's filled with protein which will help him feel fuller for longer. You can even smash some raspberries or blackberries onto the top to mimic jam.

Just to add OP that your son might only be “over eating” by a small amount but say the calories from the ice cream and toast at bedtime are excess to his needs just that alone will put weight on him over time.

Looking at your typical day I wonder if he is satisfied enough from his evening meal. Especially if you limit the amount and don’t eat meat. That might be one place where he needs to eat a little more to satisfy him enough to be able to cut back elsewhere.

My dd is asd and vegetarian by choice she will eat 1 brand of veggie sausages when they didn't have them dh brought different ones and she had a melt down and would not eat them because they tasted different .

Some people that are commenting have no idea how set in ways asd children can be.

OP mine will eat veg but raw not cooked , most meals they have protein ,carbs and raw pepper, carrots, tomatoes and cucumbers. Dd will only eat carrots as batons she's that set in her ways. It's worth experimenting with.

They won't have things mixed up or sauces, everything is presented separately. This is the only way I can get them to eat a balanced meal.

If they have pizza we make our own using a small wrap with tomato puree, cheese and toppings.

I make homemade versions of flap jacks with fruit instead of sugar and muffins sweetened with banana.

Yogurt and fruit are the only options I offer for pudding unless we have a treat like at weekends.

It would be good if you could try and eat with them and eat the same foods, my youngest definitely eats better from watching me eat things and then trying them.

Just wanted to add that I really sympathize. My DD (9) is overweight. She has always been set in her ways over food and we have terrible meltdowns over the wrong food. I could go on and on. It's exhausting. So solidarity from me.

Anther tip is to try not to talk about his food or what he has or hasn't eaten on the phone to friends etc when he is in the house

I'd forgotten about Pokemon Go! YY to that, definitely. Our DD really enjoys that when we have time - we played a lot more of it when schools were still closed. Maybe see if any of his friends do it, they can play it together. Perhaps if he gets really into it he might be able to persuade his father to take him out as well, you never know, the suggestion wouldn't have to come from you.

@TheOccupier
I think the point people are making (certainly the point I was making) is that a lot of the excessive and poor-quality eating here is probably down to habit, not hunger. Even a large energetic/active 7yo boy is unlikely to have a physical need for that many calories, which makes me wonder if this little boy is actually asking for so much food or just being fed as part of his routine - especially as routine is so important for a lot of autistic children.

Well yes, i made that point too-however the op is asking for help and the faux outrage/perceived blame by so many (not necessarily you, i rarely notice individual poster’s names) just doesn’t help. For whatever reason, op’s ds is overeating/eating the wrong foods/is obese.
No its not ideal by any means, and there are many possible reasons-if it were simple to be a perfect mother and have a perfect child, we would all do it-most parents want their children to be healthy, happy and doing well in school-unfortunately, because each case is different there is no ‘one size fits all’ solution-however blame and guilt rarely help in my experience.

My 6 year old daughter is overweight. It's hard! Her diet is pretty good, she just likes to eat!! So lots of empathy and understanding and certainly no judgement.

We're lucky that our dd is not too fussy and we try to fill her up on veggies and less calorie dense food. But I do see that she has a larger appetite and is more interested in food than her friends are.

Ignore the haters and some of the extreme advice. As others have said, there's a lot of good stuff in your son's diet. Yes, there's perhaps too many empty calories and areas you can cut back but lots of nutritious stuff too.

For what it's worth, the tweaks I'd suggest would be:

*slowly changing the brioche to something more healthy and filling. If your ds will kick off, do it slowly. First from choc chip to plain. Then perhaps to a regular white soft roll, then with some healthier filling then to a wholemeal roll with healthy filling. Doesn't have to be overnight (personally i'd love to have a choc chip brioche for breakfast but it should really just be a treat)

*school snack: change to piece of fresh fruit and/or cheese or similar

*after school snack: can you slowly change petit filous to plain yoghurt with chopped up apple or sliced banana? Chopped up veggies in a dip? celery with peanut butter? whatever works but trying to reduce added sugar and increase satitety. again, make the switches slowly if needed

*dinner: are there other veggies he likes? can you fill up more of the plate with them? can you reduce the ice cream for desert and up the fruit?

*bedtime: could you reduce here? maybe just milk with something really small if he's hungry. As I said, my dd is an eater and loves her snacks but even she manages from dinner until bed, maybe just a glass of milk

*weekend snacks: I'd really try to cut these out, they're adult sized and very calorific. Maybe just as a treat? If you're in costa/starbucks, my dd loves to have a hot frothy milk

Take it easy and go slowly if there is pushback. These are long term changes, it's OK if it's not overnight.

Hi it would help for context to write his height and weight. Our ds is the opposite very tall very skinny and for anyone looking he looks underweight by about 2 stone. He is 6' tall and 8.4 stone. Most of his friends are shorter and about 10 stone plus.
He has been checked and his weight it's ok for him but many would look severely underweight. His bmi it's probably too low but what normal to one may not be normal for another.
I'll concentrate if I were you in being more active and to be open about food. Your son can be part of the change and get some good habits.

I applaud you for facing up to the problem and for providing an honest account of your DS' diet. On MN it is much more common for someone to claim their children eat a sensible, healthy diet with moderate portions, exercise regularly, and are still magically overweight. Those people are either completely deluded (likely) or their children suffer from a serious underlying medical condition (possible but unlikely).

The main issues that may make it difficult for you to change your son's diet and relationship with food seem to be the possibility of ASD, the free-for-all of junk at his dad's house, and the emotional connection between treats and comfort. Those are all very tricky and complex issues.

I have a brother on the autism spectrum. Although he has a fairly varied diet, he is extremely rigid about what, when, and how he eats. Even as an adult, if he has a plate of meat, potatoes, and veg, he will invariably eat all of the meat first, then all of the potatoes, then the veg. He also eats extremely quickly. Does your son do that as well? That may also make it difficult for him to know whether or not he is full.

I agree with some PPs that it is important to tackle things in stages. So maybe first work on snacks, then breakfasts, then dinners. I'd leave the school lunches until last, though I have less faith than some on this thread about the nutritional value of school meals (pizza, chips, etc. seem to feature constantly at some schools). By September I would start him on packed lunches.

I'd definitely work toward healthier snacks (fruit or veg, maybe with peanut butter or hummus), eggs or porridge for breakfast, fewer processed foods for dinner. If you can get him involved and interested in cooking, so much the better. I noticed that you said he feels despondent because his younger sister is happy to try new foods and he is not. That seems to indicate he already feels some sense of negativity, perhaps even shame, about the way he eats. If he could become excited about the cooking process, seeing exactly what goes into each meal, he might feel more in control and also more willing to try something new. I most definitely would not insist he try new things or bargain with him about "one bite of this" in order to be allowed pudding or whatever. I don't like that approach with NT children, and I think it can backfire spectacularly with those who have ASD.

Wishing you much luck. The situation sounds difficult but you seem clear-eyed and ready to make serious changes.

When my DS1 was about 7yo, I noticed that he was gaining weight. I introduced some changes, which was easy to do, as he took packed lunches to school, had no access to money (so couldn’t buy things in the shop) and DH and I are together, so he wasn’t away for weekends or evenings. Ds wasn’t even aware that I had removed things as he wasn’t hungry whilst eating the substitutions.

The changes I made were:

Only cereal (shredded wheat, weetabix or Cheerios, DS doesn’t like porridge), wholemeal toast or eggs for breakfast, with honey or marmite - as much as he wanted, but his portion was a normal size

Banana or chopped fruit as a mid morning snack at school

Lunch - wholemeal bread sandwich, carrot sticks, small packet crisps (non-negotiable), chopped fruit, fruity yoghurt

Dinner - lots of protein, lots of veg, v little carb. This is what made the biggest difference I think. I think I pretty much doubles the protein, and as DS didn’t like a huge range of veg, he had the same veg every other day at least. Carrots featured heavily!

Plain Yoghurt with honey and vanilla, or fruit salad for pudding (I would chop it and serve him a small bowl).

We had a treat of his choosing in a Friday night - inherits could choose a multi-pak of chocolate and we would have a bar each. Those bars are smaller than the ones you can buy as singles, so fewer calories. But DS chose every week, so he had some control.

At the weekends, we would have things like pancakes for breakfast. I’d do American banana ones, blueberry ones, normal crepe style ones. Filling!

Ice lollies instead of ice cream - fruit pastille lollies went down particularly well, and the ones that are 100% juice.

I also limited juice and milk to one small glass of each a day.

Good luck.

Wanted to send you an unmumsnetty hug OP. You've got a lot going on at the moment, and your divorce sounds like it's fairly horrendous. Would definitely agree on going to the GP and get a referral to a dietitian. The school nurse might also be able to do this. A dietician will be good for two reasons 1) help your DS from an ASD friendly strand point 2) ensure you are getting professional help and your exH will have to get on board or hell look shit.

For reference, my 8yo ASD DS is 75th centile for height and 60th ish for weight. This is what he eats on a typical school day:

Breakfast:- large bowl of shredded wheat/cornflakes/weetabix/porridge with whole milk

Morning snack:- piece of fruit

Lunch:- ham sandwich on wholemeal or seeded bread, little piece of cheese, yoghurt, veg sticks (cucumber and pepper)

After school:- fruit winder or a soreen mini loaf

Dinner:- tonight we're having vegan meatballs, hidden veg sauce and pasta, yesterday was salmon fillets with roasted new potatoes and broccoli

We have dessert at weekends only now because my 3yo was becoming obsessed. If the 8yo is hungry before bed he can have plain toast or some rice cakes and a glass of milk

@Ritasueandbobtoo9 Thanks, I hope it made sense. The other thing I wanted to add OP is that if you take on a lot of control for his diet, well-meaning people will pull you up on it, and say you need to relax because he should be eating intuitively, and you'll ruin his intuitive relationship with food. This may well be good advice for raising neurotypical eaters, but I'm afraid for this of us on the autism spectrum, it is often untrue. Either we lack those cues entirely or we interpret them differently to neurotypicals and they prompt different behaviour in us. I will never be able to eat intuitively, because whilst I can feel hunger (I think), the sensation doesn't prompt me to eat. Quite the opposite. It prompts me to avoid food and makes me hyperactive. There's an evolutionary hypothesis about why this happens to a small minority of people, but that's off the subject. If your son is ASD, 'intuitive eating' might simply not be practical. In the short term, you will have to be responsible for the rules of his diet. As he gets older and can understand the reasons for what he needs to eat and when, hopefully he can take on more responsibility. (Presuming he does turn out to be autistic, of course. If he isn't you can probably disregard the above. Intuitive eating is undoubtedly a laudable goal for those whose intuition around body signals works properly).

[quote iloveeverykindofcat]@Ritasueandbobtoo9 Thanks, I hope it made sense. The other thing I wanted to add OP is that if you take on a lot of control for his diet, well-meaning people will pull you up on it, and say you need to relax because he should be eating intuitively, and you'll ruin his intuitive relationship with food. This may well be good advice for raising neurotypical eaters, but I'm afraid for this of us on the autism spectrum, it is often untrue. Either we lack those cues entirely or we interpret them differently to neurotypicals and they prompt different behaviour in us. I will never be able to eat intuitively, because whilst I can feel hunger (I think), the sensation doesn't prompt me to eat. Quite the opposite. It prompts me to avoid food and makes me hyperactive. There's an evolutionary hypothesis about why this happens to a small minority of people, but that's off the subject. If your son is ASD, 'intuitive eating' might simply not be practical. In the short term, you will have to be responsible for the rules of his diet. As he gets older and can understand the reasons for what he needs to eat and when, hopefully he can take on more responsibility. (Presuming he does turn out to be autistic, of course. If he isn't you can probably disregard the above. Intuitive eating is undoubtedly a laudable goal for those whose intuition around body signals works properly).[/quote]
Not just for neurodiverse kids. My dd is NT and just finds self-regulation hard. It does not come to her intuitvely. We live in an environment to which we have not evolved genetically so it doesn't even make sense that kids - all kids - will all be able to intuitively self-regulate. Some kids do, but most certainly not all, before even adding issues around neurodiversity. Funnily enough, my one ND kid is able to self-regulate amounts and is not overweight but is just very picky about what goes in her mouth and when.

@4PawsGood 58% fish? Is that a typo? What else is in fish fingers if only a little over half is fish?!

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.

Is there rigidity on this issue?

Is there a link between the strong feelings and autism traits?

A child of 12ish really isn't able to see a nuanced picture of food production with all its many elements.

Pescetarian diet is at DS's request. He feels very strongly about it
Again the child is dictating the agenda here!
You need to be educating him about the damage sugar does at a cellular level, nit pandering to unsubstantiated whims.

I got my ASD son to watch the BBC documentary about ultra processed food that has helped a lot. I restrict nuggets and chips/beige food to once a week.

It’s tough cooking twice for ASD child and rest of family but I do variation - we have a stir fry he has plain noodles plain chicken and plain veg.

I have not sorted breakfast it got worse during lock down - so chocolate pancakes do feature too much. However some breakfast is better than none. My DS would eat nothing rather than something he doesn’t like.

Those suggesting curry I have to laugh. However, trying to have a good diet as a pescatarian snd being ASD is hard as DS likes plain cooked salmon potatoes and veg but interesting veggie food often is spicey otherwise you end up with the ultra processed food of veggie sausages . My DS loves pasta and plain cheese but keep portions small.

DS has no idea if hungry or thirsty you are in charge not your DS.

Make the changes very slow

Don't have much to add excellent advice here but just to say my dd was overweight at 8/9, as she entered puberty. I tackled it through portion sizes and she didn't even notice, also we agreed one sweet thing a day, and she picked when it was (this included if she had something sweet for breakfast ). She then also had a growth spurt and now looks great at 13.

Portion sizes are key I think, she now can't eat massive meals as she gets full easily. You will need to try and tackle her dad as well though as I had this problem s it wasn't until (for other reasons) she stopped seeing him that the weight really flew off.

It's a great time to notice this because he is about to grow a lot and that will help massively , so you've done a great thing facing this now.