DD is Very Overweight

[SteveBuscemisRheumyEye]

I posted this in SN parenting but I think it might get seen more here

DD is 10 and Very Overweight. I know exactly why she is overweight but really struggling to address the problems.

She has ASD and an extremely limited diet (all beige, not a single vegetable and only strawberries). Portion sizes are too big but she freaks out if she doesn't have the amount requested. Have tried gradual reductions but it doesn't work. She's set in her patterns and I just don't know how to break them.

Absolutely loathes physical movement.

I'm failing her and I don't know what to do. I'm so fucking tired - she still cannot sleep on her own and right now I could just cry.

So as not to drop feed, I was an overweight child who later developed an eating disorder. My mother had an ED throughout my childhood, so that's something else I'm anxious about.

Sorry you are struggling OP. Please don’t blame yourself or feel any shame. Where you say DD loathes physical movement, I’m assuming she hates targeted exercise e.g. PE. Does she like walking? Could you go walking with her after tea time each evening? Good time to chat as well.

Re the portion sizes, what does she do when she doesn’t get the full amount she wants? I would be tempted to just let her have her meltdown on this one, but of course I don’t know how physical and/or aggressive DD’s reaction is. As long as you know she is not going hungry, I would maybe just leave her to it.

I hope you’re ok. You must be very frustrated.

Thank you, you're really kind. Hates walking, too 😔 I think you're right about just letting her meltdown (she's not aggressive but extremely, extremely upset). It's just all such a battle!

Oh op what a tough situation for you all.

Have you had any advice from the gp? I think it would be useful to see if you can get a referral to a specialist with experience of ASD or eating disorders..This might even be a dietician with specialisms in this area.

Or perhaps the way to deal with it is not to approach from a dietary perspective but to get support and guidance with helping a child with ASD alter habits so that in time you can introduce dietary changes?

Sleep deprivation is awful, having a child with SEN can be exhausting.

are YOU eating well?

what is DD's height/weight?

would she be keen to go to a trampoline park? Swimming? Could she roller skate? Any friends with a dog you could walk?

even dancing/games on a wii/PlayStation/Xbox ??

put the focus on fun, not 'exercise'

ASD & food is very difficult. You know your DD & have, no doubt, tried everything you can.

At her age, she can grow into her excess weight, so even if you can maintain her weight (& not increase portion sizes) that will really help.

How does she request stuff? If it's "half plate of chips and 3 fishfingers" what would happen if the plates were smaller? Or only 2 fish fingers per person were cooked?

Does she drink calories? Snack on anything?
Can you get her walking longer distances? Even if it's parking at the far end of the carpark initially?

I'm usually one of the ones saying if you think your child is overweight, you need to make massive changes. However in this case, I think you might be better with a very, very, very slow burn, and think overweight is not the biggest battle to face.

What is your weight like? Could you lead by example?
Reduce the portion sizes and stop being scared of the meltdowns. As the parent is your job to decided portion sizes and what you provide.
Don't buy unhealthy snacks. Find recipes together. Cook together.

Warn her in advance about portion size. She may not like the surprise element.
My DS has some autistic traits and does not do well with the unexpected. However, it’s also a mistake with him to make it a big deal. So I sneak the info in, under the guise of something else. So, when I’m warning him he’s got homework to go, I’ll say ‘we’ll get your homework done quickly before we then do xx’, so it’s mentioned, but not the focus of the sentence. Then it’s in his head.

So with food sizes, you need some diversion fact I guess. Or just some flannel. It could even be something silly, like, ‘there will be three fish fingers tonight, which is the same number as the steps out of our door at the front, isn’t it odd how there are more steps at the back?’ And have a chat about the sloped garden. Or pretend you’ve run a bit low but luckily there are still three left.

Hi @SteveBuscemisRheumyEye is DD at a special school? If so, can they help? Perhaps doing some activities around healthy food? What 'beige' can DD eat? Is there anyway you could make healthier versions? Such as 'hidden veggie sauce'? Does DD like the water, could swimming be an option?

I can empathise, I actually have the opposite problem my dc with asd is underweight. We recently got refered to a dietian which has helped because dc seems to take note of what the dietian says and wantd to please her so have had small positive gains. Its really slow but the dietian has given goals like every day have something with calcium in (dc is responsive to this route). My eldest also has asd and was /is very restrictive with food, when he was younger dietian did challenges with him so he wrote with my help a list of twenty foods (took us a while to write) that he would try and each week he was to try this food 5 times (only had to be a bite) it took a long time but did slightly increase food choices. Also dietian got him to play around with numbers of foods so he always had to have 2 fish fingers so she gave him 3 or 1 to make him realise that nothing bad was going to happen by eating different amounts. He's a young adult now and although has a restrictive diet is able to eat out, manage different portion sizes and is healthier.
What I'm trying to say is each child's different, will react differently and be receptive to different ways you probably need to tap into this. Can you see a dietian? Have you looked at afrid support? I'd also say that I really had/have to have a lot of patience and have kept a note on my phone to show improvement because week on week I wasn't seeing progress for a lot of effort however if I skip back a few months can see huge progress.

OP, I'm not in your situation so I apologize if this is a stupid idea, but my first though was to replace her nuggets with vegetarian fake nuggets ? It may not help her lose weight, as it's still fried and the amounts are also an issue, but at least she'd be eating vegetables ?

On the vegetable front- this may (or may not help).

Disclaimer- I have a child with ASD and who has sensory issues around food. He is now almost 13. He was also a vegetable refuser completely.

What I did is got those plates that have separated compartments in them (he hates his food touching). Then every day for about 2 weeks I put a new vegetable on his plate... just the same one for 2 weeks. Cucumber first (I know it is not a vegetable, but anyway). A slice of cucumber just there in one of the compartments. Never mentioned it for the first 3 days or so. It went untouched.

Then I asked him to just touch it with his fingers- pick it up. After a few days of that I asked him to just put the tip of his tongue on it. Nothing else. Then to lick it. Then to nibble it, all with a day or two between the next stage. Usually by the end of the 2 weeks he would be eating perhaps a bite or two. Then the next week put the cucumber and a couple of sweetcorn kernels - 2 weeks again.

Its been a hard road but now he will eat about 10 types of fruit and veg. With the exception of sweetcorn it always but always has to be raw. Cooked veg will not past his lips and I have started the process again- a little bit of mash potato etc..

It's just what I have done/ am doing- you may have tried this sort of thing before of course, but in case it is of use.

But I do also recommend seeing if you can get a referral to a paediatric dietician... they may have some good tips. Mine gave a great recommendation for vitamins (Tesco own brand vitamins and minerals for kids is apparently the bext out there according to her).

OP, you need a multi-discipline referral to a paediatrician, a dietician and CAMHS. You need specialist support before assisting your DD to lose weight in a way that isn't going to be harmful to her in the long run due to her particular set of ASD needs.

For most overweight children the goal would be to maintain their current weight so that they grow into it as following a weight loss plan can mean they miss out on vital food groups or on calories needed for growth. However you need professional assessment and support to this.

Portion sizes are too big but she freaks out if she doesn't have the amount requested

It will be hard but this is where you have to start. For her own good, you’re going to have to let her have that meltdown.

Is all physical activity disliked, for example would she join in at a trampoline park or have a go at roller skating?

I'm assuming the type of food she will eat doesn't lend itself to hiding veg in it? Could you give an example of a typical day's food?

Would it be possible to get her to have large glass of water or sugar free squash before starting meals, so that she starts to feel full sooner?mid suggest a bowl of soup but am guessing that would be rejected.

Oh OP this is super hard. My mum
had an awful body imagine was always on diets. I developed an ED and I worry about my kids too.

Being tired is horrible and an SEN child, please be kind to yourself!

Does she respond to choices? Say she eats chicken nugget and fishers fingers. On two paper plates draw the meals; so you can say do you want 4 chicken nuggets or 2 fish fingers and she picks so still feels in control?

Are there any fun exercise activities she’d like? Could you get a trampoline or a games console to play just dance on perhaps?

You say her portion sizes are large - what sort of portion size is she having? Adult, teenager etc?

Sorry for all the questions, sounds like you’re in a particularly tough position where you know the changes you’d need to make but are unable to make them

My youngest was very overweight (he is asd) until 16 and then it suddenly clicked. It's like he swopped one obsession (food) for another (exercise)
He got a stepper at the beginning of covid and that's all we heard...... it sounded like the jig jig jig of shagging reverberating round the house.
I wouldn't say his palate was diverse now but he gets portion control.

Well first of all, you’re not playing with the same rules as a lot of us. You’re in very different circumstances. There’s some good advice on here, but remember, you cannot judge you or your daughters actions or reactions by the perceived norm. Reading your post it sounds as if you’re tired, worried and feeling a failure. You’re absolutely not a failure and it comes across as if you don’t actually realise how well you’re coping. Wishing you well.💐

You'll have to let her meltdown.
You can still be gentle and kind. Something like, I'm sorry that's all there is. I ran out. while giving a slightly smaller portion.

What has her pediatrician or counselor said about it?

What are mealtimes usually like?

As others have said you aren't failing you are trying and it is hard.

I agree I would ask your GP for referrals now as they may take a while. If you know dd's current weight and height and they indicate she is very overweight you should be able to see a dietitian through your local child health team. They can be very very good with SEN as many of their referrals involve SEN. Nothing you say suggests she is dealing with more than issues linked to ASD but if she is developing an ED (absolutely not suggesting she is) they can request your GP refers to CAMHS too.

Just having a professional to help may reduce your anxiety.

I am a psychologist working mainly with young adults with ASD. Some have ED too, often severely restricted eating. I would suggest avoiding the meltdowns if possible. It sounds as if food is reassuring to her, and exercise causes her discomfort. Long term that's not healthy but it will cause her huge distress to change it abruptly. A dietitian can help you and her look at her whole diet to make changes that she can cope with but are healthier leading to an ongoing calm and happy relationship with food.

Could you introduce a hobby that incorporates movement, one that could appeal to her traits, interests? I found dd would walk with us if we went bird watching for instance. There's also just building exercise into the day by parking further away. As far as diet, you could weigh her portion, reduce it by about 5% and use a smaller plate so it's not obvious there's less. But as she's still growing, just ensuring you don't increase portions plus a bit of movement could be sufficient

I agree with not giving in to the meltdowns.

My DS is 8 and has had sensory issues since he was little and I’m sure there’s undiagnosed ASD. I’ve never ever given in to his meltdowns, nor do I avoid them. Its been a hard few years but they are so few and far between now, it’s been worth it.

You need to reduce portion size and no snacking apart from fruit, even if it’s just strawberries. It’ll be hard but you’ll get there if you persevere.

Thanks all, I really appreciate everyone's thoughts.

I agree that an MDT assessment would be ideal, but getting one is going to be the difficult thing.

Those that commented on swaps etc, all vegetables are a no go - she will literally vomit at the sight and smell of most veg. She doesn't eat anything that can have veggies in. She has a rigid routine of what she will eat:

Monday - jacket potato with tuna mayo
Tuesday - pasta with crème fresh and salmon
Wednesday - chicken nuggets and chips
Thursday - hotdog in bun
Friday - chicken nuggets and chips
Saturday - jacket potato and tuna mayo
Sunday - a bit of roast chicken breast with roast potatoes.

For school lunch she has pesto pasta

Breakfast is always white bread and butter

Oh, and hot chocolate made with nesquick at breakfast time and before bed