to worry about my DD's weight

[IceBeing]

DD is 3.2 yo, in the 50-75 centile range for height and in between 91 and 98 centile for weight. This means her BMI says she is obese/very overweight.

So, she has always been in that weight centile from birth. She used to be in the 75 - 91 range for height but that has obviously slid down (which given her parents are both average height would make sense).

So apparently I have an obese toddler. Should I worry, and what if anything should I do about it?

We have always fed on demand as a BF baby and toddler. She has always self-regulated her solid food eating. This seems to work as she will leave food on her plate if she isn't hungry or ate more at lunch etc.

We eat a reasonable varied diet. We do full fat milk etc. but don't do sugar packed stuff. DD does eat a lot of fruit. It is her favourite food and that could be an issue.

The only things she will eat even after saying she is full are raspberries and tomatoes....

How does she look? I dont hold much truck with bmi calculations tbh especially with little kids. Is she actually chubby or in clothes older than her age (for the width rather than height)

What is her physical activity level - does she walk and run plenty and have the capacity for say a walk to, around and back from the park?

Makes more sense to me to look at these things that stats on a graph.

What are her activity levels like? Does she have lots of running in gardens? A bike? A scooter?

YANBU to be concerned-those who won't even entertain the thought that they might need to help improve their children's health are the unreasonable ones in my (judgemental I guess) opinion. Head in the sand doesn't help anyone so you're right to question it.

However, whether she does have a weight issue is something for you and you gp/hv team to establish.

You have tried her numbers in the NHS child's BMI calculator, right?

She definitely looks chubby, but she has progressively gotten less chubby as she has gotten older.

She is full of energy in a climbing, jumping, dancing, running around the house/garden way. But I don't know about stamina. She will play in a park all day if allowed...but walking any distance doesn't seem to happen.

I am a little vague on this point because I'm a WOHM and my DH looks after her during the day.

llijk I used the WHO uk centile charts. It has a BMI bit on it that uses the height and weight centiles to measure BMI.

firstly do some experimentation with the BMI calculator, what weight does she need to be to be in the normal category? With smaller bodies it is usually just a small amount up or down to alter the result.

When I weighed DS at that age he was in the "obese" area, so I did it again properly , making sure I weighed him with lighter clothes (he had jeans and jumper on the first time) and got his height exact this meant he was in the "overweight" category.

I then worked out he only needed to drop 1 lb to go down into "normal" and achieved that by switching from full fat to semi skimmed milk.

It isn't like an obese adult where you need to lose lots to get the weight down!

What does she eat in a typical day?

gorgeousgeorge that is actually a very good point. even a few cm in either direction makes a HUGE difference.

I will measure her tonight.

She is chubby though...but I genuinely don't know if it would be better to interfere in her eating or not.

She has weetabix/porridge with milk for breakfast. possible some fruit too. She has sliced veg, bread, cheese, yoghurt at lunch and then whatever we are having for dinner (tonight will be salmon, veg, rice) and more fruit.

She definitely also has snacks during the day. This is usually fruit related...like bear yoyos or dried mango.

The amounts she eats are REALLY variable. Some days she will pack away dinner and be raiding the fridge for yoghurt. Some times she has one mouthful (of the same thing) and then starts playing happy families with her cutlery for the rest of the meal.

So I really don't want to start telling her to start or stop eating...because I think she following her internal cues and I don't want to break that. I also don't want to make her concious of food choices decisions etc. Although I have been pushing the 'eating a bit of lots of different things is better for you than eating lots of one thing' business.

We also have the whole meal together IYSWIM. So yoghurt/fruit is available at the start (if it is going to be) this means she mixes and matches more and stops eating when full rather than finishes and then demands 'pudding' etc.

You can 'interfere in her eating' in a positive way without her even being aware.

When my middle son was flagged up as overweight (reception checks at 4), I realised it was just a couple if habits which had become a but too regular over the summer (I was recovering from an operation)-like brioche for breakfast/snacks too frequently, too many smoothies etc.

As others have said, it might only be one or two tweaks which make all the difference. Perhaps limit fruit slightly from what she currently has (constantly grazing on fruit won't be good for her teeth, it can be quite calorific even though healthy, and will also get her in the habit of constantly having to eat).

I think the physicality thing is the important bit isn't it? If she gets to the point she can't move or enjoy moving it is a cycle.

She has always struggled with physical activity a bit, because she has always been so heavy. She needs better coordination to do the same things etc. But she is totally up and at it at the moment...so maybe she will become a lean machine by 4.

I think switching fruit snacks for veg snacks might be a good step. I think we have gotten a bit complacent on the basis that she doesn't eat chocolate, coke or crisps so everything must be fine front.

Some fruits can be very high in natural sugar so are not as wonderful as they ought to be.....sadly!

Maybe just slightly reduce the portions of everything so she doesn't really notice, especially dense calories like cheese.

She may well shoot up in height and slim down (DS2 does this all the time) but you can't rely on it as she may go the other way and just get chubbier. Cute, chubby children often grow into chubby teens and adults, so it's worth getting things sorted out now than struggling with a stroppy kid who has the pocket money to buy their own treats.

I think changing fruit to veg snacks would be easy and not really noticeable to her. Also, dried fruit is very high sugar per g - so might be an idea to limit that too?

Yes -I think reducing the number of times dense calories appear would be a good thing. We don't really do a portion size...it is all just there and you eat what you want. She hardly ever finishes her plate. When she does she asks for more food. I don't want to say no because I don't want to interfere with her listening to her hunger cues.

I lost mine entirely because my family did 'clear your plate' then rewarded this with pudding etc. I really really don't want to go that route if at all possible.

Eating this way with DD has actually improved my health and weight and relationship with food substantially so I really believe in the method...but then sooner or later you have to stop and over weight child from eating too much...I guess am trying to work out if we are there yet or if wait and see is still valid.

The numbers at that age really don't matter.

What matters are that she is getting a varied and appropriate diet - which from the sounds of it she is...

And that she is active. Just because she will run around (all 3yos will) doesn't mean that she is getting enough regular outlets for this energy. That, I guess, has to the parent's responsibility so speak to your DH and check that she really is getting out and about enough.

Similar to an adult, exercise should mean getting exhausted (not to the point of collapse, but genuinely tired not bored). I'd think she should get this opportunity almost every day.

Agreed - will speak to DH and make sure she is getting to run around outside every day.

He is paranoid about sun burn so she may have been a little house bound recently.

Well thank you all - a very civilized AIBU about weight there....there can't be many of those!

Very civilised for AIBU

It's so difficult with food. You don't want to get into a clear your plate mindset, but having unlimited food (even if it's if the good variety) offered and waiting for natural cues to kick in may be difficult too as there is so much lovely fruit and even healthy food on offer these days. I don't listen to hunger cues usually but just see some scrumptious apple cake and like the taste! I was never overweight as a child or adult until I had 2 children then greed took over and I am about a stone overweight. Maybe in the 'hunger cue' culture we were grubbing around for nuts and berries and hunting the occasional mastodon!

It's so difficult to get it right though especially with children!

My advice would be to cut out all dried fruit, too high in sugar and sticks to teeth. It's very easy to over offer these too, because they are healthy, but the calories are there and add up. If she will eat eggs, offer these instead of porridge for more protien. Also, you say that you don't do a portion size, that could be you're problem, if you are not concentrating you could be giving her more than you realise. My tip would be to let her serve herself, with clean hands out of the bowl, as this is the size of her stomach. Lastly, nothing to drink other than water in the middle of the day, milk in the morning and before bed is fine.

your not you're

I wouldn't worry overmuch but I would swap sweet snacks to mainly savoury ones, and limit them to once or twice a day. My DC have no off switch with fruit, whereas crackers they will only bother with if genuinely hungry.

Also I think you can serve up some pasta and say there's no more, and that has nothing at all to do with encouraging them to clear their plates. If she virtually never finishes what's on her plate, are you putting on more than you need to?

I found my children were often not hungry for lunch/evening meals because they never went long enough without food (which I've also discovered is why I'm overweight-not recognising and accepting that some hunger is ok at the right times).

I would imagine that if you reduce snacks (volume and frequency) between meals, there'll be more of an appetite for proper food. I agree about not insisting on finishing what's in the plate however.

Might be useful to google portion sizes appropriate for age, so you can be confident that you're not offering too little or too much (and leaving her hungry or overwhelming her with a huge plateful).

Sounds like you're doing the right things.

You could switch to semi skimmed milk.
Some of the dried fruit has added sugar.
DD is 2 50th centile for weight and height.
She has semi skimmed milk, probably too many raisins.
She cant have ice cream or chocolate due to allergies and really only has water to drink with milk before bed.

Numbers are important - BMI, weight, quantities, DO matter.
She's thriving, which is great OP.
The fact you've even posted signals you have concerns though.
Cut the snacks, no seconds, etc.
Running, swimming, all help.

Children cannot self regulate their eating, they will eat what's available and if they like it, they will eat more of it.