Obese daughter 14 years old

[MochaShots]

As the title says, my 14 year old daughter is obese. She weighs 17 stone and I am so desperately sad for her.

I take full responsibility for letting it get this bad, but because of her poor mental health, I've struggled to be strict enough to see through any health changes we've tried to implement.

I know what a healthy diet looks like, what portion size she should be having, good fats, bad fats, enough protein etc. It is not that I am not educated. The problem I have is the lack of will power to stick it out. She is on the CAMH'S waiting list regarding her mental health, and I've requested a nutritionist, but the waiting list is so long.

She is so fragile mentally, that I always cave in and allow her bigger portion sizes or treats. But, even when I've tried to make adjustments to her diet, I cannot get her to increase her activity. Realistically now, she has gotten so big that she genuinely struggles to walk more than 10 mins without her legs chafing or her feet hurting. I cannot afford paid activities, and she also lacks the confidence. I've tried encouraging slow walks to build herself up to gradual fitness, but she refuses as I know she knows she will feel pain or discomfort.

Until she gets help with her mental health, I feel I'm fighting a losing battle.

Given that I eat a reasonably healthy diet, and am active and that I know about healthy eating and cooking- what can i do to help my daughter take steps to get healthy?

I've tried every approach I can think of including a delicate conversation - a blunt conversation about the negative effects on her heart (I try not to make it about her appearance). I've tried to make things fun and take the emphasis off of weight, but she doesn't like any activities at all. She goes to school, then comes home and sits around while I'm at work. Weekends she refuses to join us on bike rides, walks etc.

I have to be careful not to make it a battle by issuing sanctions as her mental health is incredibly fragile.

Please help!

A bariatric surgeon saying surgery is the only way is a bit 🙄she's 14, not 44. The sugeons way is not the only way, bet Joe Wickes would say otherwise.
I'd be banging on the GPs door on a daily basis asking for a ref to a dietician, and to a lifestyle programme (so she can access swimming etc for free). Is there a rugby club near you? Ours has a ladies section and the women and girls there come in all shapes and sizes and are so supportive. Exercise could be a lifeline for her MH.

Your daughter must feel shit about herself .

I think I would focus on lots of love and time and attentiion. I also remember a poster on here who worked in children’s homes saying that she told them lots of good things about themselves. So grab any chance to give meaningful descriptive praise to your daughter, no matter how small. So is she brings dinner plates through from the kitchen ‘ thanks, that was helpful, I appreciate it’

I think I would focus on that whilst waiting for proper mental health support. It may help to set the groundwork to getting her into a more receptive frame of mind when she does receive that support too.

Can you look at it as a money issue? There’s a cost of living crisis, so explain that treat foods and extra portions won’t be happening. Show her your budget for food and what can be bought from that, and there will be no extras and it has to last the week. Emphasise that vegetables have to be the most part of your food shop. Give her some input into what she would like. Can she go shopping with you? After a couple of weeks or so, show her the money you have saved, and get her a treat - cinema or whatever.

There’s a lot of stuff on here about OP enabling her daughter, not controlling what she eats….you do realise she is 14. At 14 she is perfectly able to take food without permission or buy food to fuel what amounts to a dependancy addiction.
unlike a lot of addiction you cannot do a withdrawal method. She has to eat. She will be drawn to the worst sorts of foods for her like carbs and sugar as soon as she starts thinking about food or eating. It is extraordinarily difficult for anyone, let alone a 14 year old with mental health issues- she is in a vicious y Le probably of comfort eating partly because she feels crap about herself for being that big. It’s a psychological mess.
The Op can probably try just about anything, but it is unlikely to work. Short of locking her daughter up to stop her going out or entering anywhere in the house where there is food , there is nothing she can do. It is very easy for posters to blame the mother or parents - but it is not that simple. In rare cases where children have become so morbidly obese they have been removed form parents, it is to place them in an environment that restricts their access to food in abnormal ways - and not practicable in a normal family.
The daughter needs help for sure. She needs medial health and Gp to intervene and support the daughter. The family then needs to work with that plan to help.
we all know you cannot make someone overweight lose weight. They have to decide that for themselves. Pressurising someone to lose weight is actually extremely counter productive. Just because she is a child does not alter that. She is 14 and has to get to a point where she can accept she needs help for herself.

Even my size 10 self (a long time ago) suffered from chub rub.. I get cotton cycling type shorts (underwear) from the big bloomers company. They’re really soft and comfortable and stop the chub rub. I wear them all the time now, even under leggings. I think investing in some comfortable clothes is a starting point at least.

Feel for your daughter. Although health issues are paramount, in a 14 year old girl's head, appearance can be everything and she could be self conscious about leaving the house. Or depressed.
Dieting is hard. Full stop. Has she had blood tests for thyroid function? Diabetes. Thinking metabolic syndrome?
Perhaps treat her to some lovely clothes or do a make over together. She is beautiful. And continue to as clothes sizes go down.
Not sure what to recommend re weight loss. I was a dumpy teenager, put myself on a diet at around 14 But complex reasons.
In that she is going through puberty I think you should push for a nutritional advice.
She will possibly need more protein and calcium than an adult as she is still developing. But no expert.
It's a case of getting good nutrition on a calorie budget. But her needs could well be different to an adults.
Cutting sugar sounds pretty safe. Could still have eg choc ice, 2 finger kit cat, both usually under 100 if factored into kcals. Or jelly. Artificial sweeteners so no nutritional value but something like 10 kcals.
Good luck.

What good would a nutritionist be to your DD when she will still have you, who already knows all about good nutrition, enabling her in the background? I don’t mean to sound harsh but your DD is dangerously overweight and she did not get like this overnight. I wonder about YOUR mental health for allowing this problem to get so out of hand. Stop buying ‘treats’ and she won’t be able to have them, unless she walks to the shop herself will she? Don’t drastically cut down her dinner portions but fill at least one third of her plate with vegetables, cut out any fried food, pastries, rich sauces etc. Try your utmost to get her to go for short walks with you-exercise and fresh air could really help with any depression. Honestly no matter how hard it is, you really need to be cruel to be kind now. Good luck.

Her daughter can't take high calorie snacks etc if they aren't purchased and in the house. OP says her daughter won't go anywhere apart from school so she's not going to be going to shops buying herself crap. The first steps to fixing this is for the OP to take control of what is available for her daughter to eat.

Bodyglide or another anti-chafe rub. Good clothes. Chafing is excruciating.

She's right, walking for an hour would be hard for her. The proper way to approach any exercise is to start very small & work up progress very slowly.

That said, diet needs to be addressed here. At that weight, she can eat loads & still lose weight. Work out her tdee off an online calculator & go from there.

Where I live, you can self-refer to dietitians & it's been very helpful. A lot of gentle changes, not the useless advice from a few years ago.

I would be contacting the GP & getting help. A couple from my local town have recently got into major trouble for neglect allowing obesity.

My mum was bloody useless when it came to my mental health/food issues so good you care.

Precision Nutrition has a lot of information & an easy way to measure portions.

Hi OP, I don't have any advice about the mental health aspect of your post, but wondered if someone (post lock-down) might have an unused exercise bike you could borrow for a bit, just so you can do a bit of exercise without having to brave the stares of people outside.

I have been an overweight teen. In my case it was caused by bullying in school.

I stopped gaining weight as soon as I stopped going to that school. It took me 5-10 years to lose all the weight though.

At 14 you need to accept that you won't be able to control her eating 100% I think. If she really wants to eat she will find a way (ask a friend, etc). Plus she'll soon be able to work and have her own money to buy whatever she wants. So I would definitely not try to control completely what she does or lock the cupboards or whatever. The change needs to come from within - but you can help her make the right choices.

• don't buy anymore snacks. Whatever you have in the house, once it's eaten it's over and there will be no more of it.
• Promote healthy snacks by making them easily accessible. For instance carrot sticks (I love carrot sticks !) or unsweetened yoghurt with fruit (frozen berries is a nice option) or apples.
• Encourage your daughter to walk more by organizing outings with her. It doesn't have to be a punishing effort at the gym - going shopping can involve a fair deal of walking, or a stroll in the park (you can stop somewhere for coffee). Shorts to help with chafing thighs. Build it up so that it remains enjoyable for her (no 30k marathon on the first day obviously !) Do you have a dog, or could she be convinced to walk a neighbour's dog ?
• Up the healthy in the meals you prepare. Don't restrict portions but try to make really healthy stuff ; lots of vegetables, tomato salad, hard boiled egg, lettuce with homemade sauce, spinach with a bit of cream, etc etc. I know you said you already eat reasonably healthy but try to up that if you can. Is she at all interested in helping you cook ? It could be a fun activity to do together.

Hi, I’m going through something similar with my teen dd! A combination of new found freedom at college after 2 years of lockdowns and reduced activity have taken their toll on her weight and her health! I’ve tried everything but didn’t get anywhere so took her to the doctors. The lovely doctor told her all the same things we had about the problems with her weight and how to combat it and was allowed to weigh and measure her! She’s never weighed before! Sometimes you have to step back and ask for help!

Let the difficult information come from someone whose opinion your daughter trusts which puts you into the role of follower of orders not giver or criticism! They may even partially ‘blame’ you, or you can explain that you know your role in getting to this point, take some of the blame actively, and ask for advice for you on improving things ( even though you may not feel you need it)! You can then crate a scenario where you learn a new way of doing things together, which will feel far less ‘stressful’ for someone with poor mental health as she’ll feel less judged and more supported.

I know even though we’ve only been doing this a week or two I’ve had to talk to myself in the shops not to buy the unhealthy food, to let her cook even though the mess is stressful and actively remind myself to say the positive praise rather than dole out the treats! We do it so easily when they are toddlers and learning those big first steps but in teenagers it’s much harder to do! Good luck xx

This sounds like a vicious circle. Her weight and her mental health are probably closely linked. It sounds like you need help from MH professionals rather than a nutritionist.

what does she say about her weight? Does she want to lose weight?

have you spoken to her school about this? They may just refer her on, but maybe there’s a school nurse who could help?

what about an app like Noom? It gets people to monitor their calories and exercise ( including steps taken) as well as giving positive reinforcement and education. It’s all done in tiny bite sized activities like taking a quiz which educates you on food density etc.

it might be the thing that gets her interested in taking care of her health.

I hope you get the help you need. Advice to exercise more and eat less is just so pointless when someone is unwilling to do either.

Want to add, my mother tried the dietitian approach and it didn't work. What did work was realizing that vegetables can actually be tasty if prepared right. I gained an interest in cooking (in baking originally but then included cooking). Since I have kids I have been making more efforts to cook a lot of vegetables, especially broccoli or carrots, which I never used to eat before (except carrot sticls

Any form of diet or restriction will not work, they only compound the problem. If you demonise or restrict certain food groups, you fuel the cycle of ‘forbidden’ food binging and shame.

It is never too late to start the division of responsibility approach, Ellyn Satter and many people influenced by her are the best resource
www.ellynsatterinstitute.org/product/feeding-with-love-and-good-sense-12-through-18-years-2/

Linked to this is helping your daughter to learn about intuitive eating, and to help her accept and love her body, which eventually may lead less overeating and becoming more healthy and moving more. There is an amazing book on this by Evelyn Tribble, and her co author Elyse Reche has written one especially for teenagers. There are some nice intuitive eating journals which may appeal.

All of the above is supported by peer reviewed evidence, unlike many of the misguided and often harmful suggestions on this thread.

It is relatively easy to get rid of unhealthy snacks in the home and do healthy meals. The problem is that once a person gets very over weight their self esteem drops, they hate the way they look at and eating becomes a short term comfort. They don't want to exercise and so the cycle continues. Once they are teens it is very difficult to control what they eat. You can't be with them all the time, you have to go to work, they have to go to school and whatever healthy snacks you provide in the house doesn't make a difference because secret eating sets in. Stuff at school, from friends and all pocket money ends up being spent on sweets, Macdonald's ext. The more you try to control what they eat, the more they secretly eat. You need to work towards a change of mindset where she genuinely wants to do it. A very long term project with probably lots of blips on the way. Hope you can get some mental health support soon. If you do, try not to ask her about it, wait until she wants to open up or she will still feel controlled and the secret eating is off and running against because it's the only thing she feels in control of. 💐

This is the worst thing you could do. Dieting and restriction is proven time and again to not be effective.

“A non-diet approach involves granting oneself unconditional permission to eat and developing an internal system based upon recognizing and honoring hunger and fullness cues, eating enjoyment, and noticing how different foods affect the body. Instead of citing a presumed lack of willpower or a supposed food 'addiction,' we ask deeper questions in a neutral fashion to explore why someone might be eating when they are not hungry or over-consuming certain foods. Our approach is flexible, we have guidelines and ideas rather than rules, and there is no wagon from which to fall."
www.buzzfeed.com/amphtml/sallytamarkin/weight-neutral-dietitians

Also, praise is not effective for children of any age. It is a source of external motivation and results in praise junkies. Children need to develop intrinsic motivation and achieve things for themselves, not to receive praise from others which developed a depended on for their self esteem.

@MochaShots Have you tried finding forms of exercise she actually likes? Something away from school? How about climbing? Look up your local indoor climbing wall. Most have clubs for different ages and you’ll find good non-judgey people there I’m sure. She’ll also be working on improving her skills not competing with others.

I weighted that at that age.

At around 16 i became more body conscious and took up running and slimmed to a size 8-10.

2 babies later i was back to being overweight so have taken up the couch to 5K challenge with my son.

Hopefully CAMHs can help with her attitude towards food as for me its obviously still an issue. How about taking up a hobby together? Cycling? Couch to 5 K? Walking? Tennis? Badminton?

Anything that gets her moving as it will help, but something she will enjoy and then it doesn't feel like a struggle. Walking to school is hidden exercise if its possible? (You could blame fuel prices 😉)I struggle to loose weight if i don't do sport. She may also benefit mentally from doing sports too. You may also find she

Also just don't buy any junk food, be cruel to be kind in that respect and if she is eating it at school there is only so much she can eat at lunch and only so much she can get with lunch money.

This is one perspective but ignores the very real issue of food addiction.

Sugar and processed carbs such as flour are highly addictive to some people. Many people (myself included) who suffer from addiction to these items have tried over and over to follow a 'non-diet' approach, often propounded by people who sound oh so reasonable (and often have never struggled with weight or food addiction themselves).

Deprivation and over-adherence to rules and restriction can definitely be counter-productive. But there is much evidence that for some people it is much more effective to for example have a couple of simple rules such as no sugar and no flour. I'm no fan of calorie counting, or using apps, or obsessing about food at all. But the one thing I've learned over my decades of having food issues is that there is no simple answer - not even one that sounds so moderate and reasonable as a 'non-diet approach'.

I'm now 51 and lost 5 stone a couple of years ago using simple principles above. I never feel deprived, I have times when I do return to eating those foods but I'm very aware that as a general rule of thumb I feel better and more in control when I cut them out and focus on nutritious, energy-dense protein and fats.

I think we should all be wary of those telling us there is 'one true way' and that they have the answer (if only we'd sign up to their XYZ course etc). Food issues are massively complex and there is no one correct course of action.

As an 8/9 year old, (in the 60's, so quite unusual) my mother used to take me along to a hospital weight management paediatrician. At home, she'd make me more and more batches of cakes because I was unhappy; after a couple of terms she stopped the hospital apointments; when I asked her about it many years later, she said she'd stopped because I was unhappy and not losing weight.
after many decades of being overweight/obese, I still have MH issues around eating - and guess what - eating /over eating doesn't make me happy.
Your daughters weight is not helping her MH - stop using food and extra portions as a treat, you are making things worse.

This sounds really hard OP. I wonder if your school nursing team or school pastoral team can advise on local free activities? Through the GP there is often free access available to either behaviour change coaching or things like slimming world for obese young people.
Sports England fund free activities in a lot of areas.
Or you tube work outs and fitness challenges? There's a great one that starts with 5 minutes of walking to music and builds up to an hour over 6 weeks.
Lower calorie treats and snacks.
The thing with the avoidance it doesn't make anxiety better it just makes it harder and harder to face the challenge next time, gentle exposure can help. Perhaps try your local mind if they are commissioned for anything for young people?
Hope you find things that help soon xx

Exercise is not the issue here... yet. I don't think you should be focussing on it at all for the moment.

Yes, it's important and she needs to build some into her lifestyle, but right now it's not a priority. You can sit on your arse all day and lose weight by eating less. And once your DD has lost a couple of stone - she will feel far more inclined (and able) to start moving more.

For now, focus on her diet. If you can help her lose a couple of stone, rather than focussing on getting her down to 8 stone and riding bikes, she will start to actually FEEL the benefit of some weight loss, and the next bit will be easier.

Tell her you are not making her diet, but you're both going to try and eating plan. Load her plate up with vegetables and salad but make sure that she can see the protein and carbs so it doesn't feel extreme.

Can you afford a cheap blender? Buy frozen fruit/fat-free yoghurt and have fun making smoothies.

Limit chocolate/crisps/cakes to a Saturday - again, do it with her and tell her it's not forever.

I know it's hard to find time to break, but see if you can do some low sugar banana bread or something for when she is desperate.

Try and keep her mind busy. It's going to be tiring, but keep offering things to do and don't feel like they have to be physical: cinema (take popcorn with you), bowling - just keeping her busy so she is not thinking about food.

You sound smart and kind and it's easy to say you've enabled her, but love can sometimes be our worst enemy. Don't be too hard on yourself.

Eating properly and doing a bit of exercise will help her mental health as well 💐

Firstly I suggested a dietician because weight loss diet could well be different for a developing teenager
Plus the larger you are, the more calories expended to move.
Any calorie deficit makes you feel hungry, weak and ill. Constantly. Plus affects sleep. With such a lot of weight to lose it's extremely challenging.
Yes ops daughter's weight should have been monitored at the 7 pounds over stage. So maybe 2 weeks of suffering to get it back to normal.
But not where we're at.