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!

I genuinely think your GP has done your DD a disservice by sending her along to Slimming World. I know it focuses on healthy eating and portion size, but it’s very “Diet Brain.” Any healthy young mind would rebel. I also don’t think the “rewards” and “points” system is logical for a kid in school to deal with, let alone one coping with everything you have discussed above. Can you speak to her school about the brick wall you’ve hit with the GP and maybe ask for more help re health and psychological referrals?

I know it’s not easy.

If you only cook the exact number if portions without any left-overs, it won’t be possible to have seconds.

If you significantly reduce treats and snacks in the house (not to nothing) she can’t eat what isn’t there.

Although she might not be happy, you cannot cave into her demands if the food just isn’t in the house to give her.

So, calculate the amount you cook to be decent portions without spares. Work out how many crisps, biscuits etc per week to allow for her to have some. It’s best to ration them out to her across a week do that, if it’s best just to let her choose when to have them, then do. Don’t keep going for top-up shops. Make sure there is other healthy food so far there is genuine hunger, food is there.

These steps can help anyone who struggles with some else isn’t here families weight or with self control for themself.

clearly the mental health issues are on going and need sorting. Sad to say, even when you finally get a CAHMS appt, it won’t be a miracle cure and you might not get much support at all. They are vastly vastly over stretched and often unless someone is suicidal or has already made an attempt in their own life, they don’t have the resources to offer much.

Dont wait until you have mental health support or a solution to start dealing with the food in the house….you could wait forever. As the adult you are the one controlling what food is in the house, so now is the best chance for your DD to get some control of her weight. Once she lives independently and buys her own food, it will be much harder.

Some great advice on this thread. One thing I’d add is that it would be good to get your sons on board with whatever eating plan you go with. My SIL was obese as a child while her siblings were slim- PIL dealt with it very badly by putting unhealthy food into one cupboard with a lock on the door, and giving the combination only to the siblings. This really didn’t help and made SIL feel deprived, ashamed and punished which in turn led to some other issues. I’m sure you wouldn’t dream of doing anything like this but wanted to emphasise that it can help to feel you’re all pulling together.

Good luck to you and your daughter xx

She does eat veg, and fruit, but just never seems full. So even if her plate consisted of mostly vegetables and proteins, she would still be hungry

This is where exercise helps. One of my daughters would eat terribly, given the chance. Lots of unhealthy grazing, then complains she feels sick, then eat doesn’t proper meals so grazes again. But when she’s swim training properly she is hungry so she eats the protein first and in quantities that means she’s not hungry shortly afterwards

Thank you for your advice, and I do appreciate the time you've taken to write this, I really do. But as I've said, I know about nutrition, it's the mental block that both my daughter and I have. I know what I need to do, I just find it so difficult because her mental health is so fragile that I cave. I know I shouldn't, and I know the responsibility to stick to healthy eating lies solely with me.

I’m obese and not judging. But, I don’t understand how a 14yo can get to this point and stay there?

Up to and at 14yo they are limited to what you have in the house. They don’t earn money so can’t use that at the tuck shop or buy themselves food otherwise. So, how is she getting this food? None of my kids were ever overweight but on the other hand we never (and still don’t) have any junk whatsoever in the house unless we are having a party/BBQ then all bets are off 😝, but that would be less than 1% of the the time. Same, if you just cook correct amount so that everyone has healthy portion size there are no leftovers for seconds! Kids don’t tend to raid the fridge when it consists of raw meat and vegetables. If someone says they are hungry after eating a correct portion size then a glass of water will do the trick.

Ive stuffed my metabolism over the years so no amount of energy in/vs out will work at this point but my kids who have grown up with the above are all fine in regards to weight and relationship with food. I can also tell the PP who said chaffed thighs never hurt anyone - nope! During lockdown I made a super effort that resulted in chaffing, completely stripped the skin off, was weeping for around 2 weeks and then one leg started to get infected. The end result was me hobbling around and doing even LESS physical activity/movement than before for several weeks.

OP it’s worth a Google for a “paediatric dietetics” service and your area of London to see if there’s a service available that you could then ask your GP to refer her into.

I just did a quick Google and found this service but no idea if it falls within the CCG for your area; clch.nhs.uk/services/paediatric-dietetics-nutrition-children-0-19
But it says they do deal with complex obesity.

I would say slimming world is not the right environment for a 14 year old. It wasn’t the right environment for me as an adult woman as it seems to attract a lot of the “loud and proud” obese women and I think you need to be a certain personality type to thrive in that environment. It would be especially difficult for a 14 year old child who isn’t very emotionally mature or confident, and also doesn’t really have great insight into the cause or severity of the problem.

I was obese in my later teens but I was also very tall (6ft) so I guess I got away with it a bit easier than a shorter teen would have done. I gained more weight as an adult and eventually got diagnosed with binge eating disorder. I got treatment for that in an ED service and it has helped me make massive changes to my life. But the single most important lesson I learned is that diets don’t work, and restriction leads to binging which leads to feelings of shame and further restriction and then more binging and it’s a really horrible self-perpetuating cycle.

I think some PP’s have said to take the focus away from restricting and put it more onto making different choices, I agree and perhaps a good change would be the order in which the meal is eaten, filling up on healthy protein first, then vegetables, and then carbs. It’s really not practical to remove all “treat” foods from a teenager (but you could certainly remove the amount available in the house), but it would be better to try to view all food neutrally, none of it is morally good or bad, nor is it a treat or a punishment. It’s just food, it has an energy value, and you can choose where that energy comes from, but some of those nutritional choices make us feel more full and satisfied and energetic than others. Attributing moral value (good, bad, junk, fattening, etc) to certain food groups is a disordered way of thinking about food.

Has she got a smart watch? Would she respond to that kind of motivation? On the Apple Watch you can change your daily targets so that you can start off small and increase them as you become more physically able. When I first got mine I really struggled to meet the exercise minutes and targets, but as time has gone on, I now get the 30 exercise minutes just doing my day to day jobs around the house and running errands.

Hope it's OK to drop in some practicals as well.

Queenieke highwaisted leggings in 2XL will fit her and be supportive and comfortable without causing the blistering that cotton leggings do. They're on Amazon and cost around the £20-25 mark. The shorts may be a little too short to avoid the just above the knee bit catching and rubbing (Snag shorts might be better if she doesn't want to wear tights with dresses). The high waist is brilliant for reducing the 'slap', as are full briefs rather than little cotton things that catch under her tummy or disappear up her behind/contribute to friction burns in the fold of her legs. They're more appealing to teenagers as they are more like the things worn by influencers on TikTok, nicer colours and, in all, they actually feel pleasant to wear rather than something to hide in and still be uncomfortable.

She's quite likely to be functionally flatfooted and vulnerable to plantar fasciitis due to the weight, lack of muscle strength and the alterations to posture and gait that the additional weight is causing - the weight of her abdomen alone will drag her forward and cause her lower back to arch, creating anterior pelvic tilt, which also affects her legs, spine, knees and ankle/foot. If you compound this with little slip on shoes or cheapie trainers from Primark, her ankles will be dropping inwards with every step and her arches will be collapsing (or tearing, as per the PF reference). This alteration in gait then means that she'll be dropping due to gravity the equivalent of a family saloon car onto her heel and up her legs and overarched spine with every step she takes. Her feet are also likely to be broader than standard width fitting due to the length of time she has been significantly larger. The entire weight will be focused upon her heel, the inside of her ankles and the inside edge of her foot. No wonder she says her feet hurt - they do and that can cause problems way beyond just a little discomfort.

Going to a specialist sports shop and getting properly fitted shoes in a size that allows her to wear orthotics - so larger than you would normally get - will enable better biomechanics and her foot to work as nature intends, which means she won't be in as much pain and it'll require less effort to move in the first place whilst ensuring that she will have less pain after activity AND also reduce the chances of injury. Brooks are a common choice, as are On shoes. They may not be Airforce Ones, but they will protect her body just on everyday activities. She'll also need orthotics for school shoes - again, the shoes have to be decent quality to prevent pain and injury.

If she chooses to exercise, other things she could consider are indoor rowing - many gyms have sessions where teenagers can attend - a cheap machine for home is likely to not be able to support her weight, whereas the limits for Concept IIs in the gym are somewhere around twice her weight. Recumbent cycling might work for her, but in all honesty, I found rowing to be far more agreeable and useful in terms of all over strength as well as cardio/fat burn activities; 10 minutes on the rower is far, far easier whilst still having good effects than a bike, treadmill or stair climber/elliptical (those buggers always strain my knees, I have no idea how people can use them, but I do have stumpy little legs). If she wanted to - and gym stuff is only if she wants to at a later point - useful resistance exercises would include the leg adduction and abduction machines, as they will strengthen muscles that she needs to walk upright. And it's sitting down again - which is a good thing when you're obese. Then she could, rather than doing squats, which are foul at any weight but damn near impossible when you're 17 stone, use the leg press so that she isn't having to shift her entire weight against gravity. This strengthens her thighs and glutes. The combination of just these three, just doing 3 sets of ten (or 8, 6, 4 if that works better for her) of a manageable weight - people often start at very small weights - would show huge results in just a month, not just in the shape of her legs, but in her strength and ability to move around.

Whilst you will hear that exercise does nothing for weight loss, it's important - it increases the number of calories she burns just existing, it reduces pain, it can make you feel better, it absolutely can make the whole process far more agreeable. And unlike school sports halls, they have aircon and in the ones I've gone to, are certainly much nicer for people of all ages and sizes than the bearpit that is school and PE teachers shouting at you.

Thank you for this info. Will look into it.

I'm glad you got the help you needed.

Yes, she has a smart watch, but it has no affect on her desire to move more. She gets in too much pain on her feet:-(

It sounds like you have been through so much and you sound like an amazing mum. It seems that you and your daughter have trauma to process, but sounds you have the awareness and determination.

Could she possibly be encouraged to join NCS the challenge when she turns 15? They are pretty hot on ensuring it is a safe, respectful environment. It’s a few weeks part-residential with fun outdoor stuff, is self esteem boosting and social. Lots of the young people who do it have their own issues.

wearencs.com

Just to say to the 'if you do not buy it she can't eat it' brigade

Been there and tried it and came down one morning to find my DGS sound asleep on the trampoline surrounded by empty jars - peanut butter and honey but also mint sauce, apple sauces, olives - he had abandoned the horseradish but other than that every single jar of food had been eaten. regardless of sweet/savoury. Luckily he is left handed and could not manage the can opener he had tried.

He has drunk entire bottles of undiluted squash and even cooking oil, milk powder is a favourite, and healthy stuff like nuts and seeds anything. I know he is extreme - and we have to be careful as he will resort to non food stuff which can be life threatening but people need to get away from the idea that this is a child sat in front of the TV crying because they cannot have a 5th packet of crisps.

If we had nothing else in our lives but dealing with his eating i am sure we would be much more successful but with other children, adults with health issues and everything else life throws at you as the OP has mentioned.....it is really not that simple.

OP - look at the Harvey Price range of clothes - these have been great for us. Also DB shoes they have very 'granny' styles but also some younger more modern ones. There is a factory shop in Northamptonshire if that is close enough where she can try them on.

I know I shouldn't, and I know the responsibility to stick to healthy eating lies solely with me

At least you're fully aware of this. OP have you been getting some counselling or anyone to talk to ?

You clearly need some help setting boundaries. I understand you feel guilty if you do not give into her wants.

Can you stop yourself from buying the unhealthy foods in the shops or are yous struggling with this too?

Its horrible to hear a child complain they are hungry 😔 but this is what's needed. Also I would stick more to food than excersice until she some loses weight as you say its painful for her moving with all that weight on her.

It has to start somewhere.

Make sure she is filling up in water all day too.

This is beyond helpful. Thank you so much!!! I feel like if I can make her as comfortable as possible, she will be more willing to increase activity which at the very least will provide some distraction from wanting to eat,and hopefully make her feel happier.

Wait to see the dietitian or pay for one privately if you can afford it.

The qualifications for a nutritionist aren't as advanced @MochaShots . In fact in theory, anyone can call themselves one.

Locks on the fridge and cupboard if food is being stolen.

Can you afford private therapy for your daughter? A psychologist or a therapist trained with adolescents? Your daughter's mental health is your first concern.
If she can find a therapist that she likes and will stay with, that will be a great support to her. The fixing of the weight may follow when her mental health is better supported. The therapist needs to be experienced with children and adolescents, your DD probably won't respond to traditional 'sit down and tell me everything' therapy.

She may like art therapy for example, could you arrange some sessions of that for her? Make sure the Art Therapist has done a specialist degree in Art Therapy and is experienced with children, and is a member of an art therapy psychotherapy association. You'd be very surprised how a supportive relationship outside of the home can have a very very beneficial effect. It will also teach that other people, besides her family, do like and accept her.

She's never full because she isn't eating to not be hungry. She's eating to change the way she feels and to swallow down her anger, fear, loneliness and to drown out the words of her father. Or to make them real, depending upon the things he would say ('you're fat and greedy and this is why everybody hates you' were the words I heard as a child. I visualised this as a little person on my shoulder nagging in my ear - and then pinged the irritating little shit off, which took away the power of their words - thanks to DP making the suggestion).

If she were 3 and demanding to go and play hopscotch in the middle of the A3, you'd stop her. If she wanted to ride her tricycle around the hanger Lane Gyratory, you'd have said no even she cried and screamed. If she had a bottle of vodka, a box of matches or a packet of pills, you'd say no and take them away.

You need to see that she is begging you to hurt her. She's asking you to abuse her. Like her father did. And for the sake of a heaped tablespoon of body weight a day over 4 years, you can and must be her parent, no matter what tears, what tantrums, no matter how much she tries to pretend that it isn't happening and you're a really cruel Mum to prevent her from self harm. You're not cruel in not giving her the means to ensure she never has a happy or healthy life and the one she does have is cut short by obesity related diseases and disability. You're doing what is right for her whilst she is still a vulnerable and dependent child.

You can do things to take a lot of the physical pain away. Take that and some of the emotional side will lessen - not all, but some of it, the bits about not being able to do anything, of being self conscious, uncomfortable in clothes, being picked on at school for her appearance. And the change in dynamic, rather than being the guilty and manipulated woman, becoming the calm, strong and dependable parent who is doing what is right for her, will also increase her feelings of security and safety. She knows that you are hurting her through caving to her demands, which contributes towards her insecurity and unhappiness. She needs to know that you are still protecting her, even when it's difficult.

Your DGS has PICA which is a little different from OP who is loading up her daughter's plates with extra portions and giving her extra treats and junk food.

Hi OP, some harsh comments here, regarding your parenting. Have you asked school for the contact details for the school nurse? Sounds like you need support to be able to support your daughter. School nurses can support with both physical and emotional wellbeing, and should be aware of and able to refer to other local services. Tackling obesity is definately high on school nurse agenda. You don't need to shoulder all the responsibility, without support. Also, what about your emotional wellbeing - have you considered seeking support for that? You usually self refer for talking therapies, there are also some free online services, for both teenagers and adults.

Chub rub shorts are an absolute must. Comfy wide fit trainers, plus size sites sell them. Don't make it a 'walk'. Go to the a garden centre, a large DIY store, a shopping centre, anywhere she'll be walking without it being 'exercise' and without food being the focus of the outing. If she won't come food shopping, you're responsible for what is there for her to eat. Ration treats to one a day. I think at this point it's better to just reduce her bad habits than try to enforce good ones. The hardest thing of all is to remain firm, and not give in. Good luck, I hope she gets the help she needs soon.

@NeverDropYourMooncup you just described my feet and ankle problems in full detail. Thank you. I have orthotics which really do help, but I think I might have to bite the bullet and find a gym kind to fatties.

@MochaShots - you sound like a wonderful mother.

I've been heavier and lighter and what has been really strange is how little conscious effort or even my day-to-day happiness has determined my weight.

I gained a lot of weight when breastfeeding - I was just so hungry. It wasn't post-natal depression, just an urge to eat as much as I could.

I have been thinner when I had more time and resources to do exercise I liked and prepare vegetables - which takes a lot of time for them to be enjoyable to eat. This morning I prepared a large spicy salad and then peeled a bunch of carrots for soup. And it is messy. People who don't live in small flats, working long hours, don't understand.

OP - I have lost about a stone over the past year without conscious effort after being prescribed ADHD medicine. It is also prescribed for Binge Eating Disorder. The meds switch off the urge and compulsion to eat mindlessly. With ADHD people have a drive to get dopamine into their system and for many that is via food. The meds aren't diet pills and I don't take them to control my weight - it's just been a side-effect. I've also been a bit surprised how little it mattered to me either way.

If your daughter has an undiagnosed condition then something like this might just be a good kick-starter.

Could she get properly fitted for sports shoes? I'm not not in the UK but there are specialist sports shoe shops that have a lot of different shoes and probably a treadmill type thing to analyse your gait (no - you run for about 30 seconds or so it's not a workout.) My sons and I all have a genetic disorder affecting the way the bones in our feet develop and we have very narrow heels that can just slip about in some some shoes and a specialist shop went to a lot of trouble and had a lot of different styles so we could get something that fitted. The only thing is that those sorts of shoes and shops tend to be expensive.

I'm wondering if she has a decent bra. Being on the small side I never bothered with a sports bra but I understand that it can make a real difference to stop everything swinging about. Again a proper fitting would be best but I can understand that she may be a bit shy but perhaps you could measure up and order something. She might be a bit embarrassed about saying something to you about this.

I suspect it's a vicious cycle and it must be very tough not having a friend to do things with. I don't know whether it's practical or not or what you faith is but could some faith based youth thing be more accepting. (You don't have to be super devout to join most of these things.) Or even a charitable group that helps others.

Thank you so much for your kindness:-)

I will look into that now. I think it would definitely help her to make friends, which would make me equally happy.

Does she like animals? What about asking around to see if any rescue centres need help walking dogs on their land and volunteer the two of you on a weekend? This might give her some purpose, build up her self esteem and get some physical activity in. Alternatively, would the GP prescribe something to help her? I don't know enough about appetite suppressants etc. to know if they are safe.