Overweight child - help needed!

[Cheescake3303]

I've posted before about this and took on board everyone's feedback but the situation is now worse and I don't know how to approach it.

13yr old DS is overweight, always been a bit on the larger side but its getting worse. When I asked before everyone reminded me it was in my control and I had a really good think about portion sizes, food type etc and we made some changes.

I thought we were on the right track but his weight is going up. It's now become clear he's swapping helping friends with homework for food and also stealing food from out cupboard. (We don't have crisps/chocolate or anything, it's things like bread).

He's obsessed with when he will be getting his next meal and what other people are eating.

I know the advice is never to make an issue if this but it's really concerning and I don't know what to do - would appreciate any advice!

Not your fault, not his fault. He's got to the point of being addicted to food/eating. I don't have a solution I'm afraid (I'm bulimic so same addiction) but I'd suggest looking into eating disorder help.

Thank you - I was thinking have we got to the point we need outside help but seems to go against the not making a big deal of it which is where I'm struggling. I just feel so sorry for him, he's active and most likely still eating a lot less than some of his friends who are like weeds 😥

You need to get to the root of his association of food with something emotional going on. Can you speak to the gp about this? It's not your fault.

The thing about not making a big deal is to try and prevent a problem situation

But when you have a problem you have to recognise and deal with it

So it's ok to try and get sone help - it's the right thing

Sounds like it would be a good idea for you to see the GP.

Yes I would second seeking help now from the gp. However they are likely to be useless, so I would also look up children therapists in your area who are much more likely to be able to offer actual help.

Thank you all. I don't think there's anything deeper going on but with teen I suppose you never know. We're seeing the GP in a few weeks about something unrelated but he hasn't needed to see a Dr since a toddler so I'm wondering if they will say something anyway. If not I think you're all right and time to get some help. I had a complicated childhood relationship with food which I got from my mum so we've tried so hard to never pass anything on to him, but something has gone wrong somewhere 😥

This is so tricky. There could be underlying reasons and it would be worth ruling these out. Both ADHD and Prader-Willi syndrome can cause hyperphagia - that feeling of never being full or satisfied - of a total disconnect between hunger and appetite. As PP have said, so can MH compulsive eating disorders such as bulimia.

He is old enough to have a proper discussion about it. Not at all about being fat. Don't mention that word. But do say that you know he is doing homework for food and that this isn't a healthy attitude to eating or to his body and that you are concerned he might be a bit addicted to sugar. Explain how this can affect him (without discussing weight) - point out it can cause energy dips and mood swings, cravings that aren't linked to hunger, poor teeth and gum disease which has been linked to serious illness later in life, like cancer.

If he mentions his weight, just say, 'That's not the issue at all, because you're still growing, so you will grow into your weight over the next few months. That's normal. But we do need to look at your health.' You could then ask if he is worried about his weight and if he is, say he shouldn't lose weight but if he wants to get fitter, you'd love to join him.

Maybe use the Easter holidays to focus on a healthy eating (NOT weight loss) diet which builds muscle - get him trying loads of different veg and meat, fish, eggs etc, cooking with you. Maybe get him some dumbells so he can train and enjoy that feeling of strength. Pick some goals together with a big reward at the end of them - swimming once a week until you can swim a kilometre without a break, or a mile. Cycling a 15 mile tour, hiking for a day.

Once he starts caring about his health and fitness, his attitude to food might shift. It did with Ds and this is the perfect time of life for it to happen, as growth spurts will help him.

Don't forget to look at what he is drinking as well as eating. A huge amount of calories can be added with soda. And if he is drinking stuff with artificial sugars that can stimulate appetite.

Can I ask how much he weighs and how tall he is? What percentile is he for his age? What size clothes is he?
He sounds hungry - could he just be a growing boy fuelling up for a growth spurt??

Sorry - I just wrote a bit of an essay already but I really don't agree with seeing the GP. That turns it into an 'issue'. A 'problem'. He could get very self conscious and develop more secret eating patterns. I really think the best way forward is to ignore weight and focus hard on healthy eating, fitness, weaning off any sugar cravings, enjoying an active lifestyle, good self care of his body. And play down the weight. It's not about weight, It's about nutrition and body-care. The weight will stabilise as he grows. Please don't make a thing about it by dragging him to a GP or putting him on some diet.

Thank you this is great advice. He loves healthy food as much as treat food but we don't get him involved in the cooking. We have salmon for tea so will ask him to help and maybe start the conversation there. We bought dumbbells for Xmas but are gathering dust. I want to do couch to 5k so will ask him to support me in that, plus a good chance to chat about things

If he's eating his regular meals and you don't buy crap like crisps and chocolate biscuits all you can do is up his protein as it keeps you feeling fuller for longer and cut back his carbs very slightly. Offer more vegetables with his meals. Leave healthy snacks like cucumber sticks or carrot sticks in the fridge for him. Buy lots of apples he can munch on. I buy my foster son chicken breasts. I will cut them in half and cook them and he'll snack on one of those and carrot battens as soon as he gets in from college. If he's still hungry I offer an orange or an apple. You've tried not making a thing of it but he's just getting heavier. He needs professional intervention now. I'd make an appointment to see your GP practice nurse and ask for a weight management programme for him. In the meanwhile could you increase his sports like swimming lengths or running. I've got my teen using our rowing machine for 20 minutes before breakfast every morning. He eats scrambled eggs and plum tomatoes on toast because that's a hot filling food to keep him going until lunch time but he has a banana in his bag he can eat at break time. Also cut back on fizzy drinks unless zero versions as there are so many calories in normal ones.

Thinking on obesity has changed. For some people, no amount of diet management (although it will ultimately form a part) will make a difference.

You need referral to a specialist endocrinologist who is experienced in obesity management.

For some people, the 'eat less, move more' principle is incorrect, in fact, harmful.

It's now understood that the genetic & hormonal causation is predominant for some people - either leading to a desire to eat, lack of satiety or inability to lose weight despite following a diet / exercise plan.

The new drug regimes are now licensed for children over 10 and appear to be considered the best route.

Look up 'Donal O'Shea' who is Ireland's HSE Clinical Lead on Childhood Obesity. He has lots of interviews, and print articles explaining this.

Personally on an intuitive level, I find this hard to reconcile, and would have been like you OP, regulating / managing diet etc but it's clear there's a underlying medical issue that needs to be addressed in many cases.

Sorry I don't know how to reply easily to each message without it pasting it all 🙈 we don't weigh him but he's in age 16-17 or mens small and about 5 foot 2.

He only drinks water or squash, doesn't like fizzy drinks. The only food we allow freely in our house is fruit and veg so he always is always allowed those as snacks.

We only ever talk about being strong or healthy and fueling our bodies so will continue to do that.

You've all given some great advice, I think I'm going to start running with him today, and see how we go over the next few weeks. I am going to speak to him about taking food for homework as that's probably a separate issue anyway as he's not actually helping his friends in the long term.

He sounds hungry! I don't know his weight/height but I would go the complete other way and feed him MORE! Lots of fat and protein to fuel him rather than carbs which would just fuel his hunger as they are burned up faster. Focus on nutrition, proper food to fuel him (eg don't get sucked into 'low fat' diet food which is just full of sugar), and good habits around mental and physical health.
I would worry that if you start to restrict food or focus on his 'problem weight' then that will lead down a more challenging path for you all.

Prader-Willi syndrome can cause hyperphagia

People always like to mention PW syndrome on threads like this.

That's nonsense, to be frank.

Prader-Willi syndrome is a rare disease, and a genetic multi-system disorder, with very clear symptoms including low muscle tone, failure to feed as an infant, physical characteristics, as well as the compulsion to eat. OP does not have a 13 yo with undiagnosed PW syndrome.

rarediseases.org/rare-diseases/prader-willi-syndrome/

It's very very unlikely this will happen in this case.

OP's DS does have a medical issue. And that's what needs treating.

To be clear, of course healthy eating and exercise is important. That's needed for a whole host of reasons not just weight alone.

But it's unlikely to really address the weight issue alone.

I suspect the challenge in the UK might be getting the referral in the first place (same issue here, but we have the option of a private referral if you have health insurance, which most people do).

I would be v careful here. I have a young teen. When he was 11 he became so hungry. He was literally piling a massive plate with food in the evenings after eating a normal meal. He became visibly chunky/slightly overweight. I was worried he was developing a problem with food and would become an overweight adult.
He then grew in a year and a half from 5ft to 5ft 10. He is now extremely slim again. In his case the fuelling up and eating came before the growth spurt.
I have no idea what is happening with your son, but wanted to give my experience.

*It's now become clear he's swapping helping friends with homework for food and also stealing food from out cupboard. (We don't have crisps/chocolate or anything, it's things like bread).

He's obsessed with when he will be getting his next meal and what other people are eating*

This doesn't seem to me, to be a normal, healthy attitude to food

I'm no expert, but if you can't stop this obsessiveness, I think you need to try tofind out why it's happening

Her DS has always been overweight. That's a different situation.

He has no ability to regulate food intake to the point of stealing it & trading it for homework done.

That's a level of compulsion that may have an underlying endocrine issue.

"most likely still eating a lot less than some of his friends who are like weeds "

What makes you say that?

Have you a belief that he's just unlucky and somehow puts on weight by eating less than his peers?

We can’t know that for sure though can we? I hope OP doesn’t take offence at this, but theoretically she could have an unrealistic idea of what is overweight.

I find it hard to imagine a 13 year old boy being seriously overweight in a home where he eats healthily and only has access to fruit, veg and bread as snacks.
Even if he’s being given junk by friends (presumably crisps & chocolate), that’s hardly unusual for teens.

The teens I know who have a serious weight problem eat fast food regularly at home and have eaten sweets and fizzy drinks in large amounts daily for months / years.

I’m not saying that I don’t believe OP, only that we don't have enough information to proclaim confidently that her child has compulsions or a medical problem. He might literally just be hungry!

Thanks for the replies, I am reading them! He's definitely overweight to look at and compared to his friends. Within his friend group he's always been a bit larger but the boys of a similar build have noticeably slimmed down as they grow but DH isn't. He's the largest within his friend group.

His friends have money to buy snacks everyday and I've witnessed them buying several family bags of chocolate and eating them, DH doesn't have a bank card or money so has no access.

His diet with us is a smoothie for breakfast (his preference as he would rather have breakfast on the way to school) he has school dinners which we monitor and he only ever picks one main and then a dessert a couple of times a week. I remind him to make good choices for things that will fuel him and keep him full but school is out of our control. Potentially we could go back to packed lunches but all his friends have hot dinners so feels like a punishment.

At home our meals are pretty normal, mainly home made things like Bolognese, tuna bake, chicken and veg, salmon and jacket. He always has access to fruit, carrots etc and eats a lot of those so can't see how he's be hungry. We are careful not to give too large a portion so is probably about 1/2 to 2/3 or my meal

Yesterday I found an empty family bag of Doritos and family mini egg wrappers in his bag that his friends had given him.

Taking him for a long muddy walk in a bit so going to try and chat a little without prying to see how he is feeling