Overweight 3 year old

[123Magic]

Just done the NHS child BMI calculator and it says my 3 year old is very overweight. He weighs 19.5 kg (just over 98 percentile) and is 102 cm tall (91st percentile). His weight is something I've been monitoring for about a year and a half as he has a huge appetite and will eat and eat unless we stop him. We are very careful indeed about his diet but I suppose it must be portion sizes making him overweight. A typical day might be as follows:

Apple when he wakes at 6.

Breakfast: 2.5 weetabix with semi-skimmed milk, another apple and glass of water

Snack at 10.30: Apple or pear and 1 rice thin (18 calories) with scraping of peanut butter

Lunch: Chicken stew, new potatoes, together with unlimited vegetables (mixed peas/carrots/sweetcorn) - he eats a bowlful of veggies. Pudding is either an adult sized pot of full-fat yoghurt or a piece of fruit.

Snack at 2.30 - same as morning snack

Tea - Salmon and brown rice and unlimited green beans. Pudding same as lunch - if he's had yoghurt at lunch he has to have fruit.

I try and give him a normal sized portion and then small seconds when he asks. As well, throughout the day he might have about 4-6 raisins for various bribes. If he complains of being hungry, I offer him mixed veggies so he sometimes has additional veggies eg. broccoli/peas/carrots etc. He only drinks water at home but I allow juice at friends' houses/parties.

We stick strictly to the routine most days and don't have unhealthy food in the house. He does however have treats at friends' houses or parties and I'm not strict then as I don't want to make a massive fuss about cake/chocolate etc and make him obsessed with them. So treats probably evens out to equivalent to a couple of cupcakes a week. Also we sometimes go to a cafe for tea and the portion sizes are larger there so he might have a large ham sandwich once or twice a week. He walks one way to nursery (20 mins) every day and then on top of that I try to make sure he has some physical activity every day, eg. trip to the park. But might need to do more on that. He also swims once a week..

I've read quite a bit about children with seemingly insatiable appetite and I'm very conscious about not making him feel too deprived as that can lead to bingeing when he's older and I'm not in control of his diet but equally I feel awful at the thought that he's so overweight. He doesn't look 'fat' if you look at him but he is clearly bigger than his friends - taller but also more well covered.

I don't know what I'm asking really - I just feel rubbish that he's so big but I really don't want it to become an obsession for me or him as I don't think anxiety around food will help in the long run! Anyone got any experiences of a child like this?

It's so hard isn't it? I think you need to A. stop the second helpings...B look very carefully at the portions you're serving and C. Stop the snacks and desserts daily.

The portions many of us see as "normal" are in fact more than double what's required. 2.5 weetabix is more than my 6 year old eats...she has one. My 9 year old has 2. You could try giving him one and some berries to put on top....or maybe switching to porrige and letting him help to choose fruit for the top.

How large is his plate? Is it a child sized one?

A piece of meat for an average woman should be palm sized...rice...as big as your fist so when you then consider the size of a child's hand it's alarming how large we make many portions.

Some children could eat what you';re describing and still be a healthy weight so it's worrying and confusing ....is he drinking enough water? Does he have squash? If so, stop the squash....sugar in these drinks is high.

He's obviously eating a varied diet with lots of fruit and veg, but it is a LOT of food over the course of the day. Two and a half Weetabix is more than most adults would eat. Plus a hot cooked meal plus pudding for lunch and also dinner? It's a lot.

Also, if he has six pieces of fruit a day, it might be better than chocolate/biscuits/crisps it's still a substantial amount of calories/sugar as a proportion of his daily intake.

Travelin he has milk, yogurt, peanut butter...that's all fat. Agree that eggs are good in the morning but not daily.

Yes...too much of everything. The habit of offering kids endless snacks is in my opinion responsible for a lot of the obesity problems. Snacks weren't common before the 80s....kids had their meals and perhaps some fruit...note the perhaps....in between.

You need to increase the amount of protein he's eating in the mornings

The amount of fruit he's eating would be a concern to me both for sugar and acid levels -raisins are terrible for teeth

Scrambled eggs take a minute in the microwave so are an option for every day and are actually more filling than weetabix

How much is he drinking during the day?

If he's 91st centile for height then his weight isn't that much over. If the portion sizes are sensible then you may not be over feeding him at all. A bowl of stew for lunch isn't more calorific than a sandwich just because it's warm.

I would seek medical advice before you start restricting his food. If he's hungry and being told 'no' all the time then you may end up with bigger problems in the future.

Yes I'd say it's the portion size I'm a full grown adult and don't eat that much.

kids often do need more of things as they are growing but look at sizing stuff. my 3 year old would never eat all that I don't think my 7 year old would either. Two main meals a day it's two much how about making one of them a light meal. look at the size of his hand that's how big a portion should be for him anything bigger its too much.

I afraid it will be hard work to start with if he's used to eating that much he's already stretch his stomach. He will complain he's hungry until he gets used to smaller potions.

Thanks for the responses. He drinks lots of water, no squash. Child-sized plates. I agree re. portion sizes and seconds though - that must be the reason he's overweight. It's hard as he genuinely seems hungry -eg. yesterday, he finished his first plate and then ate an entire bowl of brocolli (eg. about 10 florets), some tomatoes and still asked for more. I think I should stop seconds but keep offering unlimited veggies (thank goodness he likes them!)

I do agree re. fruit as well - we buy special mini- apples but still it's too much :-( It's just so hard when he says he's hungry though.

Re. breakfast - do you think 1 egg and 1 small slice of toast is better than 2.5 weetabix?

Re. fat - he does have a fair amount of good fat I think, eg. salmon is very fatty and also he has full fat yoghurt.

Does anyone have any thoughts or experience on the later psychological effects of him feeling deprived? Ellyn Slater (a dietician) writes on this and says a child who constantly feels deprived throughout childhood may well then go crazy on food when they have control over it and then end up totally obese? I would be really interested in hearing from people who have struggled with their weight as adults (maybe I should start a new thread to get responses on that?). Neither me nor Dh nor any of our family have ever had any weight problems.

X posts Rogan - I have pushed the GP to refer him to a dietician. First GP said he was fine, so I went back to see another one and asked her to refer. What you say re. saying no is exactly what I'm worried about! It's so hard, I do think some people are maybe just meant to be a bit bigger and forcing him to be a shape he's not meant to be could cause problems. And I'm not trying to make excuses - as I said neither I or my husband or family are overweight, so I don't have a skewed idea of what's normal. Gah, it's so hard!

Could he do more exercise? It can help regulate appetite, raises the metabolic rate and burns calories. My toddler walks the dog in the morning and takes his bike to the park after dinner - so a couple of hours a day of being outside and having fun. Also, thirst can become confused with hunger at that age.

Hi - just wanted to say DS2 was similar at that sort of age, about 98th/top percentile for weight and height. He looked bigger and stockier than all his friends. He is now 7 and still high up the percentile charts for weight and top for height but if you look at him naked he is a bag of bones! However dressed he looks bigger/broader etc. What I'm trying to say (maybe not very well) is that if you son is tall, to be in proportion he will be heavier and higher up the charts than more average or less than average sized children and he will look bigger. I wouldn't worry too much about what he eats (sounds very healthy what you are giving him) unless he looks very obviously over weight. I really don't think what you have described him as eating is necessarily too much. As they get older they get more active and both my DSS slimmed down again by the time they were 5 and got a more boyish than babyish shape. Are you and/or your husband stocky or big boned? Could it just be his shape? I would look at portion sizes if you are worried but I would have thought if his height and weight percentile are similar you have nothing to worry about.

It sounds counter intuitive but I would cut back on fruit and increase fat and protein - eg offer cheese instead of fruit for snack, or a proper serving of peanut buttr on his rice cake. It will help him feel fuller for longer and may be what his body is after - he could be building up to a growth spurt :)

I have struggled with weight and eating issues - my parents along with other stuff really controlled my food. I was then trying to fill up on veggies and it just made me binge. By increasing fat and protein and lowering fruits and carbs I no longer binge. And I do this for my toddler - she is a very good self regulator and won't eat more than a bite of chocolate or cake when offered now :)

I have to say that I think you may be over thinking the psychological ; aspect of it. I say no often in relation to food...if a child is "over interested" in food then I would look at their activities...is he bored? Is he expending enough energy? Being entertained enough? Is he happy at nursery?

why is he having two proper meals in a day? That seems like too much unless the portions are very small?

What exercise does he do?

I would start making small changes to his diet plus small increases in his exercise to gradully change things so he doesn't notice too much

Just a tip when it comes to him asking for seconds tell him he can in 10-15 minutes by that time he properly won't even be hungry as his food would have went down and if he really is hungry then offer him a glass of water before you let him have more food

Sirzy it's not too much to have two "proper meals" in a day! Mine do....they have school lunch and then a cooked meal at teatime. They're both far from overweight but don't have snacks....ever!

they do of course have the odd cake or packet of crisps but not regular snacks as many children seem to be given.

For instance...if we go to the park at 9.30am on a saturday....they've had breakfast...they won't have a snack...they'll just wait till lunch at 12! Maybe an icecream now and then but I don't pack anything. They have a cooked meal or perhaps a baked potato, ham, cheese and salad...then go on that until teatime....when they have another cooked meal.

I think he sounds reasonably in proportion tbh. Why are you asking for a dietician referral? Are you making an issue out of something that isn't?

Assuming your portion sizes are Ok the only thing I'd say is yes to more protein, and reduce the amount of fruit as it's probably giving him sugar highs followed by sugar lows which make you hungry.

Toddlers are VERY active, even if they're at home, so he probably is burning off a lot of energy without you even realising.

His diet sounds perfect for an adult! ".2.5 weetabix really is quite a lot- I would have 2. Of course fruit and veg are much better for you than chocolate/biscuits etc but in terms of calories a banana is much the same as a penguin so I wouldn't have unlimited fruit and veg- 6 pieces of fruit a day is a LOT.
A friend of mine had a similar situation with her dd- similar age and weight but a bit shorter. She really couldn't understand it as her dd was constantly eating fruit and veg, steamed fish etc but the key was the "constantly eating" part. The advice she received was to have smaller, more filling meals and not to be too afraid of fat. For instance a small bowl of macaroni and broccoli with cheese and some ham chopped up in it would be better than a large bowl of steamed fish, brown rice and veg. I agree with pp about swapping his weetabix for some protein like eggs

I have three boys who have all been overweight at 3,4 and 5. They have a genuinely healthy diet, only drink water, and do lots of exercise. Treats and chocolate are not in the house but are eaten with enthusiasm under the right circumstances. Puddings are fruit based usually though sometimes home cooked sweetened with bannana and little sugar etc. they have all had big appetites though and although not a snacky house I haven't limited seconds of healthy food ever.

Why were they fat? Who knows they were all hugely chubby and off the scale as ebf babies, they carried on that way as toddlers, they grew upwards and into their frames. By 5.5 they were all healthy bmi, by 7/8 they were all 60% centile. The fattest is now the thinnest and the tallest by some distance.

They are athletic, do lots of sport have bags of energy and still eat huge amounts and love their food in all forms. Those posters who have children who eat little or who are adults who can't eat a few weetabix would be baffled by our house. Anyway I do believe you get family patterns, that if you hold your nerve and offer healthy food and keep upping the exercise all will end ok.

there's a boy of 6 in my DDs class...he's taller by head and shoulders than all the others and also "more covered" but not "fat". His parents are also tall and well built...athletic types...I think he'll catch up with himself....as someone said OP, there's not a huge difference in his height and weight percentiles is there...it's possible that with smaller portions and less snacks he will even out as he hits 5-6.

For my friend who has a very hungry dc the key to success was massive amounts of activity. Her dc is no longer overweight at age 9 - heavier than mine, but not noticeably overweight like they were at age 3. They do I think 6 organised sports type activities per week and my friend just doesn't use the car unless she absolutely has to. If it's walkable, they'll walk. If they have spare time at the weekend, they'll go on a bike ride. When they get home from school, they go out into the garden and play on the swings or trampoline.

Just my view but I think her dc was just born more hungry than mine. Nothing to do with parenting. I struggle to get mine to eat half a piece of salmon for tea. Hers will clear the plate then ask for more. It's always been the same from when they were weaning babies.

Haven't read all the replies (yet) but have to agree with the comment above about all the fruit. People assume fruit is great for you because there's no fat, but fruit contains ALOT of sugar which will turn to fat if he's not burning the calories off.

Vegetables, however, contain little if no sugar. I would swap his fruit for carrot and/or cucumber sticks instead. And celery if he'll eat it. Just as filling and nutritious but with no sugar.

By 10.30am, he's already had 3 apples! IMO that's too many. It wont be doing his teeth any good either. They really are sugary.

I would definitely cut out the lunch pudding too. A full fat yoghurt and piece of fruit isn't needed if he's filled up on his veggies.

Thanks for the responses. In answer to some of the questions, my dh and I are both of slim build. Dh has an enormous appetite but is very thin - so I do worry that DS has inherited his appetite but not his metabolism!

Namelessonsie - thanks v much for sharing your experience. What do you wish your parents had done differently? I will try giving ds a mini babybel instead of one of the pieces of fruit, thanks for the tip.

Well, I tried giving a smaller portion at lunch (tuna, chickpea, tomato, pepper and brocolli salad) - I gave a smaller first helping then usual, then allowed him a little bit of seconds, then said no to more. He didn't take it too badly. Then out of the blue asked for a cup of milk so I said he could have that instead of pudding which he accepted -maybe that's a way to cut out his lunch time pudding - presumably a small cup of milk is better as a 'pudding' than a piece of fruit?

I will try egg and toast for breakfast tomorrow, and maybe a mini babybel instead of a piece of fruit and cut out the early morning fruit - tbh the apple at 6 is a bit of a bribe to get him to stay in his room as he wakes at 5.30 and says he's hungry and wants to come down for breakfast.

Titchy - I asked for a dietician referral because I really struggle to manage his appetite on my own and thought there was nothing to lose by getting an expert opinion on the best way to satisfy his appetite without him gaining weight! I do vary between thinking that he will grow out of it and slim out but also thinking it's irresponsible to let him be overweight, especially as you read so much in the papers about how awful obesity is. What I really want to be like is what my parents were like with us, eat everything in moderation including treats and don't stress about it. But that doesn't seem to be working!