Nearly obese 7 year old - what else can I do?

[Shmanmonet]

My DD is 7, nearly 8. She's 127cm and 33kg. This puts her on about the 95% percentile for her BMI, verging on obese.

I struggle to find the best way to approach this with her and to balance ensuring she eats healthily and exercises with not driving her crazy and making this into an 'issue'. I always think 'Will she thank me for this when she's older?'. Obviously she won't thank me for not trying to control her weight gain but similarly she won't thank me if I make her miserable about this!

We eat healthily at home and we're relatively active. The differences I see between her and her peers and her normal weight sibling is that:
a) She loves to eat, she doesn't seem to have an 'off' button and stop when she is naturally full, she will always notice if a meal is late, she'll talk about food a lot and she hardly ever refuses food
b) She's not naturally very physically active. She's just not that kid who runs around and it's a struggle to get her to be physical. She's not the kid racing around the playground playing footie at breaktime.
I think she really gained weight around one when she was just not moving. She only crawled at about 15 months and walked at about 18 months. Since then she's kind of tracked the same BMI percentile. I thought it might even out but it clearly hasn't and I'm increasingly worried. i did take her to the GP once when she was about 4 who just laughed basically and said she looks fine!!

My strategy with her is:
a) Fill her up with veggies and restrict carbs. I try to give her appropriate kid-sized meals and if she wants more, she has to have finsihed the protein and veggies and then only a little more of the carbs. Thankfully she's not fussy and more or less eats where we give her. I have sometimes told her no, that she's had enough. i don't know if this is right or wrong in terms of strategy. Should I be restricting more? Would that backfire? I don't want to be controlling, it doesn't feel right, but am I letting DD down by not doing more?
b) Restricting junk food at home. Is this right? Will this just make it mroe attractive elsewhere? Sometimes if we want something junky, i'll make it at home where i can control sugar, fats and portion size e.g. homemade healhier cakes, homemade popcorn for movie night, frozen banana icecream (whizzed up frozen bananas - she loves it and thinks it's a real treat like real icecream). But is even that too much if she's still obese? And what to do when we're out or with friends? Like today we were out at soft play with a friend, I bring water, an apple and a cheese stick for a snack for both of them. But then friend's mum arrives and allows friend to buy a pack of cookies. Friend of course offers my DD and they share. In this case, stepping in and not allowing would be far more harmful to DD (I think) but at the same time not helping DD's weight.
c) Fun physical activity as much as possible. We do try to get this in. I know she'd probabyl prefer to do activities that were not physically active (drama, art, robotics) or to just hang out at home but we do push her a bit to get out. She does Taekwondo 3 times a week and she does come out quite hot and sweaty so she works hard - thankfully we've found something she enjoys there as I think she likes the structure and having to think quite a bit as she's quite smart and has a good memory. She also does basketball once a week as an activity at school (which she enjoys because her friends do it too) and swimming once a week (enjoys less but swimming is an important skill). Then she has PE twice a week at school. At home, we try to get her out for at least an hour playing ping pong, badminton, cycling, walking the dog or roller blading. Again, she won't take herself out to play - she prefers to be at home playing with lego or reading a book - so we have to initiate and encourage it. I think she already does quite a lot of formal activities so probably not much more to do. But how much to force this if she doesn't want to be active? If she'd prefer to be inside? We aren't at the point of tears but definitely a lot of cajoling and encouragement is needed!

I will say that she doesn't stand out as a fat kid (but completely aware that's because the population overall has grown fatter compared with the reference population) and she does have decent physcial fitness. But I know her BMI and that she is very close to being obese, not just a little overweight, and I see her compared with her friends that she does have more of a tummy than they do.

Apologies for the long post but what else can I do to help DD? Where am I going wrong? And how do I address this issue without fucking her up (to put it bluntly)! I feel like I'm in a minefield here and I just want to get it right for her

Family style may cos her to wolf down her dinner before she's realised?
maybe plate it OP? Theres no " competition "element this way

I'd secretly count her calories for a few days and try and work out if there are any particular areas where she is getting too many calories. I'd wonder about the milk. It's so easy to drink a lot of calories.
Do you think she has a way to sneak more calories? Maybe at school,or at friends or maybe a relative?
I think it's ok to say no when a kid asks for more food sometimes. You sound like you are handling it well.

Could you send her with a packed lunch instead of schools meals?

It's such a tough one, because you don't want your children to be obese and unhealthy, but you also don't want to set them up for a poor relationship with food, so I can see why you're finding it hard. It's good you encourage healthy food and exercise, maybe use the 'fitness' angle rather than the weight loss angle, and you and in particular your husband model good behaviours, it sounds like maybe it would benefit your husband to lose some weight and try and get fit too?

Any advice regarding weight loss is about as clear as mud, even for adults! At the start of the first lockdown I was obese as was my husband, and when we heard that covid impacted overweight people more, we set about getting healthier, and a calorie deficit worked for us, eating less calories and moving more.

What does she drink? Sometimes juice/ smoothie / milk / squash can be hidden calories.
water is best

You have your answer, she’s eating too much and moving too little. She’s having breakfast, substantial snack potentially 2 lunches depending on how much seconds they give, another snack and 2 dinners.

At 7 that is a lot of food her stomach and brain are getting used to. This needs to be nipped in the bud now. Ask school to stop seconds, cut out snacks and reduce seconds at home. Plate her meals for her.

If you plate the meals for the whole family, it shouldn't develop any bad food attitudes among any family member

If she asks for seconds you tell her there’s none left. Make this true by portioning it out and freezing any leftovers / store for next day before you sit down to eat. If she’s genuinely hungry she can eat fruit or seconds of salad.

a smoothie with yogurt and nuts is literally a suggested meal for people who are trying to gain weight. I would cut that out and replace it with fruit juice and veg sticks.

I would also cut out the babybel, i wouldn’t think she needs a morning snack at all but I understand that’s something she will really notice.

Stop second portions /leftovers. Give everyone a plate and that's it. Save leftovers for another meal and /or don't make any excess.
If you have given her an appropriate sized plate she can hardly be starving immediately once she has finished it. Saying no to more when she has had a full plate shouldn't create food issues. It just becomes the norm.
Equally snacks should be small and make sure they are fairly healthy, they shouldn't be needed often). For snacks I wouldn't give her anything that's a favourite food. If there's occasional treat food then a very little will suffice- I will split a small bag of crisps between 3 children, break a snack bar in two etc.

I was an overweight child, I had no off button. I could eat an excessive amount of food and food portions were out of control. I still have problems with food now. I wish I had known what normal portions were and my options to eat excessively had been removed however I'm not sure if it would have changed much longer term. My issues are impulse control (ADHD) and sensory issues - I love eating and have to try so hard not to gain weight. Whilst being active is important for health it has little impact on weight loss if you are just used to eating too much so I would focus on how much is consumed.

OK, calm down. We are allowed a little light relief as well. She's a kid.
I'm not telling the school she's not allowed seconds and singling her out. Other kids go up and she's not allowed. That IS a recipe for disaster.

Shes not getting 2 dinners though. She wants more, she gets directed to veggies and protein. And i tend to serve her her food as she's still quite little so know how much she's taking.

Smoothie doesn't have nuts. If she has nuts, she eats them separately to anything.

So this is the problem with all the conflicting advice and why we need some professional help.
Sometimes Dd has a smoothie made with yoghurt whizzed with frozen berries for after school snack and someone said replace with fruit juice. How can fruit juice be nutritionally better? A (small) thick smoothie, mainly with protein and fat from yoghurt would seem to me to be far preferable to a fruit juice!

It's always framed around healthy eating and behaviours, never weight loss.

I should say that I struggle with this a bit because my brother was obese as a kid. And this was in the days when there were far fewer fat kids. He really WAS the fat kid of his year group (although looking back at photos he probably wouldn't have stood out SO much these days!). And I think my parents handled it terribly! I remember a time when there was a lock on the fridge! I also remember us all going out to eat and everyone got a dessert apart from my poor brother.
As he's grown up, not only has he remained obese (and became diabetic in his 30s which is one example of our bad diabetes genes) but has a terrible relationship with food.

At the end of the day, if DD remains a bit bigger but with good habits regarding exercise and physical activity and a positive attitude towards a healthy diet, then at least we're still a good way to setting her up as a healthy adult.

Yes, I am obviously concerned about her weight but I'm also concerned about making sure that this doesn't become more than that. And I have my brother as a shining example of ending up both obese AND with a fucked up attitude to food.

I hear what many of you are saying about plating up and seconds. But because of our family history, I find the more controlling aspects of trying to address DD's weight issues difficult. I can make sure there's only healthy stuff at home, in her dinners, in her snacks. But I can't help thinking she should have some control over how much she eats even if I guide her to what, otherwise I'm really disempowering her when I already make so many of the decisions here.

Excercise is great as a supplement but 90% of weight loss is from what you eat.
you need to stick to as much non processed foods as possible. Carbs yes but not pasta or refined flours and sugar.
potatoes. Meat. Fish. Fruit and veg. Nuts.
limit sugar and wheat right down.
if a friend offers a cookie or similar just let her take one. One is all you need and she need to learn restraint.
At home make treats and meals with as little processed stuff in as possible.
you can also work out her calories for her age and height. Keep a track of what she is eating and the calories consumed. You wk probably be shocked that she is eating far more calories than she needs.

We used to do family style, food at the table. Now I plate up in the kitchen, and never offer seconds. It helps all of us not to overeat - it’s just too tempting! I notice on the rare occasion that I put a dish on the table that we all eat a bit more than we otherwise would so although I prefer the ‘look’ of dishes on the table and the theory of self regulating food intake, in practice I don’t think it’s necessarily great for portion control. It might help your husband as well? I don’t necessarily refuse seconds if someone asks (my kids are older now) but the fact they have to get up and go to the kitchen just makes them pause and think properly about it.

i agree with you re yoghurt berry smoothie vs fruit juice.

And I could do packed lunch rather than school dinners. It's something I've though about. But because in primary it's included in the school fees and all her friends eat school dinners and the food is pretty good I'm reluctant to single her out. The seconds issue at school is not as bad as it could be because she often doesn't have time to go back for seconds (thankfully!)

Maybe we should plate up apart from the salad and veggies. It's going to be a very different way of eating for us though! This is how we've always eaten. I'll talk to DH as I'll need him on board for this change.

You've described a pretty healthy diet for a kid so it does sound like quantity is the issue. I think we can assume she has a good amount at school lunch given her weight and her appetite in general, so you can cut down at home on those days.

Small portions, no seconds. Can you reframe your evening meal as a light supper, recognising that she's already had her dinner that day? An easy way to avoid getting sucked into seconds is to portion up your leftovers into containers for future meals and fridge/freeze while you're serving up. Then there's nothing left to tempt people to go back for more.

Yeah, it must be down to portion sizes and getting those down.

She really does eat healthily and well compared to her friends and it's hard in today's environment where they are exposed to food all the time. And I can't see how we can put in much more physical activity without making it a burden and negative for her which I really want to avoid.

Not helped that we live in a country where they love seeing chubbier kids and feeding kids is almost a national obsession!

I’ve just read the whole thread OP and what’s standing out to me is that your dd could be eating up to 4 main meals a day.

with my kids who have a hearty school lunch, which may or may not contain seconds, they have a healthy tea when they get home from school, so a sandwich with cooked meat or tuna (no Nutella or jam) or scrambled egg on toast, it’s accompanied with 1 portion of veg and 1 portion of fruit. As mine like to go crazy running around after each other they’re allowed a treat too. Mine seem more active though, they don’t play on gadgets on school nights.

i also give my kids porridge/weetabix/shreddies with whole milk as it fills them for longer.

"She loves to eat, she doesn't seem to have an 'off' button and stop when she is naturally full"

You really need to stop giving her seconds. You can call it 'directing to protein' or whatever to make it sound better or justify it to yourself but it's really not needed at all and could be making things worse. A lot of the eating problems seem to boil down to you never wanting to say no to her. I don't think my son has ever had seconds and it hasn't caused any weird control issues in him that you suggest earlier in the thread. It's not necessary, sorry.

I'm going to agree with the suggestions not to give seconds. It's not a question of autonomy, it's habit. She likes feeling full but needs a little help to re-educate her stomach.
Give her the amount of food appropriate for her needs and that's it. Not more. At 7 these are still your decisions not hers.
Thirst can also be misread as hunger, so make sure she's drinking enough water.

It sounds like you are doing a great job OP.

I would access a dietician. Obviously the goal is for her not to gain weight rather than loose it, but this will give you confidence it’s going in the right direction.

I think your main issue might be school dinners - can you send her in with a packed lunch?

Other than that the things that stick out are not plating up at dinner time (this encourages everyone to eat too much), drinking milk - check w the dietician but this is probably unnecessary calories so I would slowly phase it out, I would also watch the after school smoothie - nothing wrong with it as such, but easy to put too many calories in. She also perhaps needs to eat a bit more at breakfast so she doesn’t get too hungry pre lunch.

If you can get her day to day diet right you won’t need to worry too much about the occasional things. It doesn’t feel that you can do too much more about exercise than you are - other than make sure she does something active each weekend day eg bike ride, swimming. If she can walk or bike to school that’s great but obvs may not be possible.

See what the dietician says but I’d have thought it’s ok to talk about the importance of making healthy food choices as long as it’s directed at the whole family (sounds like your husband could use it) and not overemphasised.

You are doing a great job so hold onto that, and remember you can’t change who your daughter is - she sounds like a great kid, so a bit too much enthusiasm for eating is just part of the package (for now anyway) - all you can do is create a bedrock of healthy choices which you are doing.