Very overweight teen

[paulapepper]

My daughter (15) has always been overweight despite our best efforts. I have two other children who have never struggled with their weight and my husband and I haven't either. We've always been very active, but it's getting harder and harder to get her to join in because her weight is affecting her fitness so she finds it difficult to participate and is clearly very physically strained doing anything beyond a gentle walk. Until 2020, she was holding fairly steady on the centile chart (around the 94th). By the end of 2020, she hadn't grown in height, but had gained a stone (to 9st 11lb) and climbed to the 97th centile. By the end of 2021 she still hadn't added to her height but gained another stone (10st 11lb), now in the 98th centile and classed as very overweight. We felt, alongside her GP, that her weight would settle now COVID was not disrupting her life so much. We were wrong. By the end of 2022 she had gained 2st 1lb (now 12st 12lb) and nothing in height and was firmly in the 99th centile. She had a GP appointment two weeks ago and I was shocked that her weight had gone up to 15st 13lb. I knew she'd gained, but to see it in black and white was horrendous. She's only 5'2". Her blood pressure was 136/91. Her heart rate was 118. They took bloods. We had to come in for another appointment this week because she's on the cusp of developing type 2 diabetes. They weighed her again and she'd gone up to 16st 4lbs. I couldn't believe it. We keep the kitchen stocked with healthy options, but that doesn't stop her overeating. She has a part time job and earns around £30 a week. I'm sure it's mostly spent on junk food based on rubbish I find in her room. Should we make her quit her job? That feels extreme, but her health is spiralling and she doesn't seem to want to change.

sorry for your situation.
did they check her thyroid?
what does the gp suggest?
does she take any medication that can cause weight gain?
do you consider to sign her to some sports classes/clubs?

It's going to be a struggle to get a 16 stone 15 year old to do a sports class. She's going to feel massively self conscious and she's going to be limited on what she can actually do.

Is she open about being overweight OP? Does she want to do something about it? I wouldn't stop the job because at least it's getting her out, doing something. If she quit the job she might have less access to junk food but may just sit at home eating what's there.

Can someone talk to her about the impact having Diabetes will have on her. I think that's the only thing that will make much of a difference at this point.
Clearly she is getting a huge amount of extra calories from somewhere and upping her exercise a bit through walking or cutting down on snack foods at home won't make much of a difference.
Definitely worth getting her thyroid levels checked as that's a huge amount to put on if you're eating relatively healthily at home.

What kind of discussions have you had with her about it? How does she feel? Having been an overweight teen, you almost feel "well, there‘s not much I can do about it now its gone so far, so I might as well eat another packet of crisps to make myself feel better". But my parents never addressed it at all, I just joined my mum on a diet when I got a bit older. Nutrition was never spoken about either. I do wish it had been addressed earlier.

It‘s hard, but it might be worth seeing if she can pinpoint a reason for it. My niece (now in her 20s) was also overweight as a teen and still is very overweight as an adult, and she suffers a lot with her mental health. I don‘t think making her join a fitness class is the right move at this stage though.

1. Is she actually overeating or is there a medical reason for her weight gain?
2. Does she have binge eating disorder? If so, she needs psychological help which will focus on exploring why she binge eats and gives her tools to manage her emotions in healthier ways than eating. Due to CAHMS waiting lists, you may have to pay privately for this.

That's very hard for ye both.
I think it sounds like it's time for a frank discussion with her. Tell her you love her but that you're worried about her health especially if she continues to gain. Ask her if she is open to trying to lose some and that you will support her in every possible way if she wants to!

I'm sorry, this sounds tough

What does she eat in a regular day? £30/week isn't enough to eat that much. Do you have meals togetjer as a family? Does she eat what the rest of you do?

What do you usually eat at home? What type of meals?

I was overweight in my early teens, felt so ashamed and disgusted with myself, went the other way and ended up with anorexia, spent my 18th birthday in hospital. It wasn't fun.

I tell this story to say that your daughter is probably very aware of being overweight and exercise classes and chats about diabetes will probably make her worse. And when she feels down about herself, she's going to seek comfort in food.

In my view emotional issues underly eating disorders, whether that's binge eating, secret eating or restricting. So my opinion fwiw is to be supportive and loving and empathetic and work with her to find out what's going on emotionally that is causing overeating. Lockdown was so hard on so many young people. Do please signpost that you want to work WITH her, not TELL her what she's doing wrong and what she SHOULD be doing, as that will make her feel attacked and will make the problem worse.

Has she had any counselling? This sounds like an eating disorder, and would really benefit from a proper professional who can help her and also give advice to the family on how to best support.

They checked her thyroid when they did the blood test and it was normal. The GP is referring us to a weight management clinic at the hospital about an hour from where we live due to the health consequences she is facing. She is not on any medication. She refuses to take part in PE at school (even though that lands her in detention). The only exercise we can get her to do on a reasonably regular basis is walking the dog.

Sorry to hear this.

What does your daughter say about her weight? Does she acknowledge what is going on to you or is it a hostile situation?

It does sound like her body reacts differently to food from the rest of the family and that she's now addicted to junk food. Could you afford to go to a private nutritionist? Or pay for hypnosis?

She tends to put up a tough exterior when it comes to her weight. I could tell she was really bothered when we went on holiday this summer and she had to have a seatbelt extender on the plane. We had to go clothes shopping recently as even her stretchiest clothes were obviously too small (an activity she resists until unavoidable) and it clearly bothered her how difficult it was to find clothes that fit that weren't frumpy. She carries most of her weight around her belly and ended up needing size 22/24 in most shops.

Oh poor kid 😕. To put on half a stone in two weeks means there is really something going on for her.

Has she had any therapy or counselling? I agree it will likely be a symptoms of something else that's bothering her, or an inability to find another way to deal with her worries.

She's probably filled with shame and that makes her feel worse and defiant and defeated.

If she'll walk the dog will you go out together each day for a long walk? any movement is good.

Yes id say she probably needs counselling/therapy to either get to the bottom of why or to help with feelings of shame, anger etc.

Grab the referral to weight loss clinic with both hands! They have a lot of experience with dealing with this sort of thing, and will stop her feeling so isolated. They can refer to specialised counselling (and prescribe weight loss drugs if needed)

I really do feel sorry for both of you. I agree with the other posts regarding therapy. Something is bothering your daughter and she reacts by overeating. It's nothing you have done wrong as a mother and a family unit. It's a habit loop that could be broken. Unfortunately for some people food acts as an addiction. Does your daughter like reading? Unwinding Anxiety by Dr Brewer has helped me a lot. His methods work for all sorts of bad habits and addictions by paying attention to your body is telling you. If she doesn't reading I have another book in mind. I will find the exact title and post it later today. The advice is only 3 pages long and it really helped me too

@Dramatico I'm fairly sure she has issues with binging. It feels like such a fine balancing act, I can see that my child is drowning. My husband and I are thinking about finding the money to get her support privately if the NHS waiting lists are too long. It's obvious she needs help now. It will be a stretch, but it may be something we need to do.

Secret bingeing is HORRIBLE for the sufferer. I did it a lot during my BED and again at points in my AN recovery. It just makes you feel so isolated and ugly and adrift.

There is a much better understanding these days of BED than there was when I was ill back in the early 90s, maybe you can find some books written to guide the families of sufferers? I do think that you need to address the mental issues as the weight is only a symptom of the problem it is not the problem itself. let your daughter know that you are there for her and more importantly that you do not judge her as BED sufferers already feel huge guilt and self-hate especially if they are in a fit family or friendship group.

Edit to add that finding the money for private treatment would be an incredibly important investment in her entire future. Eating disorders can really wreck all areas of your life if left untreated and allowed to progress.

Eating is usually a reflection of how we feel about ourselves. There is absolutely nothing you or the doctor can say that will make her suddenly switch to a healthier lifestyle without it having other nasty side effects imo.

Instead i would focus on the small glint of light that she is happy to walk the dog. Is this something she can focus on? Longer walks, family walks, new locations, beach walks etc. Is the dog up to going to agility classes which your daughter might enjoy. Could you and her do it together? Could she earn some money doing dog walks for others?

I was overweight until 12 months ago. I have made a huge effort to lose weight and everyones way of doing it will be different. But i found my walks with the dogs have gotten faster and longer the fitter i have gotten and have been a huge help in the weight loss.

I would take her to a therapist who deals specifically with eating disorders

When you break down the numbers for her weight gain since the end of the year, she's probably over eating by 500-600 calories a day. Two chocolate bars and you're there, it isn't a vast amount of food really.
I was an overweight teen and am still an overweight adult, although I mostly keep it in check. I wish someone had dealt with it when I was younger rather than just say "well there's healthy food available in the house". Why would I have a pear when I can eat a donut? I was made to finish my meals even when I was full. I had no control over my own portions and no one knew what a healthy portion size was, I was the only child who couldn't "burn it off".
If you are eating meals as a family then you can start by learning what a portion looks like and making sure that size is served. If everyone is eating the correct amount then you are all equal, no one is being deprived.
I would also look at getting some professional help for her to get to the root cause of why she is eating more, if that is the cause and it isn't something else. Speak to her, ask how she is feeling and say that you want to help.

Further to the earlier message, here is the link to the 2nd book. It's very expensive new as it;s now out of print. However cheap 2nd hand copies are also available - look under used section I found a section on eathing disorders very small and very helpful https://www.amazon.co.uk/Positive-Living-complete-positive-thinking/dp/0749926031/ref=sr_1_11?crid=2HGNGIUEQC0D&keywords=positive+living&qid=1693913321&sprefix=positive+living+%2Caps%2C195&sr=8-11

At the risk of getting a lot of hate - I don't think exercise is key- you can't put run a bad diet. Low carb high fat? Means you can still eat sweet treats if you use a sugar substitute.

I just came on to say this. exercise is great for self-confidence, endorphins etc, but it won't make her lose weight.

I do think getting the experts involved is the way to go at this point. I also wonder if she's checking out these body positivity influencers who are encouraging people to be accepting of their weight, which in some ways is great, but in others means people can be setting themselves up for all sorts of health complications.

If the rest of the family- including DCs - are at a normal weight, then it suggests very much that it is specific to DD rather than what is being fed at meals.

It's great that she will do dog walks- as much for the psychological benefits of fresh air and being outside as well as keeping some sort of mobility and base fitness. It sounds like she is beyond the point where joining acquafit of zumba will make any difference.

Does she have friends and a social life ?