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.

At the start of the pandemic - which I started overweight - I put on a lot of weight very quickly; I seemed to trigger some weird metabolic thing. My waist ballooned, my neck, I could feel that something had changed in how my body was laying down fat. It sounds as if your daughter has also triggered some metabolic reaction. I agree with PP - there will be some emotional driver to the eating and the only way to address this is by looking at both the psychology and the physiology. For me it was Fast800 to reverse the metabolic damage, quickly. It’s also used by doctors to avert the onset of Type 2 diabetes.

I really wish you all the best; I imagine she is terribly low about it.

In addition to the weight management clinic, the GP should refer her to a paediatric endocrinologist. She might have genetic obesity and it would help if they were able to test for one of the monogenic (single gene) obesity syndromes as there are treatments available for them depending on where you are. She should be seen by a psychologist as part of her weight management referal

Absolutely do not put a teenager on a diet of 800 calories on some days. That could trigger the opposite reaction of a starvation ED when she sees it working.

It is recommended, and proven, to reverse Type 2 diabetes/stop it developing. Surely it depends on her age? And Fast800 is a two week sprint to kickstart better eating. Two weeks of restriction to better health surely would be worth trying (obviously under medical supervision depending on her age).

Exercise is great for health and fitness but you can't out exercise a bad diet. Your dd's issues are either consumption issues or medical.

My dd is 15 and it is such a tricky age. Mine is a lazybones and had to be practically forced off the sofa. Her diet isn't great either but her weight is perfectly ok. So i'm trying to get mine to do more for her heart and mental health.

Your dd has a different priority. In your shoes I would be silently monitoring what she is eating and, for example reducing pasta intake. I also wouldn't be frightened of pulling her up on excessive junk food intake - just in a non blame way.

Can you afford to get her some counselling to see if you can get to the root of the overeating.

In addition, she seems to have gained hugely post puberty. This was me (to a leaser extent but still). I would have her checked for pcos.

I agree. You're best finding a private therapist for this, nhs therapy just doesn't cut it.

This is also true, it's 80% diet.

So even a couple of sports sessions a week isn't going to make much impact with this kind of weight gain.

What a pp said - low carb high fat

Hard to binge if you've had a three egg cheese omelette

A diet will only work if DD is motivated to follow it. This much weight gain sounds like it has a psychological origin.

Totally agree to check for PCOS. I was an underweight teenager until 14 when my period started. Started gaining weight rapidly- diagnosed with PCOS. Everything you eat which is high in carbs will make us put on weight rapidly. Only low carb, high fat, moderate exercise helps. Now 35 and have to constantly watch what I eat.

The speed of the gain sounds like a medical issue, I would agree with getting a referral to an endocrinologist etc

Its not that straight forward to make assumptions that she has an eating disorder or there are psychological issues behind this, there isnt enough information to determine that.

I agree with others that exercise can sometimes be counter productive because for me personally it makes me eat more! That might not be the case here though

I think some of the 'reversing diabetes' diets can be very helpful and are proven to support health almost instantly. The reality is she wouldnt be doing it under 'medical supervision' she would be given the tools to do it and sent away to do it, just like any weight loss programme or plan that any of us follow or access.

The GP might refer her to a weight management group etc but thats more to motivate and get her sticking to whatever weight loss plan she chooose to use. Or sh emight choose not to engage with any of it. She needs to be at a stage where she wants to engage, is she expressing that at the moment?

For this mentioning PCOS, GPs always rule this test out if the periods are regular.
Anyone know about PCOS and regular periods?

PCOS presents differently in women. Some have PCOS with regular but anovulatory cycles, some have no periods, some have irregular, some have one period every 2-3years. Also there are overweight and lean type PCOS with hirsutism or not.

@paulapepper please buy this book. It's really insightful about how the body works and might explain issues with your daughter's hormones. All can be remedied. The author writes in a really understandable way. It's been really useful, not sure why this isn't taught in schools. amzn.eu/d/3AssOCX there's a fantastic community on Instagram. I'm not sure if the nutritionist still offers consultations but she's really interactive and I feel certain she would help you.

Slimming World was excellent for me at a similar age. Fairly non-restrictive. You could all do it together as a family? Worry about exercise later, I agree with pp that a self conscious teen isn't going to do an exercise class or go to the gym at her current weight.

Obviously you've got her best interests at heart but be careful about going the opposite way and inducing eating disordered behaviour, it is very easy at such an impressionable age

There's nearly always an underlying mental health condition that causes people to over eat for comfort. Please try and get her to talk to a mental health professional and hopefully that will push her in the right direction and give her the motivation and help that she needs.
Best wishes.

I don't think you should follow the advice of posters saying 'concentrate on dog walks' or 'don't put her on X diet as she will see it's working and go the other way.'

Of course she needs to go on a diet and see it working, that's the whole point in losing weight!
Upping dog walks, or any exercise won't budge her weight. It's 80% diet and moderate exercise at a minimum.

I agree with PP, a professional therapist and endocrinologist. It sounds like something has switched her metabolism and/or an emotional trigger.
Perhaps something like slimming world, but for the whole family so she doesn't feel singled out. Or everyone on a low carb, high fat diet. You can put her into a calorie deficit without her probably realising, as long as you make and prepare all her meals, in the hope she isn't binge eating elsewhere. Would I make her quit her job? At this point, when her health is on the line, absolutely. No question about it.

It shouldn't be hard for a 15 year old to lose weight. It will become harder and harder as she gets older. I think a very frank, but non judgemental conversation about the health implications is a good thing. There is a fine line though between shaming someone and informing them. I would reinforce the urgency to get this sorted, but doubly reinforce that you are not judging her and you are supporting her. She will probably feel incredibly insecure deep down and this can fuel the binge eating. It's not as black and white as 'she has an eating disorder.' She may have an addition to food, she may not. But if she does have an addiction you will need professional help for that for sure. She is very heavy for her age, and her weight is getting heavier and heavier. A lot of overweight people would probably wish their parents reinforced / help but a lot of parents haven't.

Also, get her off of social media if you can. That place is toxic at the best of times let alone to an insecure 15 year old with weight / eating issues.

Good luck OP, it sounds hard.

Definitely agree with getting the experts involved.

However sticking everyone on Slimming World or similar sounds like a really bad idea. At the minute 4 members of the household are a normal weight with no food issues, suddenly changing everyone's diet for the sake of one person is just likely to cause more eating disorders within the family.

It seems pretty obvious that most of her weight gain is coming from food consumed outside the house. OP can't force her to do very much and making her give up a job which gives her independence and a reason to leave the house is unlikely to help her self esteem.

OP
I don't have any advice as I am in a similar situation.
However, do not make her give up her job.
Her self esteem will be very low at the moment. She needs something that is not stressful, not body or looks related and this could be the thing that keeps her sane.
Hopefully you find something that helps you help her.

Thanks for this information.
I may try this for DD

Exercise WILL NOT MAKE A DIFFERENCE!!

She needs to cut her calorie intake.. I was there size 24 .. four years ago.. I was referred to weight management through the nhs and had a gastric bypass.. I am far from "thin" (it's not magic" but I am a size 12 bottom 14 top and that will do for me..

Do NOT have a band (nhs don't do them anyway unless you are in the chronically obese stage 30st plus range - as a means to get you to bypass surgery safely )

She may even qualify for the new weight loss injections without surgery .. whatever you do CONCENTRATE ON FOOD INPUT NOT EXERCISE ... (exercise is useful alongside but won't help her lose the weight)