My child is overweight

[NickMyLipple]

Hello!

Looking for advice and suggestions - my daughter is 6 years 5 months and is overweight, but this is proportionate to her height. She's 134cm and 37.6kg.

She's quite literally off the centile charts for both height and weight, but they're tracking on similar lines (if that makes sense) and the NHS BMI checker suggests she's "very overweight".

She is an excellent eater and eats pretty much everything. We cook from scratch every day at home and she goes to a liberal school and has a very home-made healthy lunch every day. (She doesn't actually like typical children's food like chicken nuggets/fish fingers/potato waffles!)

She definitely eats too much (she can probably out-eat me for most things) but if she has smaller portions, she will complain she's hungry.

A typical day would be:
Breakfast - crumpet with marmite
Snacks - apple and a couple of bread sticks
Lunch - budha bowl (rice salad, veggies and protein)
Dinner - stir fry with rice/noodles, broccoli and green beans
Snack - yogurt

She isn't a big snacker in between meals but we are often out and about and when she does have a snack it will be stuff like crisps, a sandwich etc.

We don't limit chocolate particularly but she does have leftover Easter eggs which are broken up and she might have a couple of broken bits of chocolate every couple of days.

She does a dance class once a week, swimming once or twice a week and we go to the park/outside running around type activities every day.

I'd like to support her to recognise that being overweight is really hard in many aspects and encourage her to eat less and make healthy choices with food. My partner is losing weight for health reasons so our family already have made lifelong changes to how we fuel our bodies, but my daughter has really grown in the past few months and she's significantly bigger than all of her friends. I obviously can't make her get shorter, but I'm keen to hear from other parents of children who've struggled with their weight about changes they've made and how we can support her to recognise the long term benefits of being a healthy weight.

Thanks!

Breakfast - crumpet with marmite
Snacks - apple and a couple of bread sticks
Lunch - budha bowl (rice salad, veggies and protein)
Dinner - stir fry with rice/noodles, broccoli and green beans
Snack - yogurt

First you need to be realistic about what she's really eating. There is absolutely no chance that a child (or adult) who eats this diet on a typical day will end up overweight. You follow this by saying she does snack on crisps or chocolate, but she only eats a few pieces of broken easter chocolate every few days. That doesn't sound very plausible.

MN food threads often start like this and it's clear why there is a weight issue because the OP is in complete denial about what they or their children are truly eating. The "we love to cook healthy meals from scratch" is usually a euphemism for a family where most or all members already overweight.

You need to start reducing portion sizes, eliminate seconds and get rid of dessert. Nobody has died from eating until they were 70% full, and then stopping. If she already has such a big appetite from such a young age, it will be a curse for the rest of her life. The aim would be to get her accustomed to eating below the point of feeling stuffed. If you've already had a plate of food, it's not possible to still be ravenous. Some children mistake the feeling of being only 60-80% full with hunger because they are so used to being 100% stuffed from birth.

It's also perfectly normal for children to eat junk food. Virtually every child I can think of even from the healthiest families would probably have something sweet every day, whether it's an ice lolly, a cookie, a slice of cake etc. The issue there is to reduce it to the smallest possible portion size. Children don't need adult sized slices of cakes or a full sized chocolate bar. If they want something sweet for the craving, offer a mini fun-sized package or half of something.

I would get her checked out for metabolic issues as it’s sounds like she has a balanced lifestyle. Is she an anxious child that perhaps uses food as comfort? Does she drink calorific drinks? With her portions, I would emphasise eating slowly preferably with protein first so her brain recognises she’s full. I would advise also try to add in a walk/scooter to or from school each day if possible. Habitual walking is something she will carry through life and help keep the weight off. But I think she’s too young to put too much emphasis on adjusting her own actions. You just need to drip feed the health eating messages but it seems like she’s not eating unhealthily anyway.

Can you see her ribs? I’m a bit confused by all the height references.

A child that age might have a slightly sticky out belly (taut not flabby) but you should be able to see their ribs.

I’d make sure you have no biscuits or snacks in the house and stops buying snacks outside of it. Take or buy bananas or cheese or crudités for you all to have in reserve for if you are hungry.

Finally adjust portion size and is she eating too quickly to register that she is sated? If you don’t already, make sure you sit down together to eat and chat and eat slowly with the TV off and no devices (for any of you). Eating can get automated and speed up if we do it engrossed in something else. Chatting slows you down as your mouth is otherwise occupied, hopefully.

I would be trying to drop snacks. DD is on the top end of the healthy BMI and pretty active (6hours of organised sport plus normal activity). She also has a healthy appetite. She broke her leg and gained weight really quickly despite eating less than usual.

Try going for protein at breakfast and drop one of the snacks. If she wasn’t a good eater or only had small portions she would need snacks. My DD inhales her food at lunch and dinner and has been know to out eat her dad so I’m slowly reducing snacks to try to get her used to three square meals a day given that she eats really well anyway.

If that's what she's really eating, it's generally quite low in fat and possibly low in protein, though you haven't specified what and how much. Both of those nutrients help with satiety (feeling fuller) as well as providing essential nutrients. Children's nutritional needs are not a scaled down version of an adult's.

BMI charts are for adults.

@User7842462 is completed wrong about that. I would end up fat on that diet.

Way too many carbs, not enough protein and fat!

I'm also confused, because her diet sounds super healthy so why is she so heavy? When my tall child was this height (he was a few months older than your DD) he weighed nearly 10kg less - and he was a normal size, not very skinny. And she sounds pretty active too. There must be something else going on here?

@Lifeinlists there are BMI charts for children, they are different from the adult ones.

One thing though, she is very tall so I would try to aim for holding her weight steady rather than reducing it. She may still have a lot of growing to do. I think it’s also worth just checking her thyroid etc as well, make sure she’s physically fine.

I would say snacking is probably the issue if you are already eating decent sized meals. I wouldn’t reduce the size of those just yet, you don’t want to leave her hungry, just a gentle reduction in the number of times she’s eating.

Portion size is key here. Also try swapping out the white bread, pasta etc for the wholewheat version. Up the protein, reduce the refined carbs.
If she eats a full plate, she's not still hungry. Make her wait 20 mins (maybe help with washing up etc) then offer an apple.

Ignore the charts for a moment and have a look at her body. Can you see and feel a layer of fat on her? If so then you can very very slowly gently give her less calories.

It might only need to be a small amount less but she will then grow into her height a little more.

Her diet seems like she would loose weight so I guess it's portion control. 'Snacks' when you are out might end up being more than you think.

There are plenty of people who eat 'healthy' food that are overweight

Children that are significantly overweight often tend to be taller. They won’t be any taller as adults but they tend to reach their adult height sooner. So unless you and DH are very very tall that could be what’s going on with her height. Her diet strikes me as quite lacking in protein but heavy on carbs so that might be why she needs such big portions to feel full. Also why is she having a sandwich, which is a meal, as a snack? And are you sure you’re being entirely honest about her chocolate/sweets consumption? I don’t understand how she has easter eggs left in July, especially if she’s eating some every couple of days?

Portion size and snack elimination sounds like a good place to start. Does she eat an adult size meal? She shouldn't - portion size is about the size of her closed fist for carbs and for veg, and her palm size for protein. If you use adult size plates it's easy to dole out too much. You might have to put up with some grumbling while her appetite adjusts.

Agree with others. Small changes will make a difference as she is growing. More protein and watch portion sizes. Priorise food that is low calorie density with high nutritional value - salad and vegetables rather than white bread, rice and pasta (although she will need carbs). Make sure she is drinking enough water.

Sounds like she is an outlier so the charts will be unhelpful to you. She should be having an hour of physical activity a day, including walking to school, playing in playgrounds etc.

She isn't a big snacker in between meals but we are often out and about and when she does have a snack it will be stuff like crisps, a sandwich etc.

A sandwich seems like quite a big snack - it's a lunchtime meal. I wouldn't do a sandwich for my 5 year old as a snack.

You also mention the chocolate, which seems to be a snack? I think possibly if you actually went through a day and wrote down the food as you gave it to her, it would be a bit more than you think.

I think with all of it (snacks and meals) portion size is probably what you need to look at.

If her height is equally off the chart, I wouldn't worry at all!

She shouldn’t be overweight if eating what you described above on a typical day. However she could be if the portion sizes are way off. What snacks exactly is she having each day? There must be more going on here than that meal plans. How many crumpets for example? How many portions of rice?

A typical day would be:
Breakfast - crumpet with marmite
Snacks - apple and a couple of bread sticks
Lunch - budha bowl (rice salad, veggies and protein)
Dinner - stir fry with rice/noodles, broccoli and green beans
Snack - yogurt

That sounds like a fairly healthy and balanced diet. You must be giving her really large portions and use lots of oil in the your cooking for her to be really overweight! Are you sure she eats like this most days?

OP, in the nicest way, are you sure she's on the same line for both. I only ask because my son is older, but 152cm and a very similar weight, and his weight is slightly above his height, so I'm confused as to how a shorter child can be on the same line at that weight. I will also add, my so is a big chubbier than he'd ideally be at the moment, which we are working on.

Like others have said, I'd certainly consider whether this is actually what your daughter is eating, and perhaps take the snacks out, or replace them with a piece of fruit if she really wants something.

I'm also wondering how active she is? This makes a huge difference to my eldest child's weight. We find he needs to exercise several times a week (currently does triathlon, hockey, running and swimming), plus we often cycle as a family and walk the dog most days. Children need a lot of exercise, which can just be playing at the parks, jumping on a trampoline, riding their bikes etc, but I think it's often underestimated.

This is not really true.

Her height and weight can't be off the chart by the same amount as the BMI calculation would allow for this.

I'd like to support her to recognise that being overweight is really hard in many aspects and encourage her to eat less and make healthy choices with food.
Please don't do this, you'll be setting her up for an eating disorder. She's 6. You can make changes gradually as part of being healthier as a family, reduce portion sizes, substitute lower calorie things like more vegetables, there's lot of ideas above, but she's 6, she she shouldn't be focused on and worrying about her weight.

I have a 17 year old teen son and a sandwich is a satisfying snack for him.

As pp have probably said, is she drinking calorific drinks ? Does she go to another family member’s house (dad, grandparent etc ) where they feed her very differently ?

Your daughter is really tall for her age. My daughter has always been really tall and she is now 132cm and weights 26kg and is 7.5 years old.

To be at 134cm at not quite 6.5 is really at the very top end of height so I would maybe speak to the GP about some tests for gigantism. Just to be on the safe side.

The fact that she is so tall has been shown to be linked to being overweight as a young child as mentioned by PP. She possibly tall because she is overweight rather than being heavier due to her height IYSWIM. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489471/#:~:text=Obese%20children%20are%20usually%20taller%20for%20their%20age%20but%20also,process%20of%20growth%20and%20puberty.
She is still very young and I'm sure new healthier eating habits can be formed. I suggest downloading My Fitness Pal app or similar and track everything she eats going forward. Cut out artificial sweeteners as they have been shown to affect appetite and insulin responses, cut out all carbonated drinks for the same reasons and go low to no Ultra Processed Foods as this will help appetite regulation too. Up the natural oils and fats in her diet and the protein too. Reduce carbs including fruit and cut out processed carbs such as white flour, bread, rice pasta etc. Well done on recognising her health issues and looking to deal with it early in her development.