Help with an overweight toddler

[Mushroo]

My 22 month old is overweight and whenever I try and raise it with the GP etc I just get brushed off and told it’s too early to be worried. But, I’m not sure that’s true?

Her BMI is 99th percentile - and she weighs about 12.5kg (about 80th percentile) and height is about 80cm (20th percentile). They might not be the exact right figures but thereabouts.

She just loves food and has eaten large portions since we weaned her at 6months. There’s no juice, chocolate, crisps, cake at all but maybe too many carbs?

Yesterday she had:
Breakfast: a weetabix, small scattering of Rice Krispies (about a teaspoon as she likes them but I don’t think they’re particularly a great breakfast), a tablespoon of full fat Greek yogurt with chia seeds and strawberries.

Nursery: see photo

Dinner at home: roast chicken, potatoes and peas.

I think the problem is she will just eat what she enjoys with no sign of getting full really! So she ate probably 3 or 4 potatoes at dinner which is what I would eat, but as she’s eating her veg and chicken too she genuinely seems that hungry.

I would say she probably has too many carbs, but cutting down carbs for a toddler seems wrong?

Actively level wise she’s at nursery all day, and I encourage her to walk there and back (it’s about a 0.3 mile walk) but she is not naturally a particularly active child and will resist walking.

Any advice? Am I right to be worried about this and cutting portions down?

She is constantly asking for snacks which I try and cut down, but she will often have a babybel after nursery, or some nut butter (she’s a little weirdo who just loves it on a spoon 🤷‍♀️)

Anybody who makes affection dependent on appearance and weight is deeply creepy.
All kids deserve cuddles, and parents who love cuddling them. Their appearance, gender, weight etc should have nothing to do with that - ever!

No real advice OP but I don’t agree with some PPs telling you to stop your family meals at home. Our daughter’s nursery ‘tea’ was at about 3pm, the portions tend to be tiny, and no later snack. Some of her little friends weren’t fed again after nursery and I don’t know how they’re not hungry before bed. Some also seem much more fussy when it comes to what they will and won’t eat. I definitely think it’s easier to try and encourage a more rounded ‘try everything’ approach at a family meal as opposed to nursery where the staff are trying to manage lots of kids (appreciate it doesn’t work for everyone!). Our daughter (now 5) eats lots but is tall and has a lot of exercise and is like a beanpole. She’ll try anything and rarely do we have issues over food. I grew up only really eating with my parents once a week (Sunday roast!) and we could be as fussy as we wanted but also exposed to lots of different issues surrounding my mum’s relationship with food. Well done on being minded to address this for your daughter :)

I'd change all snacks to fruit and vegetables only, as she has plenty of food. I'd actually keep that spoon of greek yoghurt as that's helping her digestion. Look at the portion sizes and try to make them all a little smaller.

I would start by double checking your measurements if you are not exactly sure of them. The centiles are very close together at this age. We were very surprised to find our toddler was obese recently (he is smaller than his friends) before realising we'd been using both a height and weight that were slightly out, and he was back to his usual centile once we adjusted. I'd also see how she's tracking compared to the centiles she's previously been on - is she gaining weight disproportionately or has she always been on the same height and weight lines?

If she still comes out as obese and is jumping up weight centiles, I'd try your HV or GP again, and if they're genuinely not concerned I'd take their lead over posters on mumsnet. They will see lots and lots of toddlers and be far more aware of the scope of normal - childhood obesity is worrying, services exist to combat it and professionals would have no reason to fob you off if they genuinely felt there was an issue with your daughter, so if they continue to provide reassurance I would accept it.

It would be a good idea to refresh yourself on toddler portion sizes as a starting point (I check this every so often: https://static1.squarespace.com/static/59f75004f09ca48694070f3b/t/5a926be4ec212d9451c595ce/1519545331398/Good_food_choices_and_portion_sizes_Jan2018.pdf) but toddlers can be absolutely ravenous at this age. I'm constantly amazed at how much DS and some of his friends eat, often as much as adults, but then they also spend most of their waking time running about. I really don't think you should be withholding food from her if the food on offer is nutritious and she's genuinely hungry (and remains so after distraction or a drink of water or being given some crunchy veg sticks to chew etc.) It is harder to control what she eats at nursery but from experience, portions are small and all the puddings will be very low sugar.

Comments saying to cut down carbs and fat at this age are ridiculous and dangerous. Your growing child needs both and it sounds like she is getting a lot of nutritious food. I also think it's great that you prioritise sitting at a table with her in the evening, and it would be a real shame to put her to bed straight away in the evening and cut down on this quality time, as some posters have suggested, without being advised to do so by a healthcare professional...

She was extreme. She was much, much bigger than other babies. But she was 100% breastfed at that point and GP had no issue. Both DP and I were chubby babies.
DD was a chubby child until she was about 5.
She was vegan and fed on a v.healthy diet. As she grew, the chubbiness dropped off.
Other kids at primary school remained fat and ate shit, facilitated by their parents; one child was so overweight it was akin to abuse.
My point here is the OP is worried about a child who isn't yet 2, whose GP has no concerns, and people on here are suggesting her food is restricted despite her healthy and balanced diet.
And yes, cuddling a chubby baby is a much nicer experience than cuddling a skinny one, this doesn't equate to loving the fat child more 🙄

I'm with this! It all looks like real food and not processed snacks, so, if she's hungry and eating, I wouldn't put her on any kind of diet at her age. Maybe make sure she has lots of water so she's actually eating because she's hungry and not thirsty? And if also up the activity wherever possible.

Just a word of warning that I developed an eating disorder very much in part due to parents that were always trying to curb the amount of food (any food!) I had as they couldn't believe I was actually hungry. It led to me having a very distorted view of food for years. I now eat whatever real food I fancy and am slim. I let my children have as much real food as they want and sometimes they eat loads and sometimes they don't. Just be careful about your viewpoints like "nip it in the bud" as she's only little and is growing...

Nb
I was commenting on formula as when I was breastfeeding my child I was encouraged by the health visitor top up with formula, subsequently a couple of years later the national guidelines for weight in babies. It was discovered had all been based on formula fed babies. The research then concluded that formula fed babies do indeed tend to have higher levels of fat , it’s very interesting research and of course very important
and worth reading not being rude at all as I experience this on myself.

But that’s much much less likely than ending up slowly sliding into obesity.

Thanks all.

I agree with those saying she’s having too much food at nursery, but she already has to have some separate meals because of her allergies, so I’m loathe to single her out even more.

She can’t have eggs or fish due to allergies so we’re quite restricted on lean protein options!

Yesterday for example was:
Breakfast: weetabix and half a kiwi, 1 - 2 teaspoons of nut butters.
Nursery: see photo
At home: at tablespoon of potato, chicken in a sun-dried tomato sauce (probably a tablespoon), green beans as she didn’t actually eat a lot at nursery.

She has to have 1/2 teaspoon of nut butters for allergy reasons so that’s non negotiable.

If she eats a lot at nursery today she’s getting homemade butternut squash soup for dinner.

For those suggesting I might pass on disordered eating, right now I’m far more worried she’s eating too much than the other way around. As a family we’re not very tall, and a lot of DH’s family are overweight.

DH and I are a healthy weight and I think we have a good relationship with food, there’s no ‘bad’ food off the table, we just eat a lot of homemade food with a few treats thrown in.

I obviously wouldn’t tell her I’m restricting her food, just change what we’re offering whilst she’s so little.

What you have changed looks great! What also helps is smaller plates - food that looks a bit lost in a big plate looks much better/more on a small plate ;) So smaller bowls, smaller plates etc to help her moderate

Protein ideas:
Tofu - I used to blend/mash with other stuff
Red lentils - great in bolognese, with tomatoes in a tart
Tinned chickpeas/black beans/cannelini beans - put these in everything
Soya mince is a great meat substitute, has as much protein but less/no saturated fat

Hrmmmmm, very possible and fair enough point. I was overweight and had an eating disorder and I think I was overweight because I ate in secret because I was made to feel bad about wanting to eat more food at dinner, etc. etc. I suppose I don't really know anyone who is obese who just eats real food and as much as they fancy. Personally the people I know who struggle with their weight are quite obsessed with what they eat and restrict lots of food that I eat as much as I want of (like carbs), but then get hungry and eat lots of packaged snacks etc. I think the OP sounds like they feed their child a very healthy diet and is doing a good job.

That looks good.

Ok so a not tall family background plus overweight relatives.
I think being aware of this at age 2 is fine. As she may not be able to know when she’s full. Healthy food is the key here.

I still feel that beef stew and dumplings followed by fruit crumble and yoghurt at 16.40pm at nursery, followed by cooked dinner number two at home at 6.30pm...less than 2 hours after starting dinner number one...and bedtime an hour or so after finishing dinner number two is where the problem is.

It’s about feeding your child sensibly, not ‘curbing’ anything. Realistic portion sizes for age. Recognising boredom or thirst over actual hunger and encouraging eating a balanced diet.

Whether that is 3 meals + 2 snacks a day or little and often throughout the day. It doesn’t necessarily matter as long as portion and nutrition is under control.

the people saying to cut out carbs are batshit crazy. No one should be putting a child on a yo-yo diet, at that age the weight they’ve gained now will be lost with better portion/nutrition management and their physical activity.

encouraging heathy eating is very unlikely to develop a ED as weight shouldn’t be the focus, it’s not what we’re seeing on the outside, that’s just a small indicator of what could be affected on the inside. We’re trying to encourage kids to have healthy organs, healthy respiratory system, healthy immune systems, all massively helped by not being overweight. Obviously no parent is going to comment on the appearance of their child and that’s not what it should be about.

I often use ‘brain’ rather than anything body related, with the expecting of too many sweets and can give a tummy ache ect. But I usually talk to my children about how X good is really good for their brains, helps their brains grow bigger and stronger as they grow, that eating healthy helps their brains fix them if/when they get poorly ect. I have never mentioned weight because I think as long as they understand how to keep the inside of their body healthy then the outside follows.

This!!

I have two children who both were notably, and worryingly overweight aged around 6-9 and I took proactive steps to deal with it.

And nonetheless, I think this obsession with weight for toddlers is ridiculous. Your doctors are not worried at this point because they know perfectly well that a lot of this smooths out. Which is what @Judecb I think said upthread as a professional in this space?

The main issue most likely is NOT what she's eating but the lack of movement. You say she doesn't like moving much and I guarantee that at nursery therefore, she's choosing activities that don't involve as much climbing and jumping and running around as other children. Actually, this was an issue with both of mine too albeit the weight only started piling on when they were older. In the case of DS, this was exacerbated because of sensory processing issues which made many fine and gross motor skills a bit harder.

The more you can encourage increased movement, the better, and of course, as she gets older, that gets a bit easier. Take her to the park, get her on the swing. encourage her to start swinging herself if you can. Get her up and down the slide as many times as she'll go. Take her to soft play and let her jump on jumping castles and trampolines. Take her swimming as much as you can.