Weight management for 8 year old

[Charb2025]

My daughter will be 9 soon and had her adenoids removed in January as she had sleep apnea. During the pre-op assessment, the anaesthetist raised concerns about her weight, as she is above the 99th percentile and is classified as obese.

Food has always been a challenge for her due to sensory issues, particularly with wet textures. Since she was a baby, I’ve struggled to get much variety into her diet. she does eat some fruit and vegetables and enjoys foods such as noodles, broccoli and sweetcorn for dinner but hates wet type dinners.

Before anyone offers suggestions around diet, please know that we have spent years trying every approach imaginable. She is otherwise very healthy, active, confident, and very tall and solidly built. Her dad is also tall with a rugby-player build, so she has always been a bigger child physically. She does carry a lot of weight around her tummy, which is one reason I understand why the referral has been made and they did ask at the time if we wanted the referral, which I said yes to.

We have an appointment with Endocrinology coming up, and I was wondering if anyone has been through a similar experience with their child. I assume they will discuss her growth, family history, weight management, and possibly arrange blood tests to rule out any underlying causes.

My main concern is making sure my daughter doesn’t become overly focused on her weight or feel that there is something “wrong” with her. I’ve explained the appointment to her as a general health check to make sure everything is healthy and working as it should.

Has anyone had a child seen by Endocrinology for similar reasons, and what did the appointment involve?

Hello, sorry you haven't had any replies, maybe this will bump for you. I haven't personally had an endocrine appointment for my child but I think you're absolutely right to have taken the referral just as a reassurance there isn't anything more concerning going on. You are right in that they'll likely take a detailed history, ask lots of questions about her diet and lifestyle (please answer these honestly and don't feel anxious, the doctors aren't there to judge your parenting), take some measurements and they may want to do bloods, perhaps urine analysis and maybe X rays if they're worried about her growth in anyway. The doctors and nurses are usually pretty child friendly and good at being able to have these conversations/do the measurements in a way that doesn't alarm the child or make them feel ashamed. If they do need to ask or tell you something more sensitive they can find a way of e.g. sending your DD off with a nurse to get measured while the doctor talks to you, or sometimes they can get you to write the answers on a questionnaire.

In general terms, her diet sounds actually pretty good for her age, it's very normal for kids to be fussy, eat the same meals on repeat and have some sensory issues with food at this age, it can of course be a sign/symptom of some kind of physical health issue or neuro-divergence but it can also just be them being 8 and something they grow out of in time. I think the general advice with kids (and the endocrinologist could well recommend something more specific for her) is rather than thinking (or certainly not talking!) with them about being 'on a diet' the idea is to try and feed them the right number of calories to maintain their current weight, as they grow they will then even out over time. I don't think you need to worry too much about her eating repetitively if it's a reasonably healthy meal, the only thing I'd definitely try and limit is junk food and sweet treats, not a total ban but ideally don't have them in the house and keep for an occasional treat? And the more exercise she can do the better, again not framed for her as something she needs to do to lose weight or even because it's 'healthy' but just finding forms of exercise she enjoys and giving her maximum opportunities to do so, and building natural exercise into her day, encouraging lots and lots of active outdoors play, walking or cycling to places wherever possible etc...

What does she do activity wise?

i wouldn’t worry too much about food. Eat to appetite, 80% stuff from scratch, occasional treat.

NEAT is very important. Does she walk, cycle, generally move about during the day?

can you sign her up for sports clubs? Girls rugby is very popular here, as is kids “CrossFit” which is strength and conditioning at the local CF gym. Martial arts? Dance, trampolining, swimming? What is she interested in? I’d aim for an activity most nights, even if it’s just cycling home from school or to a friends. Even brownies will get her up and playing games- there’s also cadets etc. it’s more up and moving, and away from the snacks.

i believe weight should stay stable, you shouldn’t be aiming for her to lose- she stays the same and her height will increase to match as she grows.

i also agree an endocrine appt is good to rule out anything physical.

Hi both thank you for your responses - they were really kind, informative and helpful.

The appointment went well and the consultant was firm but lovely. She had bloods taken when she had her op in January which despite chasing I’ve never had the results (even took it to PALS) because I was being passed around and ignored, but her bloods were discussed and shows anaemia and high triglycerides which is worrying but means we have to action.

He was just adement she needs to be more open to fruit and veg and less snacking (when you have a child whose a fussy eater, snack plates become the normal) she’s always had a sweet tooth so we are just making adjustments.

Shes so shy that she doesn’t like after school clubs etc, she goes to brownies but doesn’t like to do anything else. I’ve ordered a walking pad for her and she’s now walking to school instead of scooting. She is large and has a very large round belly but she’s also tall and stocky (same as her dad) I’m a size 14 and curvy and healthy, so she’s following the same shape as us.

This is a bit left field but rereading your o/p a couple of things jumped out.

i had a “fussy” child. She did a lot of activity so the weight didn’t really creep up till lockdown and enforced inactivity, so I do think you need to look at trying to increase that. Trampoline is a good one if she’s shy, as it’s one to one activity mostly as they take turns, so she won’t have to interact much. Or what about skateboarding at the park, archery, there’s a lot out there that isn’t a group or team thing.

her diet was similar- noodles, broccoli, rice. A lot of snacking, at one point she barely ate meals and just seemed to graze all day.

has anyone thought about food allergies? Mine got to 14 and developed horrific acne, so she did a trial of no dairy for two weeks after seeing it on TikTok.

well that changed everything. The “fussy” eating was because dairy was making her permanently low level nauseous. She stuck to plain foods she knew and also explained the constant need to eat to alleviate the nausea. It wasn’t the texture so much, more that a lot of “wet” foods are dairy based.

did they test for coeliac at all? Dd has since cut out gluten too which again changed even more. She feels so much better she won’t go back on it to be tested so we don’t have a diagnosis.

have you an appointment with a dietician?

have you kept a food diary at all? Might be worth it and see if any patterns jump out at you. Mine was older so was able to make her own choice about trying to restrict food groups, but maybe have a chat and see what she thinks?

Oh wow, they sound so alike! It’s honestly such a relief to hear from someone who’s had a similar experience because it can feel really isolating, especially when people constantly talk about how much their child eats or make it sound like it should all be so easy.

She only has lactose-free milk now because regular milk used to make her feel really sick and nauseous. If she had it too close to bedtime, she’d often be sick during the night. She also takes probiotics, which seem to keep her tummy pain under control, and she has a fresh smoothie every day. She goes to the toilet once or twice a day at least, so thankfully constipation or anything like that doesn’t seem to be an issue.

The paediatrician has done a referral for the dietician, so hopefully my daughter will take their lead on any suggestions. I’m keeping a diary and have reduced the snacking, including chocolate. I think the next challenge is getting her to be more active, which is hard, and people always judge when you say you have a fussy eater without realising how difficult it actually is—we really do try every way possible.

That is a brilliant idea - I have just ordered her a trampoline , so I’m really hoping that getting her bouncing around and burning off a bit more energy helps with the weight loss, being more active. Fingers crossed! X