Is my 4 year old overweight and what should I do?

[RoseGoldEagle]

I was told by our HV that DD is overweight. She’s on the 91st centile for weight, which is the same as she was at birth (she’s now 4). The problem is that her height, which was 75th centile at birth, has dropped to under the 50th- it’s been like that for a while. So there’s quite a discrepancy between her weight and height. We feed her a good diet- range of healthy foods with the occasional chocolate/sweet thing so it doesn’t become an obsession but overall she eats well, and I did lots of research into portion sizes etc and think they are fine. DH and I are tall and slim, not that that’s necessarily relevant. She has what I feel is a good attitude to food at the moment, enjoys a range of things, has a healthy appetite but stops when she’s full. HV suggested reducing portions but I’m so wary of doing it as I’ve read restricting food can lead to over eating in the long run as they then binge when they can, and lose their agility to self regulate. (And I feel trying to bring her down to 50th or 75th centile when she’s always been on the 91st seems wrong somehow). Am I in denial though, certainly taking her height and weight into account she’s coming out as very overweight. Any advice would be really appreciated, please be kind, I’m really worried but just don’t know what to do for the best. Thank you!

Can you give us an idea of a typical day's meals, snacks and drinks?

Have you worked out her BMI? That should give you more of an idea than centiles.

I had a very similar issue, overweight 4yo DS
but I couldn’t see anything obvious we could change. I got some really reassuring and kind advice from a poster about watching and waiting and trusting things, which we for do and DS is now a normal weight, albeit higher end.

Does she look overweight you you OP? It sounds like you are doing all the right things. As long as she is eating healthily and getting excersise Im sure its absolutely fine x

It’s that’s what she’s always been, I wouldn’t try and change it. Just make sure you offer a range of different foods.

It’s that’s what she’s always been, I wouldn’t try and change it*

It isn’t. The op says her dd has dropped from 75th to 50th centile for height

Even though her weight has always been at the top end.
Op - what does she eat and drink ?

My ds was 9 '3 at birth. Always tall and heavy. Not fat at all but scales and hv said otherwise. At 2 he looked 3. As a teen he looked like a skinned rabbit!! At 16 he took up boxing and gained muscle. No fat at all. Never was...
Ime don't waste your stress on charts and scales if hand on heart she isn't fat..

Hmm yes that's quite a difference between height and weight now so I can see why the Hv would be concerned.

(When I see these types of posts I really try to be as honest as I can because I grew up as an overweight child and know the detrimental health impacts)

Op, you’re child is in the obese category according to her centiles.

Continuing to feed her the types and amount of food you are just now will make her continue to be obese or will push her in to the clinically morbidly obese category.

It doesn’t matter wether she’s 4 or 44. You need to change things for her now, before it becomes too difficult to get on top of.

QAplomb her BMI puts her in the very overweight category according to the NHS website. The HV said it could be that her height will come back up nearer what it used to be at some point, in which case she’d be fine, but that hasn’t happened so far and I have no idea if that’s likely to happen, or instead we should be aiming to bring her weight down to nearer her height centile! Do you mind if I ask how old your DS is now? Did you try anything to get him to lose weight in the end, or did he seem to just settle?

Also I would add that by cutting portion sizes you aren't making a big deal of it that could then lead to issues for her. You don't need to talk about it at all in fact. Just smaller portions, change a snack to just an apple, only offer water to drink...
can't comment too much without knowing what a typical days diet looks like tbh

Continuing to feed her the types and amount of food you are just now will make her continue to be obese or will push her in to the clinically morbidly obese category.

Not necessarily, she might just be due a growth spurt.
What does she eat in a typical day, OP? How active is she?

It was @msflibble who commented on my post so helpfully, hopefully she has got notifications on and will see this and come and help you!!
Ellyn Slatters book is often recommended.
I didn’t do anything, I had a routine I wanted to stick to.... lockdown hadn’t helped what with the lack of exercise and the treats, family film nights etc. I knew what he should be eating and so when he started school in September I just implemented it more strictly. I didn’t restrict anything, just things in sensible amounts.

This is the thread. I got lots of lovely advice actually, hopefully you will too but you may want to take a look www.mumsnet.com/Talk/am_i_being_unreasonable/4025649-My-DS-is-ENORMOUS-Can-I-have-some-reassurance-please

Breakfast is usually 2 pieces of toast with butter and some fruit (she would say she was hungry if she only had 1 piece, but often doesn’t finish both pieces)

Lunch; sandwich- 2 slices of bread with ham or a bit of chicken (would usually eat three quarters of that though and sometimes less) or a tuna wrap plus salad and whatever veg we have. Or a one egg omelette with ham and cheese (few small squares of ham and small sprinkling of grated cheese) with salad and veg.

Afternoon stack- half a pack of mini breadsticks or a 2-3 jacobs crackers or a few mini rice cakes with hummus and some grapes/carrot sticks/ whatever fruit or veg we have in. Or 5 or 6 small cheese cubes and crackers and a few cashew nuts. Sometimes a small amount of chocolate (like 6 smarties) on the side as trying not to make chocolate a forbidden thing- a few times a week.

Dinner: range of home made thing like cottage pie or fish pie with veg, or make your own pizza, or mild chicken curry with rice and veg. Maybe once a week something like chicken nuggets and chips. Usually a yoghurt and fruit afterwards, maybe twice a week a more exciting desert (small piece of cake, or small jelly or small bowl ice cream). Have researched portion sizes and give her a small plate with suitable portions on- she will sometimes ask for seconds which I do usually give her, but she doesn’t always.

You wouldn’t be seeking to have your lo lost weight per se, but to maintain her current weight until her centiles are more in line.

So if she is 19kg (which is 91st centile) at 4 years then maintaining that weight for a year will mean she will be (almost) 50th centile at 5 years old.

She’s really active, would be outdoors all day if she could be. Used to do swimming, rugby tots, gymnastics but all that’s obviously stopped, but we still get out in the garden and go for walks every day.

PinkyU. Thank you, I appreciate your honesty, and yes I see what you mean about the aim being to maintain the same weight and growing into it rather than losing it (yes she is 19kg)

QAplomb thank you so much for that, I’ll take a look!

i would swap the morning toast for something like boiled eggs, does she need that afternoon snack? It sounds quite a lot.

My 4yo is 85th centile for both weight and height and he would only have one slice of bread for a sandwich. He also wouldn't normally have such a big snack. Probably just a piece of fruit or at the weekend a piece of cake if we go to a cafe. For a pudding he wouldn't have a yoghurt and fruit, it would be one or other.

That's a lot.

My 3 and 5 years old for breakfast have the bottom of a bowl with cereal and milk, one slice of toast, portion of fruit (do half banana or half apple).

Lunch if a sandwich is one slice of bread and some salad items, occasionally an extra like fruit / something to use up.

Snack something like a bread stick and cheese or half a bag of crisis each, occasion smal treat like half a gingerbread man or a biscuit.

Dinner side plate with dinner and a dessert generally half a pot of yoghurt, small ice lolly etc.

I feel you OP. My 12 year old is increasingly chubby and I don’t really know how to address it. Crappy lockdown doesn’t help.

Hi

In simple terms, the things you can do are:

• adjust portion sizes
• adjust the type of food
• help her to be more active (not easy in a lockdown)

I wouldnt have thought that a small adjustment in portion size would affect her self-regulation.

Is there scope for increasing protein to fill her up a bit more?

Activity - hard in cold weather etc but dancing is good - we have a little disco light thing and I make Spotify playlists.

If she is very overweight, you probably do need to do something - the older she gets the harder it will get - but it can be gradual.

Op before people jump in and start saying maybe change this and this, that seems balanced to me and if you think your portion sizes are small enough and your child plays enough, maybe it is just a case of watching and waiting. My 11 yp always seemed like he might be heading towards being bigger but evened out when he was about 7. But I'm not an expert, I do just see that sometimes people recommend tweaking this here and there, but they're looking at a day's example, not the whole picture. Also as someone said above if you dont make a huge deal of changing portion sizes, children don't notice really

There is a lot of bread in her diet...
Bread for breakfast
Bread for lunch
Crackers / breadsticks for snacks

Her snack sounds more like another meal, she’s eating a lot of food. My 10yo DD would have the equivalent of your 4yo’s snack as a lunch.

Individually each meal seems fine, it’s the combination of it all in one day,

She shouldn’t be have toast and sandwiches in the same day.

Fruit is enough for breakfast... add some nice yoghurt instead. 2 slices of bread for toast is a lot for anyone, especially if it’s white bread as each slice will be over 100 cals. So there’s 400 calories she’s consuming which are effectively empty with no nutritional benefit.

Up the protein and healthy fats and cut out the bread.

If she needs a snack then give her carrot/cucumber/pepper sticks with hummus instead of breadsticks.

Sounds like you're doing all you can do already op, in terms of balanced meals and exercise.