How do I help my 14-year-old daughter lose weight?

[Mangelwurzelfortea]

I'm at my wits' end really as to what to do. My daughter is 15 and weighs 90kgs. She is 5 foot 5. I realised she'd put on a lot of weight over the last year but was shocked to find out how much. She's always been a large child - she was a hungry baby, always over the top centile range, and although I have always cooked healthy meals from scratch, she's always had a huge appetite. I think I still just about kept her weight under control until she went to secondary school, but now judging from all the wrappers and cartons in her room, she buys herself loads of snacks and I guess that combined with a tendency to take too-big portions has made her put on weight. She also hates exercise, which I think is because she feels embarrassed by her size.

I don't know what to do because every time I try and discuss it with her she cries and says she hates herself. I've decided to book a private session with a specialist in childhood obesity and endocrinology and she's just had blood tests to rule out hormonal issues/PCOS etc. My daughter is convinced she has ADHD (I do) and that's why she can't regulate her eating. This may be true but the waiting list is 3 years long and I want to sort out her weight before then. Has anyone got any suggestions? I am hoping the childhood obesity doctor will prescribe Wegovy, which is licensed for children, but I suspect they'll want to go down the 'natural' route. She is already in the binging/starving cycle of unsuccessful dieting, unfortunately.

For reference, I am not overweight and nor is anyone else in the family. I've always tried to model healthy eating and exercise and don't have any weird eating habits or disorders.

I'd recommend if you can working with her on her wellbeing first. You may need to pay for therapy though. Provision is awful sadly.

To be honest, I am not sure you can work on this by directly intervening in her eating and exercise. I was very very similar at that age, and nothing my parents did helped and a lot of it made it worse. I was struggling with puberty and generally being a teen, and being quite different to nearly all my peers.

Does she have a nice friendship group, or is she struggling with that sort of thing? Does she have hobbies that she enjoys? Presumably she will have GCSE exams coming up, is she stressed about those? Trying to lose weight whilst navigating GCSEs sounds like a big challenge tbh.

She does have friends but has also struggled with friendship groups. She's always wanted a 'best friend' (perhaps because I have the same best friend I've had since I was 11) but that hasn't really happened. She IS different to her peers because she loves punk and riot grrrl culture and is really into feminism and they used to call her 'emo' - she's not bitchy or into boys (yet!). And she's great with adults, so I think it's partly that she finds most girls her own age a bit basic (those are my words not hers!).

She's such a clever, lovely, funny, beautiful girl, I hate seeing her so upset about this. And I am worried about the potential health risks.

She sounds a bit like me at her age. I was lonely, a bit weird in comparison to my friends. None of my friends really felt close and I could talk to adults more comfortably than kids my own age. I was super lucky though that we moved halfway across the country and I went to a different school where there were other bright girls. Then I started to fit in and feel more comfortable in my skin because I was accepted.

I would genuinely work with her on her mental health first. Trying to lose weight while also feeling down is so hard and can make you feel worse. It's also far more likely to have long term health impacts than her current weight.

I think at all ages as well, we all want something and some way to belong. Is there a club or group she may be able to attend outside of school that fits with her interests? She may find friends there.

14 is possibly a difficult time but in a year or two she'll be doing GCSEs and even if her school has a 6th form, you don't have to keep her in the same place. We're looking at somewhere which isn't the typical choice for my son. He's been involved in the decision and he's chosen a super academic 6th form which is going to attract very different kids. It's clear he's outgrown his current school now from an emotional perspective. So I'm glad we're making that move.

Also it's fair to point out at 14, some girls are still growing. I went through a growth spurt at 15 and suddenly became a very different shape and size.

I would Google Beat Eating disorders and ask for advice. I agree with @SilenceInside that you shouldn’t intervene with diet and exercise.

Could you pay for a private ADHD assessment? It might not be possible to prescribe outside a certain BMI or blood pressure range though, and ADHD medications are not licensed for weight loss in the UK.

How far does she live from school? Can she walk there? I was very fat at 14 (though I do have PCOS too, which didn't help). I weighed about 92kg.
I decided to go all out to slim.
I used to walk to and from school, also go home for lunch - it was about a mile each way. I started to walk very briskly, jogging sometimes instead. So 4 miles a day.
With my mother's help sorting out my meals, with the main meal at lunch time, often soup for evening meal - and no snacks - my weight dropped to 66kg. in about 18 months. Not slim- I have never been able to lose more - but I was very happy, and healthier.

I think a lot of teenagers struggle with this I did my daughter did. We both had home cooking healthy food. My mum used to say have an apple instead of a biscuit & being told what to eat didn’t help. I got to 15 started eating less rubbish found I enjoyed swimming more & running. Encourage her to maybe do something together dance class a swim a walk. We are both ok now it may be a phase it may be a habit if you can encourage instead of telling that helps. Impress you just want her to be healthy do something together. Talk to her about her mental help teens sometimes eat if unhappy as it’s the only thing they feel in control of. Her mental health is more important than her weight I feel & weight loss injections are not a magic fix you have to eat properly exercise.

I've never been judgy about her weight - my mum was very judgy about me and critical because I wasn't as skinny as her. I was still a size 10! (And actually she wasn't that skinny, she just didn't like me that much. But anyway!) I've never been like that with my own daughter as I don't want her to develop body issues, and have just tried to give her healthy food and encourage her (gently) to exercise. She's developed body issues anyway. Sigh!

I'm paying for her to see a private endocrinologist/childhood obesity expert. We're on the pathway for ADHD and I'll probably pay for a private assessment of that too, down the line, but I can't afford both right now, and I think it's more of an urgent matter to tackle the weight. Maybe that's the wrong way round? Not sure!

I think the endocrinologist is worthwhile to rule out PCOS etc.
Maybe have a look into ADHD and dopamine - food can be a massive dopamine crutch and if your DD does have ADHD it may be hers

I don’t think you can tackle the weight without knowing whether she has ADHD. It would be as much of a contributor as PCOS to excess weight gain and you need to get a handle on the root causes.

I know you said you’re not judgey when you have spoken to your daughter about her weight, but you also said every time you do she ends up crying and saying she hates herself. Gently, you probably are being a bit judgey and your perception is off because your mother was very judgey and critical of your weight when you were a slim teenager.

It would be better for advice to come from a dietician or therapist than you for this. In the meantime, see if you can build a habit of something active with her that you do together which is fun? You said she dislikes exercise, but what about something like bowling? Or kayaking/canoeing? Something that is gently to moderately active but the focus isn’t on exercise but on having a fun day out.

I have to admit. I still think this is the wrong question.

I would ask, "how do I help my 14 year old daughter be happy".

Of course I want that for her, but she's told me multiple times that she won't be happy until she's slim.

Yes, I am aware that my own upbringing is a strong influence, but I don't think I am any more or less judgmental than anyone else in today's heavily beauty-focused society. I can't undo what she sees on social media/TV or hears from her peers though. The body positivity movement seems to have come to a grinding halt now everyone is on Ozempic!

Anyway! Yes you're probably right about the ADHD. It's been a right ballache trying to get her assessed for that though. I've been fobbed off by CAHMS, sent back to the doctor, referred back to CAHMS and ended up nowhere. But maybe then we prioritise the ADHD testing over the private doctor. But then again, I also think she may well have PCOS. It's really difficult to know where to start. If only we had an NHS that took childhood obesity and mental health more seriously! But they don't care these days unless the condition is obviously life-threatening.

ETA - the kayaking suggestion did make me smile. She HATES kayaking with a deadly passion. We've done it a couple of times and I loved it but she gets seasick and she was green by the time she got off the kayak!

As someone who has been that child (and still dealing with the effects at 31yrs old), if I had had the chance of WLI they would have honestly changed my life. I've done the cycles of diets and diet clubs to the ends of the earth but it was never sustainable. Don't get me wrong, there is still a lot of work that you have to do but WLI help with the 'food noise'. If you have never had a weight problem it's hard to explain but it's as though everything has ties to food. Some examples are if I was sad, I'd eat heavy food (pushed my feelings down/felt like a hug from the inside), if there was a celebration like a birthday it was what sort of cake or meal would there be etc. Even just going out for the day meant I'd think about what shops/stalls I'd go past, what 'fun' drinks I could have like hot chocolate etc. It took me years to understand the emotional ties I had to food and how to start moving on from them.
Things I have been learning now I am losing weight (with the help of WLI) are portion control (SW said rice & pasta etc were 'free foods' which just meant I ate as much as I could) actually reading portions and weighing it out- weighing what a portion is vs what I would usually portion for myself was a massive eye opener! Nutritional values of foods and what they do- protein keeps you fuller for longer and veg is great for volume eating. When i buy veg I prepare it as soon as i can because if i look in the fridge and see a whole cucumber or carrot etc I'd reach for crisps but if it was already chopped up id be more likely to eat it.
I found buying single serve portions worked better for me than buying a larger bar of choc/ bag of crisps. If she is in the binging cycle of diets as I used to be, buying multiples of things is a bad idea though it seems good at the time. I'm now in a place where I can buy a pack of 6 bags of mini cookies and only have 1 at a time but previously, I'd buy that pack thinking I'll just have one and end up eating the lot. If it's not there, I can't eat it. If she's buying things going to/from school, suggest she 'forgets' her purse so the ability is not there. It might also be worth her starting to save for something that she wants by saving what she would have spent on food instead- even if it's 'I only bought 1 bag of crisps today, I'll put the other £1 into the pot'.
The most important thing is to start small, exercise isn't everything though it will help so maybe park at the back of the car park if she's going shopping with you etc.
Sorry for the massively long reply!

Don't be sorry! It's massively helpful. One of the problems I have is that her older brother is massively sporty and eats like a horse (endless snacks) but never puts on a pound. He moans if I don't have snacks in the house. I tried putting them in his room but then my daughter feels like I am judging her, which doesn't help.

Really interesting about the food noise. I am pretty sure that's what she experiences too. I don't - I love food but it's never had that drug-like quality for me. Can I ask - do you have ADHD? Do you think you've been chasing that dopamine hit with the food addiction?

Never been diagnosed but I see a lot of boxes I tick for it. Dopamine chasing is definitely a factor, I also do it with shopping- not expensive shopping but I tend to buy multiples of things as I'm happier with fuller cupboards. It's almost a fear of not having enough of something, even if it doesn't necessarily make sense. I had the same in that because my fiance can eat more & not gain weight I almost felt like I was missing out if I couldn't do the same. Before I started the WLI and learning portion control I focused on volume eating, so every meal like bolognese or curry was full of vegetables like mushrooms, courgette, brocoli and baby corn. It meant that although I was eating sometimes more food than before it was actually less calories- stews are great for that as you don't need to add rice I could just eat a bowlful with a spoon

I think you have to accept there will be some tears and 'I hate myself' reactions, that you just have to let her express and then say: I know it's a sensitive subject but we have to tackle it. We need to work on you not hating yourself or feeling guilty or doing extreme diets because none of these are helping. We need to work on what would help.

One thing that really might help is finding exercise that she loves. especially one that burns loads of calories quickly like bootcamps, bodyweight training, weightlifting etc. Why not take up a fitness regime with her, and do it together four times a week, with a walk or swim or cycle on the other days.

Focus on lots of treats that are non food based - maybe face packs, bath oils, hair products, nail polish, hair accessories, magazines. Have one every time she completes a work out. Keep a progress report too, so she can see how much fitter and stronger she is getting. Focus entirely on this - fitness and strength - muscle tone, power, speed maybe rather than weight loss. Buy workout gear, take her for a new hair cut etc, so she gets lots of treats that are focused on a healthier way of life and an appreciation of her own body - looking and feeling good.

With food, focus on two things: optimum health - so you create dishes and snacks that are really nutritious, and as a less important things - any treats she loves that happen to be healthy or at least not fattening - eg fresh raspberries or strawberries, flavoured but unsweetened soft drinks like san pellegrinos. Encourage her to treat herself to things that don't make her binge.

Maybe suggest she keeps a food diary to see which unhealthy foods she eats most often trigger a binge or really aggressive cravings. see if she can swap those for treats that don't trigger binges. Tell her not to feel guilty if she buys and eats these treats. It's an experiment to see which ones harm her natural appetite most. this puts her in some control over the foods that control her, by having her study their effect on her.

It could help to do the opposite too. Work out which recipes and snacks help her feel full and lower the food noise. Make sure she has access to these at times when she feels like she might be more likely to binge.

Maybe also encourage her to practise saying things that will help, so that the phrases just come out instinctively in social situations e.g. if offered sweets or cakes at school, to say, 'No I am on a health kick' or 'No, sugar upsets my stomach'. If people pester her with comments like 'just one' or 'it's my birthday' or 'you just did a massive workout' encourage her to smile and say 'Thanks but no thanks. I really don't want one.'

No doctor will prescribe wegovy to a child without diabetes and with a history of disordered eating.

Put her health and wellbeing at the centre of the house. The sporty brothers can put their trainers on and walk to shops if they want crap.

She already has eating issues, you can talk about changing what food is and isn’t . ADHD might have a role or not. The solution remains the same. It starts with your next supermarket shop.

No child gets to 90 kgs unnoticed.

Why?

I know it sounds like a stupid question but I see this kind of comment from adults as well all the time. But what if you were happy anyway? What if happiness was not related to what the scale said?

If you logically think about it, do you know thin people who are unhappy? Do you know overweight people who are happy? You probably do. People often think that with lots of things in their lives. "I'll be happy when..." then if and when they achieve whatever thing it is that makes them happy, they realise that didn't make a difference. Or at least not as much of a difference as they thought it would. And often low mood and weight gain are correlated but in the opposite direction. People more often love themselves into losing weight rather than losing weight to love themselves.

But I've said it, it's not something you're interested in pursuing so I'll stop labouring the point.

I posted on another thread about tactics for behaviour change. The one I think is the most interesting is called "crucial influence" because it brings together lots of other ideas in one place. Worth looking online. But basically there are 6 levers you can use and you can use some or several but I'd say the more you use the better.

One - What's her personal motivation? How can she make this desirable? So for example, as others have suggested, finding an exercise she enjoys. Or spending time together learning new healthy and interesting recipes (Vietnamese food is often pretty healthy, why not learn recipes together?) But ultimately she needs to be personally motivated and ideally it needs to link to her values. How she sees herself.

Two - What's her personal ability? Is she able to make healthy choices? Does she understand what they are? Does she need to grow her knowledge of what is healthy and isn't?

Three - Social motivation. Could she join a club that gets her a bit active? I didn't take up running till I was in my 30s but in my 20s I loved climbing. What about dancing? Or many of the other suggestions other people have given. Even if it's just one day a week to start with then maybe she attends a class with you as well? That commitment to you and to the group she does something active with is motivating.

Four - Social ability. This is that coaching from people who know lots about it (which might be from clubs or groups). For example, joining a cooking group for healthy eating together?

Five - Structural motivation. What are the rewards for doing the right thing? Could you plan some non food treats? Also time together when you do some of all this might also be a reward.

Six - Structural ability. How to make it easy. For example, get some weights to be able to work out at home. Or not having unhealthy snacks in the house.

Thanks for all your suggestions.

FWIW - I only buy healthy snacks (yoghurts, dark chocolate, nuts, raisins). Also she won't exercise with me - we've tried this but she doesn't enjoy it. I've literally set up a private gym for her in the basement with weights and a treadmill but she rarely uses it!

Anyway, I'm taking a two-pronged approach: health insurance (thankfully) is paying for the appointment with the endocrinologist, and I am going to pay for her to have a private ADHD assessment. Once those are done, we'll reassess.

Get Wegovy prescribed to her privately, don’t wait any longer.

i went through a tubby phase as a teenager. like your dd i probably had undiagnosed adhd and got into a binge/ starve cycle which actually caused the weight gain.

anyway my mum really helped me lose weight before university by making a huge pot of very tasty vegetable soup. it had stock as a base and large chunks of veggies and i think marmite in it too. whenever i was peckish (like 6 times a day lol) i would have a bowl. She kept that pot full and in the fridge for months <3 Obviously because of the water content and the fact that it was nearly entirely wholefoods (aside from the marmite) it did stop me snacking on crap and i lost weight fast even though it had potatoes and other starchy vegetables in it.

in all fairness, this only worked because we discussed it first and i wanted to be slim before starting university. so if your dd isn’t on board then it might not work. but the general principle of having tasty, sugar free easily accessible snack food is key when the person in question has no will power like me.

If I were you I wouldn’t be sending her for tests and ramping up the pressure. She needs to change what she’s eating and take more exercise. Have you looked at their diet generally? What exercise does she do?
What exercise might she enjoy? Skating, swimming , cycling ? Buy her a bike and go for cycle rides with her. Get her membership of the local leisure centre. She can do dance classes or exercise classes there. Find out what motivates her and what she enjoys. Focus on that. Don’t buy cakes or snacks or high fat food. Make sure she has one portion of a healthy meal for dinner and lots of fruit and water. What does she have for lunch? Help her find a way through it by supporting her not making her feel like a freak. Breakfast could be fruit and Greek yogurt. Don’t have fizzy drinks or desserts in the house.

For gods sake she’s 15

I was 14 stone at 14 years old, and developed an eating disorder not long after. Please tread carefully.

My mum mentioned my weight and looked to make changes in the food that was available - I just took that as her not liking who I was, which made the whole thing worse.

Following treatment, which took up until my early 20s, I actually went the other way.

I really struggle to diet or restrict myself in terms of desired foods. Not because I’m not able to, but because as a more aware adult, I recognise in myself that restricting my diet leads me back down the “teenage” path and I’d end up taking it too far.

I’ve tried, and don’t even dare have scales in the house because I become obsessive and weigh myself upwards of 10 times a day looking for change. I calorie count and undercut them by a few hundred.

It’s not that I don’t understand healthy choices, I’m not able to confidently make them.

I grew up into a woman who knew she was big, and was confident in that body. I’m 36 and 16 stone (doctor checked). I’m not far off pre diabetic, and in a few weeks have a liver scan to check for fatty liver. Already concerned what I’ll need to do healthwise, baring the above in mind.

I guess my advice would be to make those changes as drama free as possible, because 22 years after my ED - it still impacts now.

Where possible, make it less about happiness (because you can be big and happy) and less about image - focus on health, and overall wellbeing.