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.

Funny a PP mentioned soup - that’s the only thing that works for me losing weight. Having soup once a day is so filling (and have maybe a roll with it rather than bread where it’s a big loaf).

I read some really good advice once which is that it’s better to think “what can I add to my diet” rather than what do I want to give up. So for example add more lean protein eg chicken or fish to a pasta dish and (I guess) that means there will be less pasta and cheese kind of by accident. Add salad to each meal or have crudités on the table to share before main food is ready. Her eating until she’s full isn’t the problem, it’s WHAT she’s eating.

Exercise wise, how about swimming? Much better if you’re feeling self conscious as you’re in the water rather than sweating on a run or exercise class.

The overall message for her is that self care is a feminist act. Her body is powerful and does so many amazing things every day to let her live her life. It deserves good things.

My daughter who is now 14
joined the local rugby club 18 months ago and now plays girls rugby and trains 4/5 times a week.

It has been transformative for her mental health.

Rugby is a sport which has positions for all body sizes, is friendly and welcoming and very values-based. Lots of feminists in a girls rugby teams too, and it is so good for our girls to have friendship groups outside of school.

I don’t know if this is helpful or not, but many people on Mounjaro say that it helps with their adhd. Not everyone and some people say it makes them feel flat so not a guarantee but maybe do a bit of research. Don’t know about wegovy but probably similar.

I think it helps with less desire for a dopamine hit. So some people find it helpful but makes others feel flat.

I have been fat since your daughter's age OP. I'm losing weight with Mounjaro currently and it has been something of a revelation. I'm going to tell you how and hope it helps your lovely daughter. ❤

There may be an element of ADHD (with me too) but the thing for me is that the self hatred comes before the fat. I am not even fat any more but I can make myself look fat in the mirror depending on my mood and attitude towards myself. I have always eaten very healthily BUT I have realised I've always eaten a load of crap as well and eating crap was my terrible coping mechanism for hating myself. When I started mounjaro I had to sit with that feeling alone as eating crap had stopped working as a coping mechanism because I couldn't do it. It was FUCKING AWFUL. I would not wish those few months on anyone. I couldn't afford mounjaro and counselling though there may have been better programmes to follow than just the drugs and me feeling absolutely shit.

My current plan is to get to a healthy weight and then exercise and self actualise my way out of the self hatred. if it will work but my whole life has been spent with my body as a problem, diet after diet, fat being the issue, trying to squash my body into a particular size. My body has always been public property and up until I got pregnant with my first child just not a thing to cherish or value at all. Really that was never the problem. It was that I just felt utterly worthless.

In your daughter's case you have a chance to rescue her from this future. I'm sorry she feels like this but please, PLEASE focus on the self hatred not the Bad Body. If that means therapy, exercise, love bombing, whatever, please focus on that.

Are all the life threatening complications associated with a morbidly obese BMI less relevant because she’s 15? My recently deceased family sister, dead at only 19 due to above mentioned complications would say no, no they are not less relevant

She has an eating disorders. She binges. Eating disorders are an exclusion criteria.

Then, WLI are for LIFE because you gain the weight back when you stop.

Putting a child on injections with no medical supervision is ridiculous. It’s not teaching her anything about how to manage her weight, eat properly or take exercise. What a lesson for a child. Quite apart from the fact that surely she has to be 18 to qualify ?

This sounds really difficult for you both. I would really encourage some form of exercise, clubs, family walks, trampolining, dancing or anything you can think of.
Never have any junk food in the house and make sure she

Obesity is a disease that kills. Turning it into a moral lesson while pushing to restrict access to treatment isn’t just misguided - it’s dangerous. And no, access to medication isn’t defined by age, but by clinical need and a professional prescription.

I don’t think you’ll find many doctors prescribing weight loss drugs to children. They don’t even prescribe them for adults unless in rare circumstances.

They do privately. There is no age restriction, or any other concern as long as you meet the criteria, the NHS restriction is to do with funding

That’s extremely sad.

That's what I was trying to get at earlier.

There's quite a bit of evidence that the GLP1s can exacerbate existing mental health problems, not because it causes them but, as you say, it takes away the crutch of food that you've been using to cheer yourself up. I'm sorry you had to do that alone. But I wouldn't advise others (especially children) do the same and, as I explained previously, working on self worth and mental health can also support weight loss.

Much as many women are finding out now, it appears I also have all of the typical traits for inattentive ADHD and didn't realise till fairly recently. But to me there is an awareness brought by that, in the way that you have a very busy mind. But not a hell of a lot of anything that can bring you support unless you want to go on drugs which I didn't and may not work anyway or unless you have an ADHD informed therapist, which could be helpful on finding strategies for you (her).

But one thing I found for me, was while over the years I have had periods of over eating and being overweight, the thing I struggled with was alcohol and using that to numb my busy mind. As a result, 7 months ago I stopped drinking entirely but much like you @Poppingby that then exposes the very busy thoughts with nothing to numb it. Fortunately I've done decades of therapy on and off so I both expected it and had support available if I needed it. I only share that as, if ADHD is a problem, removing the food issue might only get rid of one thing she may use to numb those feelings. (I use exercise to support with mine but I understand that's difficult to accept it will help until you get the bug.)

There are structural things wrong with our society, with the types of food we eat, are easily available, cheap and how they're marketed. But we also have other problems. How busy we all are. How we don't sit together and eat, modelling good behaviours. We have created (unwittingly) an obesogenic world in the UK and a world that poorly supports wellbeing and mental health.

I don't know if this is helpful advice as I started much younger with my son but I think it's good advice even for adults. Keep creatively making healthy food and having it available as part of just what's good for you all. If you can, sit down and eat together. Talk about stuff as you do, it's a great way to build relationships. Fill half the plate with vegetables and make no fuss if the veg isn't all eaten. Food isn't punishment. My veg dodging partner only sits down to eat with us at weekends (he works long hours) and yet the variety of fruit and veg he now eats has hugely grown. Last week he was waxing lyrical about how great cavelo nero was.

I also make packed lunches still for my son. He does have some sweet things in there but he also has 3 different fruits or vegetables a day. So for example, carrot sticks, cucumber sticks, an apple or cut up melon, grapes, some sweetcorn in the sandwich etc etc. The idea being that he's not being stopped from eating a cake etc but he also then eats the fruit and vegetables as well. Sometimes it's what you do include not what you exclude as that is filling and means there's less space for other things.

Good luck. I wish you both well.

For goodness sake; she’s 14.

That isn’t to say that obesity isn’t a health concern, trust me - I’m well aware that it is.

But we do not need to start medicating teenagers into losing weight.

She’s a child, she has plenty of time to learn the proper way to lose weight, and to feel better about herself.

i think best not to focus on her weight. we all remember how horrible being a 14 year old girl can be, now imagine you also had your mum on at you to lose weight all the time? yes it's a health concern but being overweight is hardly the worst thing she can be. she sounds like a lovely girl. i'd leave her be

Whoa. That statement needs a lot of unpacking. That's an unusual view for a teen these days (IME they are much more accepting of different sizes these days). Where has she got the slim = happy idea from? Is that something you have passed down from your mum? That's a very unhealthy standpoint that you need to very gently challenge. She can be happy and overweight and she might be unhappy and slim, but linking one to the other is dangerous thinking especially if you are thinking about weight loss drugs.

It also suggests a lot of self hatred and self sabotage going on. So she thinks this key thing will make her happy, but she is overeating? That's often the behaviour of someone who thinks they don't deserve to be happy and this is linked to low self esteem too.

I think weight loss drugs could be really risky for your daughter, look at her mental health first.

I’d stop buying any supermarket UPF foods and snacks altogether - style it out that it’s for the whole family to outsmart the evil food industry that wants us to keep addictive poor quality stuff and you guys all should do it. Just stick to three nutritious meals a day, no snacks. I come from the former Eastern Bloc, and we were never given snacks growing up. I’d also avoid giving pocket money that can be spent on unhealthy stuff. Say that money will be spent on amazing experiences- days out, cinema, travel etc.

That said, it’s hard to change taste buds and habits at this stage—it takes real willpower. And I wouldn’t stress too much about exercise. You can’t out-exercise a poor diet. It’s mostly about what you eat (I’d say around 80% impact, rest is lifestyle / exercise, sleep, stress ), and how you manage emotions and boredom.

That’s where I’d start. A lot of it is mental—but snacks, UPFs, and sugary drinks make it much harder, and they’re designed that way and not being able to emotionally manage boredom / stress.

Surely they wouldn't prescribe it to someone with an eating disorder? Ops daughter hinges and then starves. Shouldn't that be dealt before weight loss injections are even considered.

I would just get very active as a family in fun ways -

bike rides, rock climbing, swimming, running together, learning roller blading or skateboarding, ice skating, just going to the park to play football, basketball etc.

this is what I’ve done with my son who has put on weight due to a health condition, he’s loving cycling, has made a load of new friends and goes out most weekend now but we also cycle as a family and he attends bmx class!

if she’s reluctant even going for brisk walks, chatting make it fun. Maybe a reward if she’s really reluctant?

be conscious of portion sizes, we don’t eat after 8 me included - I’m trying to set by example.

or if you haven’t and could… get a dog that needs walking!

Current studies show that patients with eating disorders report semaglutide significantly reduces intrusive 'food noise.' The fundamental failure of traditional dieting is the 'last supper' cycle: you binge today because the 'starvation' starts tomorrow. This leads to a dangerous oscillation between 8,000-calorie binges and 600-calorie restrictions.
For those struggling with morbid obesity, the math is often misunderstood. You can’t just eat normally and lose weight if you’re obese. To lose significant weight, a substantial caloric deficit is required. However, the 'normal' intake for a healthy-weight person is often actually above the maintenance level for someone with a metabolic history of obesity.
The paradox is that the necessary deficit triggers the very food noise that leads back to binge eating. It’s a biological trap. Semaglutide is the first treatment to address the root of this 'unsolvable' cycle by silencing that noise. Suggesting we solve this without the appropriate medical treatment is like asking someone to fix a broken engine by just 'driving better.' We have the science to make lives better; we should be using it.

It's really interesting you say this @kalokagathos because I think it's something that feels true but I'm not sure it is:

"That said, it’s hard to change taste buds and habits at this stage—it takes real willpower"

There's really good evidence that your gut microbiome changes very quickly when your diet changes, which is one driver of cravings but relying on willpower to change behaviours alone is fraught with failure. A better approach is to change structural and reward mechanisms to reinforce the behaviour you want. Much as you suggest, remove unhealthy food from the house is actually changing the environment and creating (good) friction towards the behaviour you don't want.

Is this true @thefloorislavayes ?

"For those struggling with morbid obesity, the math is often misunderstood. You can’t just eat normally and lose weight if you’re obese. To lose significant weight, a substantial caloric deficit is required"

I'd always read that your calorie requirements to maintain when heavier are actually much higher than someone with a lower BMI. Therefore the calorie deficit to lose would be higher too wouldn't it? While losing weight quickly would require a substantial calorie deficit, is that advisable? Isn't finding an approach that works for life so something that probably later becomes your maintenance approach a more sustainable one?

Please please please be kind to her. I was an overweight child and my mother was very incessant about exercise, diets etc from the age of probably 8. It was very disheartening, and it really drove a wedge between myself and my mother, even to this day. I didn’t lose weight - I didn’t enjoy any sports or anything, and still don’t really. I even had a personal trainer and didn’t shift anything as my heart wasn’t in it, I just felt insecure. I became hypersensitive to any comment she made about my appearance or weight. It was very clear to me she was embarrassed by me.
Im not saying this is what you’re doing/or what you think at all, but it’s clear by your daughters reaction it’s a very sensitive area for her. She will realise even you suggesting sports is a comment about her weight - it just needs to be handled right.

I am still overweight but I am now on mounjaro, and I’ve lost 4stone in 4ish months. I never lost the weight in childhood. But I’m doing better for myself now. No matter how badly I wanted to lose the weight as a child/teen I just couldn’t.
im almost certain I had an eating disorder that was never addressed. So you’re doing the right thing getting her seen!

An obese person has a higher metabolic rate in absolute terms, but often lower relative to body size, that’s because fat tissue burns far fewer calories than muscle

I have ADHD and a lifetime of finding it VERY hard to regulate how much food I eat. I see it in my two boys as well who also have adhd, they are constantly asking for snacks. As in every 10 mins.

Personally I would spend the money to sort out the adhd first as I believe with the right meds for that your daughter would crave food less and have more regulated dopamine. She would also have more focus and hopefully be able to stick with healthy eating and excersise plans. It might then be a good time to see the childhood obesity expert. If you see them prior to sorting out the adhd then I feel like any steps they suggest to help with the obesity will not be able to be stuck to by your daughter and she will feel even more like a failure / even more desperate over it. It’s a horrible feeling to not be able to control how much you eat.

My weight stayed fairly under control as a teen despite eating in a v disordered way because I was working down at a stable yard and riding horses a lot. I was obsessed and it was lucky because I could not control what I ate. I then worked jobs when I was on my feet in my 20s which also kept it off. Excersis alone would not have cut it I don’t think, well it would have had to be a lot of excersise! Pp suggestions about walking or biking to school are a good one, if you live close enough but also far enough away for it to make a difference. I found a 30 min bike ride to work and back made a big difference to my weight at one stage.

basically my point is try to make the exercise into a daily routine or part of a part time job rather than a gym class she needs to take (for example) as then it becomes ingrained and a necessity rather than something that can be just dropped