Helping "fat" ten year old

[singin'intherain]

My dsd is undeniably overweight. She's ten, about 5', and weighs 130 lbs. She has a big tummy, and a double chin. However, she is very active, loves swimming, gymnastics, riding bikes, and is always out and about. She does eat more than the other kids, but I have never seen her binge. The only diet thing she does is go for a long time without eating, then eat a lot of heavy foods because she's so hungry. Honestly, lifestyle wise, there isn't a good reason for her to be so heavy.

My take on it, and her dad's, is just to continue offering healthy foods and opportunities to be active. We've had blood tests done, including thyroid function, because her doctor is sure she is a chip-swilling couch potato with pre-diabetes. Everything came back normal. She's always been big, and her mother is big- but her mom really does have an inactive lifestyle and a not-so-great diet. She (dsd) is also very strong and has great balance, which tells me that she could have significant muscle mass contributing to her high weight. Any suggestions on what to look into health wise would be appreciated.

The other big issue, though, is her growing feelings about her body's appearance. Kids at school have started calling her fat. Relatives are starting to police her food intake when she's visiting. She talks about dieting and how to lose weight. So far she hasn't tried to restrict her calories, because we both keep up with the mantra "just keep eating a healthy diet, keep being active, you are beautiful just the way you are." My mother has been dieting off and on (is there any other way to diet?) for 60 years, and is still overweight, so I know all too intimately that dieting doesn't work.

My heart breaks to think of dsd going into our society fat. It feels like throwing her to the wolves. I don't blame her for wanting to get rid of that big tummy at all. I wish she could just blow off all the comments, but that doesn't seem realistic. So how do we help her navigate this without falling into the weight obsession trap? We are working on a referral to see a dietician, with the idea that if she learns more about how food affects her body, she will feel empowered to eat the way she wants to, but not be fooled into thinking that calorie restriction will solve her problems.

Any other resources or ideas?

[dejagerw]

Maybe you could record a food diary. Once it's all written down, maybe you'll be able to better evaluate what she's eating and problem areas. How often does she eat take out or at restaurants? For example, even though a particular meal at a restaurant can seem "healthy", in reality there may be 1200+ calories in a meal that seems healthy. If the doctor ruled out any health issue and she's active, it has to be that she's consuming more calories than she needs.
 

[beanma]

I would continue to emphasize that being fit is the important thing. Sometimes kids do add on weight before they have a growth spurt. It does sound like she's a little bit heavy, but also very active and I think that's the main thing. Her height may take off again and catch up with the weight.

Give her some good resources like New Moon Girls — they recently had a blog entry on healthy girl body images in the media. We really like the American Girl self-help type books, too. http://www.amazon.com/Real-Beauty-Great-American-Library/dp/1584859083/ref=pd_sim_b_45

http://www.amazon.com/Food-American-Girl-Lynda-Madison/dp/1593694156/ref=pd_sim_b_50

http://www.amazon.com/Care-Keeping-American-Girl-Library/dp/1562476661

There are tons of them on all sorts of topics. 

Maybe you can get her involved in a girl-oriented program like Girls on the Run that, again, emphasizes fitness over the media image of women. Even if you shield her from the Barbiesque portrayal of women in magazines and TV and movies other kids (and adults) pick up on that flawed message and may re-deliver it to her. She needs to be getting another message ("be active, eat well, be healthy") to counteract that bad societal message. It may be that she's just destined to be "big boned". Some women are, but they can still have healthy self esteem and fabulous role models.

Look at Leisel Jones, the Olympic swimmer and silver medalist from Australia. There was a big flap over her being called "fat". She's a FOUR TIME Olympian and won the silver this go round. She's incredibly fit and healthy! What's unhealthy is our preoccupation with the Barbie-style figure for women. Put a Barbie woman in the pool with Leisel and let's see who wins. 

Keep her active, keep her eating healthy, keep her self esteem up. 

[singin'intherain]

dejagerw, We were thinking that any dietician worth their salt would probably have us do a food diary for a few days. I wanted to wait, so she doesn't feel like we're putting her eating habits under the microscope. We eat fast food maybe once every month or two, and when we do, she eats whatever she wants. Most of our meals are some variation on meat-veggies-grains dishes. But I bet if we really examined what she's eating, there would be some surprises.

Beanma, thanks, these are just the kinds of resources I've been hoping to share with her! She's not really shielded from media, though we don't have magazines around. We don't know people who put a lot of emphasis on appearances, either, but there's just no way to avoid exposing her to our society's obsession with thin!

The worst thing, to me, is that even doctors assume she must be eating an unhealthy diet and sitting around, because she's big. I understand those things are a big problem in our society, and of course there'd be no way for her to put on the weight if she weren't eating the calories. But when one kid can mack on a lot of fattening food and be thin as a rail, and another is eating much more sensibly and still carrying around a big tummy, it looks a lot more complicated.

I hate that her size, whatever the reason she came about with it, makes her a target for others' judgements. It's so unfair. Even if she were binging on candy and chips, she deserves and needs to be comfortable in her own skin.

[savithny]

I wonder if you might find some useful resources at some Health At Any Size (HAES) blogs?  

My DD is built like a belgian workhorse,  She's never going to be a graceful arabian.  But she's strong, and fit, and sturdy.   So we talk about feeding your body good foods to keep it strong, and staying active, but we also talk about how different bodies have different natural shapes.

My great-grandmother was born in 1890 and was very tall for the time (5'8") and weighed about 200 pounds most of her life.  And she did hard physical labor for most of her life as well - she grew up on a farm, then worked as a "rolfer" and physical therapy assistant in the hot springs spas, lifting women into and out of baths and onto massage tables, and after the springs closed she worked on her feet in a store all day.  She was big, strong, and fit, and lived to be 90.   Some people are just shaped that way.    

IT's hard, though.  I'm actually out of shape right now, but I haven't always been -- even though even at my most fit and active I was still in the "overweight" BMI category.  I was swimming a mile a day, walking to all my classes and NOT overeating at that point.   I wish I'd realized how very nice my body actually was, then.....  I look at pictures and think about how other girls made fun of me for wearing a size 12, and I want to punch people.   

So focus on staying fit and active.   She may well "grow into" some of the weight -- its very natural and normal for a kid at the edge of puberty (or any growth spurt) to get thick aroudn the middle and then shoot up.   But she may well always be an endomorph, and have it be natural for her body to be softer and rounder.

(Note:  When they control for activity level and fitness level?  Being overweight does not actually confer higher mortality.  In fact, those people live *longer*)

[beanma]

I think the thing to do is help her to find some things she feels good about for herself—maybe she's got an awesome voice, or is great at art, or is a straight A student, or maybe she's really clued into other's feelings and is a great friend, or maybe she's crafty and makes beautiful friendship bracelets—having something to feel good about can go a long, long way when she inevitably hits the bumps that life throws at you.

Here's a nice blog post about Leisel Jones and the fat comments:

http://sports.nationalpost.com/2012/07/29/a-weighty-issue-at-olympics-swimmer-leisel-jones-is-fit-not-fat/

[Shami]

I had a long detailed post that just vanished, ugh!

First, it is not her fault.  Her body is insulin resistant.  Check out Gary Taubes,  Why we get fat, I think is the title, and he wrote Good Calories, BAd Calories.  Dieticians are going to tell her to eat 7 to 11 servings of whole grain products bread/pasta/rice which is exactly what is making her fat even though she is active and not junking it up all the time.  I would skip the dietician and fill her plate with protein, veggies, and fruit (heavy on the veggies) and a small serving of bread or grain (a serving of rice is the size of a tennis ball).  I would try to limit the breads/grains to 3 servings and that's only if she really must have it.  Cut back on sugary drinks, even juice.

And just for fun,  go to Hula and watch the documentary called "Fathead".  It's the best for making it real clear that it isn't her fault.  As far as emotions and actually implementing a new way to eat...sorry I have never done that with a child so I am not much help.  Just wanted to throw in my 2 cents worth and my rant about dieticians.

Check out the book Wheat Belly, I think Davis is the author.  People lose weight just by cutting out wheat.
 

[tropicana]

Originally Posted by Shami 

I had a long detailed post that just vanished, ugh!

First, it is not her fault.  Her body is insulin resistant.  Check out Gary Taubes,  Why we get fat, I think is the title, and he wrote Good Calories, BAd Calories.  Dieticians are going to tell her to eat 7 to 11 servings of whole grain products bread/pasta/rice which is exactly what is making her fat even though she is active and not junking it up all the time.  I would skip the dietician and fill her plate with protein, veggies, and fruit (heavy on the veggies) and a small serving of bread or grain (a serving of rice is the size of a tennis ball).  I would try to limit the breads/grains to 3 servings and that's only if she really must have it.  Cut back on sugary drinks, even juice.

And just for fun,  go to Hula and watch the documentary called "Fathead".  It's the best for making it real clear that it isn't her fault.  As far as emotions and actually implementing a new way to eat...sorry I have never done that with a child so I am not much help.  Just wanted to throw in my 2 cents worth and my rant about dieticians.

Check out the book Wheat Belly, I think Davis is the author.  People lose weight just by cutting out wheat.
 

i agree with the dietary advice offered here. bread, pasta and rice makes you gain. so does dairy by the way-- another HUGE industry propegating their product to the detriment of consumers.

cut back on fructose -- better yet cut it out completely. children don't need it at all.

boxed breakfast cereal -- very very bad in so many ways. eggs for breakfast -- very good protein. lean meats, especially if you can get her to eat it without the bread. maybe do open faced sandwitches for half as much bread without going hard core no bread.

make sure she eats lightly frequently, she is still growing and doesn't need to "diet" to lose weight, just control for the "bad" foods -- they are out there, don't kid yourself. there is a long long way to go to clean up one's diet. 

can you get her involved in learning to cook vegetables deliciously? i know, raw is best. but baby steps. also fruits are an investment, but worth it, they are natural sugar. 

it's a tricky line and a tricky business, weight loss, even without the preadolescence figured in. but if you can find ways to make it fun and a learning experience without getting obsessive about the food, that would be the ticket. if her genetics are to be overweight, it's probably her future to have this body type, not to say things can't be improved. 

and it will do her a great favor to really get educated about healthy eating and feeding one's body nutritiously.

good luck!

[LynnS6]

Where does she eat?

Our dd, who has a naturally solid build, but on a little too much extra weight this summer. I realized that we'd become lax about our "not eating while watching TV rule". I lowered the boom on that (not so much because of her weight but because the basement where the TV is was a pig sty). I can already tell there's a difference in how much dd is eating -- not  huge, but I bet it adds up to 200 calories a day. If we can keep that down, she'll grow into her weight and get back to her "typical" size -- which is about 85th percentile for height and 93-95th for weight. It's how she was born and it's how she's been.

Weight Watchers has a good book for families and one of the rules they stressed there is that whatever rules you adopt, they apply to the WHOLE family. So, I've changed up the bedtime snacks so that they have to include one piece of fruit, and dd's brother (who's 7" taller than dd and 6 pounds lighter -- he's on the skinny side) also has to do this. For him, it's about his teeth. He tends to sugar. Dd tends to fatty foods like cheese. She would drink gravy as a toddler. so, each of them are getting a healthier diet and I'm not singling her out.

Does she get 60 minutes of movement a day? Even if she's active in classes, she might not be getting the 60 minutes of activity that she requires. Dd took ballet this summer, for example, and it was a lot of sitting around waiting for explanations. I prefer her swimming lessons because of that. She gets a good 30 minute work out. When you add in her bike riding and running around with friends, it's better for her. What can you do as a family to help get everyone active and involved. I have to say that the one huge difference between my skinny kid and my not skinny kid is the amount of movement they get. Ds moves constantly.

[rubidoux]

I was thinking about Taubes, too, and I agree that whole-heartedly that it's the grains/dairy and to some degree fruit (grapes and watermelon are not much but sugar, blueberries/strawberries seem a better option) that wreak havoc on bodies.  I hate the idea of putting any young person on any kind of diet because its so damaging to one's self-image.  I do think if your idea of healthy eating includes lots of grains and little/no meat, then reading Good Calories/Bad Calories would be a great idea.  My metabolism is so shot now and after I read it, I wished so badly that I had not spent all of those years feeling like I was taking care of myself by avoid fat like it was the plague and feeling like I was so virtuous every time I had a serving of "whole grain".  I think back on all the juicing and, omg, how could I really think that was so good for me?  I felt like absolute crap even though I was eating so well.  Anyhow...  just saying that "healthy eating" isn't what has been ingrained in us all these years.  If it were my dd, I think I'd cut out the grains/dairy/fruit for the family, but I wouldn't in any way single her out or try to keep track of what she was eating at home or elsewhere, just try to model healthy eating and make it available for her.  

Originally Posted by Shami 

I had a long detailed post that just vanished, ugh!

First, it is not her fault.  Her body is insulin resistant.  Check out Gary Taubes,  Why we get fat, I think is the title, and he wrote Good Calories, BAd Calories.  Dieticians are going to tell her to eat 7 to 11 servings of whole grain products bread/pasta/rice which is exactly what is making her fat even though she is active and not junking it up all the time.  I would skip the dietician and fill her plate with protein, veggies, and fruit (heavy on the veggies) and a small serving of bread or grain (a serving of rice is the size of a tennis ball).  I would try to limit the breads/grains to 3 servings and that's only if she really must have it.  Cut back on sugary drinks, even juice.

And just for fun,  go to Hula and watch the documentary called "Fathead".  It's the best for making it real clear that it isn't her fault.  As far as emotions and actually implementing a new way to eat...sorry I have never done that with a child so I am not much help.  Just wanted to throw in my 2 cents worth and my rant about dieticians.

Check out the book Wheat Belly, I think Davis is the author.  People lose weight just by cutting out wheat.
 

[Shami]

I agree with pp...do it for the whole family.  Make healthy changes because it is good for the whole family so she isn't singled out.  My pediatrician tries to help us every visit with nutrition and exercise.

She says comfort food is anything you make with love.  A whole milk greek yogurt parfait with blueberries and nuts/seeds sweetened with a little honey is comfort food.

And try to make family activities together.  Instead of movie and a popcorn, go for bike rides together, explore hiking trails, go sledding depending on the weather.

I know it's easier when kids are little to begin something like this.  Once they are older it's a bit more challenging, but baby steps toward that way of living.

Maybe one night can be movie night and other times are more active.  She says that this gets it in their way of thinking that family time is active and healthy foods are made with love. 

She also said to let them help to find a good recipe that is a healthy version of a treat, cookie or cake.  Let them help make it. 
 

[~cassie~]

My niece is 9 yrs old and is 120 lbs.  She is overweight and it makes me sad for her.  Her 7 yr old sister is 90 lbs, so overweight as well as both parents.  My sister has put everyone on a new eating lifestyle and is following a plan that has you cut out all grains of any form.  She is also having everyone record what they eat everyday and they as a family duscuss where they made a bad choice or could have made a better choice and then talk about their good choices.  They also discussed the role of food for our body and what it needs to be healthy and what "bad" foods can do to your body.  They do it all in a very good manner and it's actually helping the girls be more responsible for the food they choose to eat for their body.  They just started it about 2 weeks ago and they do emphasize that it is to make sure their body is as healthy as it should be not about losing weight.

My sister and I grew up overweight and it was hard.  We fear for the girls that they will go through what we went through with regards to the bullying and low self esteem so as a family(and I mean extended family as well!) is making an effort.

[singin'intherain]

Weight is such a complex issue. There could be many reasons why she's overweight. Her activity level and diet really do not differ considerably from our six other kids, so it's hard to believe that tweaking her lifestyle could change this. My reasoning in going to a dietician is not that they are right on the cutting edge of nutrition, but that she will get a chance to hear from someone other than us that dieting is not the way to go. She trusts doctors, and is a lot more skeptical about the things we say. I also want her to have the tools to manage her own diet, not just be stabbing in the dark wishing she knew how to lose weight.

I've read Wheat Belly, and done some research on the Glycemic Index. Insulin resistance does seem like an angle worth looking into. Her blood glucose test was completely normal, however. I will definitely check into Gary Taubes, I haven't heard of those books before.

There may be no magic reason why she's fat. It could be lifestyle, genetics, saving up for a growth spurt, and diet all put together, and if we tweak those things that can be tweaked, she'll gradually grow out of it. Or maybe she's destined to be healthy and big. I still think the main focus has to be on building her inner resources so she can stay strong. School might not be easy for her in the coming years. I will definitely be checking out the resources that have been offered here. Thanks!

[meemee]

OP i am only going to respond to the emotional aspect of weight. 

dd almost your dd's age with similar issues read all the posts here and we've had quite a discussion.

now i think what's key at that age is - peer pressure. throw those ads out the window. its not ads and barbie dolls that create issues for our kids, its peers. our kids are smart. they know a lie when they see one in the ads. 

like dd pointed out - if she is trying to lose weight because the kids are teasing her then will she change the colour of her hair too if they are teasing her about it because they dont like the colour of her hair? dd hates makeovers because the uniqueness is gone and you look like everyone else. 

so the first thing is having a good self image that depends on herself - not on what others say. 

dd has the same issue. she is a buxom, tall girl. and yes she has a belly. and yes she is teased. 

and i had to really talk to her and ask her what SHE thought about herself. not what society says. somedays dd has come to me and asked me 'mama am i fat'. and i've told her depends on who you ask. yes you are fat according to the models who are like sticks. but ask botticeli if you are fat and he would say no. your pedi would say yes. so it really depends on who you ask. 

one key thing you guys need to look at is genetics. was her mom a chubby child too. the ped. wants dd to lose a few pounds. of course that's right. but genetically dd's father was exactly like her. in time she will lose the weight like he did at 14. and then if she doesnt that's when we might have to do something about it. 

however i would seriously look into why she is so different amongst her siblings. could it be medical? could she be sensitive to gluten? 

does she suffer from a lot of tummy aches? a lot of gas? does she have anxiety. my dd eats super healthy which shocks a lot of other people around her. has the occasional junk. she is active. no reason why she should be so fat. yet she is - and so i am leaning on genetics. however i have found she is gluten intolerant. 

but the key is having your dsd feel ok with who she is - no matter what society says about her. its not easy being the lone one in the crowd. peers can be the most cruel people. 

[chaimom]

What about taking her to Weight Watchers? She's apparently aware she's overweight, and I think WW focuses on healthy eating and should give her information to use to make better choices.  I like that it doesn't ban any food, but focuses on making choices.  

[singin'intherain]

Originally Posted by chaimom 

What about taking her to Weight Watchers? She's apparently aware she's overweight, and I think WW focuses on healthy eating and should give her information to use to make better choices.  I like that it doesn't ban any food, but focuses on making choices.  

I don't want her to go on a diet- I don't know much about Weight Watchers, but my mom did that quite a bit when we were kids, so I lump it in with other diets. I don't think it would be a good idea for her to start monitoring how much she eats with any kind of precision. First of all, she already tries to make food choices that will help her lose/control her weight, as much as a ten year old kid can do that consistently. I really really don't want her to start feeling guilty when she eats something she "shouldn't". If we are going to change what she eats, it will be as a family- having new things available, and making others unavailable. I refuse to manage how much she eats- I might worry about it if she were binging, but she doesn't binge. Even if she did, my mom's a binger and I know that monitoring portions is the absolute worst approach to dealing with this emotion-based problem.

I guess what I really hope to do, is to give her the tools to tweak her diet, mainly for health but also for weight loss if she chooses. But I want her to understand that being skinny doesn't equal being healthy, and to put her health first. I want her to love her body and see it as a work in progress that doesn't have to meet any standards of beauty, and whose main purpose in life is her own enjoyment.

The thing is, though she can use more education about healthy choices, she does pretty much have the gist of it. She knows fruit and veggies are healthy, and lean meat. She knows candy and cookies and pop are unhealthy. I see her, often, consciously choosing to eat nutritious food. We don't have treats at our house very often, we don't drink soda or have bags of chips or hot dogs around. I kind of find it frustrating that there's always this assumption that if she has a big belly, it must be that she's eating too much junk food and not exercising. The truth is, she can use improvement in both areas, but no-one that knows her would agree she's sedentary or that she eats a fattening diet. As I've said, I have other kids who sit for hours every day- honestly I worry more about their unhealthy lifestyles- but they are skinny. I think that fat is a lot more complicated than we've been led to believe, and sometimes I wonder if that's because the diet industry thrives on peoples' belief that being thin is just a matter of applying a simple equation.

[beanma]

Singin', I think you have a great handle on it. 

Have you seen the Dove campaign and social mission? They have activities for girls. I haven't tried any of them, but I love that they use real women with "real curves" in their ads.

http://www.dove.us/Social-Mission/default.aspx

[mumkimum]

My favorite PP suggestions are working at revamping your families eating habits (if needed) - not at tv, more easy fruit/veg for everyone.  Little changes here are good, and make a difference.  As well as more family activity - walk to the store, long weekend hikes/picnics, etc.

As for her own feelings and dealing with others perceptions - learning about fashion can end up being a help and healthier to focus on than food, and I think tends to crop up as a normal interest around that age.  

I'm thinking about shows along the lines of 'what not to wear' in talking about how to choose styles that accent your best body features and look flattering without a focus on having to change any part of your body.  As an adult, I know it makes a difference in how I feel and how I might be able to ignore negative comments/feelings about my body - and isn't something that I ever delved learning about as a teen/pre-teen.  I can't think of anything more kid-oriented that's similar (there's probably something out there though).    If there are a lot of healthy choices and habits being made on her part, I'd err on trying to deal with the issue using other options (focus on activities/talents, try new things, meet new people - just keep up with keeping her life balanced so it isn't focused on weight/food).  She's likely storing energy for teenage growth spurts, to a degree at least.    

[savithny]

Originally Posted by singin'intherain 
I kind of find it frustrating that there's always this assumption that if she has a big belly, it must be that she's eating too much junk food and not exercising. The truth is, she can use improvement in both areas, but no-one that knows her would agree she's sedentary or that she eats a fattening diet. As I've said, I have other kids who sit for hours every day- honestly I worry more about their unhealthy lifestyles- but they are skinny. I think that fat is a lot more complicated than we've been led to believe, and sometimes I wonder if that's because the diet industry thrives on peoples' belief that being thin is just a matter of applying a simple equation.

I am so glad to see you saying this, because it's so true.  Especially the idea that it's just a matter of applying a simple equation.   I'm glad for her that she'll ahve someone in her life who will support her in being healthy without equating health with thinness.

I've been reading a lot about food and metabolism, not from an ideological ("Pure Foods!  Grain Free!   Go Paleo!   No, Go Vegan!") standpoint, but history and science.   While you'er looking up the Taubes book, I'd also recommend "The End of Overeating," which talks about how processing changes how we digest foods and how our body responds to them, "Mindless Eating" which talks about the ways our brains respond to the availability of food, and "Catching Fire: How Cooking Made Us Human," which is partly about the vital role cooking played in allowing us to evolve into modern humans but also has a really, really good section on how the energy value of foods is not set in stone and different people actually extract different calories from different foods.   

Most of all, I think it is absolutely vital to describe health and fitness as something that exists alongside weight but is NOT THE SAME.    I have always thought I knew this, but have recently realized that every time I've gotten out of shape and felt bad, my motivator for getting back into shape was weight -- and when I didn't lose weight, I mentally disengaged from exercise because "It wasn't working," even though I was stronger and fitter and had more endurance and felt better.   I want my kid to exercise and be active because it feels good to be able to, not so she can fit into a pair of size X jeans.

(and she's never going to be a size zero.   She had the same waist measurement as a size zero when she was five.   Much like me and my mother -- my mom is 5'10", and in her 20s she had a thyroid condition and weighed 110 pounds -- and was still a size 14, because of her bones.   Some people will always be big.

[singin'intherain]

I really like the idea of learning how to flatter her body with her clothes. That's a great tool- not hiding her body in shame, of course, but learning how to make her assets stand out. Clothes really do make a big difference. Imagine being a big girl in the era of low rise skinny jeans- what a fashion disaster!

Does anyone know where to have a reliable body fat percentage test done? Dsd is very strong- she can easily hoist herself up onto a high place, which should be hard because she weighs a lot. She also has big solid muscley legs and butt. I'd like to see if some of her overweight is due to muscle mass.