What to do when your child is diagnosed as overweight?

[Katie Gardner]

My 6 and a half year old son went to the doctor today for the first time in a long time and was charted on the "growth chart" for the first time. His BMI is 18.2 (height 48 inches, weight about 60 lb). His doctor reported to us both that he is overweight and needs to lose some weight in the next year. So, I have been noticing that my son has a belly that looks a lot like mine. Otherwise, I would not have said he appeared overweight.

We hike, take walks around the neighborhood regularly, he swam a lot this summer, and he plays HARD with the neighborhood kids at least 2 times per week. We eat much better than average (veggies every meal, no sweets/cereals for breakfast, nothing but water to drink during the day, sweets only in the evening) although have been traveling a lot this summer, so eating out more than usual. 

I'm just wondering how seriously to take this. Part of me feels so self conscious and scared that I want to seriously change what he/we eat/s. The other part feels like it's likely "baby fat" and that restricting him too much will undermine his confidence and make him feel very self-conscious and ultimately not work (but then I also feel like if I don't take it very seriously, he will become obese).

I'm having an inordinate amount of guilt. I feel like I must be treating food the wrong way, I have rewarded him with sweets in the past, etc. He really loves food and loves to eat. He likes to play with his friends, but otherwise doesn't enjoy physical activity unless required to do it. I have a very poor relationship with food, have been working on it a lot, and I feel no matter what I do, I'm passing it onto my son.

No matter what, I'm going to put more emphasis on physical activity and seriously limit sweets.

Any advice/support other than than is appreciated.

[katelove]

If it were me I would probably start by documenting everything he ate for a week, including portion sizes. At the same time I'd do some research on what is considered healthy amounts for a child that age to be eating. I wouldn't make him aware that I was doing it. If, at the end of the week, I felt that there was room for improvement then I would start making changes. I wouldn't make a big deal out of them and I'd probably make them for the whole family.

I'd also, and this would be the hard bit for me, increase the family's activity levels. Probably a 30 min daily walk and try to increase our incidental activity as well.

If, after a week of documenting food intake, I thought his diet was good then I'd probably take a more watch and wait approach although our family can always use more activity so I'd probably still implement those changes. I'd review the diet and weight situation in a couple of months and make another decision then.

I'd probably also do some research on medical causes of overweight in children and consider sme testing if diet nd exercise were good for a couple of months with no change in BMI.

[MelW]

I think your doctor's advice about weight loss for your son is off target. My understanding is that at his age and BMI range the focus is on slowing the rate of weight gain, NOT losing. Essentially allowing his height to increase as he grows with slower weight gain with a goal of achieving a normal BMI. Weight loss, especially through calorie restriction isn't good for growing bodies.

The biggest thing that jumps out from your post is his dislike/disinterest in exercise. I would suggest finding something vigorous that he likes- lots of swimming this summer? Try swimming lessons. Or soccer, biking, whatever else excites him. On top of that, I'd encourage as much family activity as possible. I've noticed a big change in my 6 1/2 year old's activity level lately- while she used to be in non-stop movement, recently I'll be out gardening and find her curled up on the deck with a book.

For food it sounds like you're doing well. Keep the focus on healthy foods that help bodies grow strong for exercise and play. Don't mention weight or weight loss. I wouldn't restrict amounts of food, but offer unlimited extra veggies if still hungry (instead of unrestricted noodles or other carbs, for example).


You're doing great- beating yourself up isn't helpful for you or for your son!