Diet for a 3 year old, pure torture

[maxeygirls]

Due to medication, difficult child is gaining weight at an alarming rate. Her psychiatrist is adjusting her medications to try to help with the appetite issue while still helping her but she has gained almost 10lbs in under 2 months. I had bought new clothes for her three weeks ago and the pants won't snap! I've cut all juice, processed foods and sweets, substituted things like white turkey for bologna, low fat dressings for heavy condiments etc. but she is always hungry and it's so hard to tell her no. We've had to put a lock on the fridge because if we turn our backs for just a second, she's in there and digging into cheese, crackers, anything she can find.
I'm offering raw fruits and veggies as snacks, which she has always loved before but she resists them now. If I make meals fun she eats them, such as a 'fruit monster' or a 'veggie tic-tac-toe' but she is still begging for other foods.
Has anyone been in this spot? How did you handle it? Are there any substitutes which will satisfy both of us?

 

[smallworld]

Hi there, unfortunately, medications like Risperdal and Depakote truly affect the appetite control center of the brain, and the hunger is very real. The kids truly can't turn it off. Besides distraction, lots of activity outside of the house and away from food and offering healthy choices (as you are), there isn't a whole lot more you as a mom can do. Sometimes after a lot of weight gain during the first few months of taking the medications, the gain does taper off and settle down.

The psychiatrist has two other medication choices, however. He could switch to a mood stabilizer that is weight-neutral, such as Lamictal or Trileptal. And he could switch to Risperdal's long-acting verison, Invega, which is supposed to have fewer side effects, including weight gain.

One further option for the psychiatrist is to add an anticonvulsant with appetite-suppressant qualities, such as Topamax or Zonegran, or the diabetes medication Metformin. But he may be reluctant to go that route with a 3-year-old.

Hang in there.

 

[timer lady]

As SW said the medications are the problem. Add in to that a growing 4 year old - ick. Is your pediatrician aware of your difficult children diagnosis? Does your psychiatrist have a good reputation in your town?

You don't want a problem with your pediatrician doctor getting all bent out of shape because of prescribed medications. There have been cases of CPS stepping in because of a diagnosis of bipolar this young. I hope your doctors are working as a team.

 

[Marguerite]

I strongly urge you to not make your child cut back on calories. THis sounds like exactly what happened to difficult child 1 on Risperdal, when he doubled his weight in six months. he was a teen, went from being skinny (six pack chest) to tubby) a beer keg). Dieting only made him more frantic for food.

What we did - we made sure there was only healthy food in the house. We didn't limit food, but we did eliminate all biscuits, cake, fried foods, sweetened foods and stuck to fresh fruit, fresh vegetables and home-cooked casseroles. Cut back on the refined carbs, substitute wholegrain everything and make it in moderation. Protein is good, but two meals out of three need to include the same amount of protein as the palm of the person's hand. Otherwise - fill up on vegetables (not potato). Keep fruit to a minimum - a child can get away with two to three pieces of fruit a day. Juice is out - have the piece of fruit instead, one serve of juice replaces one serve of fruit. Otherwise - low-fat, and low cholesterol (although allow eggs fairly freely, ignore their cholesterol).

Strawberries - unlimited. As for whichever fruit & vegetables you choose, try to avoid the ones with high natural levels of sugar. What to avoid - watermelon, banana, grapes. Also avoid yogurt (no sweetened yogurt at all) and no sweetened milk. Substitute artificial sweeteners but also keep those to a minimum, they really aren't much of a substitute.

Also what we found with difficult child 1 - when he went off the Risperdal, the weight fell off. No diet needed.

So don't sweat it. Just aim to keep her healthy, and please, do NOT put her on a calorie-controlled diet, you set them up for problems for life. Instead, change the lifestyle of the whole family, to healthier eating in general. If she fills up on, say, carrots or cauliflower (plus drink LOTS of water - it really makes you feel fuller) then she is getting the fibre and the vitamins, but not the loads of fast calories. She will also get into good habits for life.

Marg

 

[smallworld]

FYI, some children -- like mine -- react very poorly to artificial sweetners so we do not use them at all in our household. It is, of course, a personal choice.

 

[GoingNorth]

Speaking as an adult who took Zyprexa and Seroquel (same class of drugs as Risperdal), along with Depakote...the hunger and cravings are very real. I was literally hungry all the time and wound up putting on at least 50lbs.

In my case, stability was more important than weight. I did wind up going off the atypicals but not because of the weight gain. Rather, I was experiencing weird and frightening side effects (difficulty swallowing, dystonia, etc)

I now take good ol' Haldol which seems effective. BUT, Haldol used long term can have permanent side effects. Plus, I don't know if it's appropriate for use in children at all.

 

[DammitJanet]

Im sure as a 3 year old she is a juice box freak...I know all I have met are. I just found a box of Minute Maid coolers that are only 5 calories a piece! They are the water ones. My granddaughter loves the water drinks better than the ones that are real sugary. Thats the older one...the younger one lives on Hi C juice boxes at 100 calories a pop and drinks at least 8 a day! I keep trying to convince her parents to switch her to at least the 30 calorie ones like my older granddaughter drinks but no such luck.

As far as food...can you get her to still eat those Gerber Graduates toddler meals? The ones that look like TV dinners. Those are still enough food for a lunch for mine. I give her one of those and some fruit for lunch. Snack in mid afternoon. Those sugar free jello or pudding cups would be a good dessert. They also have a ton of low sugar popsycles out there now. Freeze grapes. She can eat those to her hearts content I would say.

She is little. I would see if you can make something fun. Maybe celery with pb and raisins? I dunno.

 

[JJJ]

Does she seem to crave any particular food?

We found when we eliminated gluten (wheat, barley, rye) and caesin (dairy) from his diet, my younger one quit craving so much food.

 

[maxeygirls]

Thanks to all for the suggestions. I'm going to call the psychiatrist to see about another medication. We reduced the risperdal due to difficult child being sluggish and her increased appetite and although the appetite level hasn't changed, her energy level is back up. I am very active and when she keeps up with me I know she'll work off the pounds. She goes with me to any fundraising walks, runs about 1/2-3/4 miles next to me on my runs before climbing back in the jogger, etc. It was just so hard to see her be so... zoned out. I'm going to seriously push for another medication because it seems that a slight increase in risperdal causes a huge drop in energy and a slight decrease causes her to be close to out of control again. All I can think is there has to be something else.
Regarding her diet, I have taken an interesting approach. difficult child is currently testing at or above a 1st grade level in math, reading and writing so I figured she could kinda understand a bit more than I gave her credit for. I took out her divided plates, and explained what can go where. I showed her where the veggies and fruit are and told her for lunch she can fill the big section with veggies, one small section with fruit and the other small section is for meat, cheese and one cracker. She loves baby carrots so we got a big bag and told her that whenever she is hungry she can have as many as she wants.
Dinner is working well if we put the food on the plates in the kitchen instead of putting the casserole dish, pot etc on the table. Dessert in our home has always been fruit, a trick I learned from my ex boyfriend's mom. The faces and 'monsters' and spiders made out of veggies are still working well after a few fits for other items. Our biggest struggle still is drinks. She wants juice 24/7 and it seems that eliminating it all together is working better than limiting the quantity.
The one thing I haven't changed is her one cookie and glass of milk after 'school,' which is her twice weekly, one hour session with a temporarily retired (she's inspired by difficult child to go back for her master's in Special Education) teacher. I can't see two cookies a week hurting but if anyone has a healthier recipe for chocolate chip (or similar) cookies, I'd love to hear it!

 

[Marguerite]

I love what you did with the plate of food. If you say she can understand this, then it was a good strategy.

As for the twice-weekly milk and cookie, what about changing it to milk and a piece of fruit? Or milk and a small piece of chocolate? Because a couple of pieces of dark chocolate a day are actually good for you, I treat it as my vitamin pill. I lost 25 Kg that way, still allowing myself to have two squares of chocolate a day. It's also got treat potential, and with a glass of milk should be very filling.

Marg