how to help difficult child with weight problem?

[sjexpress]

difficult child is significantly overweight. He was always off the charts since an infant with weight and height for his age and all along the doctors kept saying just watch what he eats, he's big, he'll grow into his weight, etc... For a while, this seemed true but the past year of so, difficult child weight has gotten out of control. We had to switch pediatricians since our original retired and the new one ran some blood work and tests to see if any thing like thyroid was an issue but everything was normal.
Obesity runs in our family and although I know genes play a part in it, more of the problem lies in the fact that difficult child just loves to eat and is never full or satisfied. husband is slightly overweight and I used to be as a kid too but when I went to college ( over 20 yrs ago..yikes) I decided to make better food choices and have been at normal weight since. I cook healthy foods but difficult child eats well over his portion and snacks like crazy. If you limit his portion or food choices, he flips out and carries on that he is hungry. I have made many changes in the house with what we keep to eat but again, if difficult child won't eat a normal amount, it won't help. He is always hungry! And, he is plenty active outside of school playing on numerous sports teams... I could only imagine what he'd look like otherwise.
A few months ago he agreed he needed to lose weight and saw a commercial for weight watchers. We spoke to his pediatrician. who gave us a note that it is safe for difficult child to do the program. At first difficult child was excited and believe me, he is allowed alot of food because of his age. I promised to of course do all the food prep., portion measurements, point management, etc... The first week, difficult child lost 3 lbs. We made a big deal out of it with praise, etc... but after that, things went down hill. difficult child complained it was not enough food for him ( which I feel is no way true), he said he hated having to not eat anything he wanted and did not want to have on a certain portion! So after one week, even though he saw results, he basically wouldn't stay on the plan. He kept saying it was not fair!!! So difficult child like!
I swear, I think he is putting on more weight than ever and even faster! I almost hate looking at him I am sorry to say! He has zero discipline in his eating. If I make just the right amount of food for each of us, he flips out and tantrums that he is starving. Again, it comes down to difficult child wanting what he wants when he wants it.We have made all sorts of promises for great rewards of things he wants if he loses a set amount of weight and believe me, the pediatrician. only wants him to lose 20lbs which would still make him over weight but she feels because of his age and activity level this is achievable.
I really don't know what to do for him anymore! After most of his sports he complains of all these aches and pains and we explain if he were a bit lighter, this would all go away. He is sched. for a yearly physical this Fri. and he is saying he is not going to go because they will weigh him and he knows he gained more weight and he doesn't want to hear it! How can he not want to help himself?!! I feel awful too because we have so many battles that I honestly let this weight thing go on too far and too long because I couldn't take anymore fights and stress. Something has to be done though! Any suggestions or ideas? I am so fearing the summer because difficult child is refusing to go to camp which he has always done for the whole summer so this means like zero moving around!!

Jan

 

[Giulia]

Hello,
Does your difficult child take any medicine, like AD, antipsychotic, mood stabilizer, prednisone... any medicine which makes him put on weight ?
Insatiable appetite comes along with certain medicines, so it's absolutely indispensable to know something like that.
Any mental health issue ? Does he see a psychiatrist ?

Another possibility is about he overeats because of psychiatric issues.
If you focus only on food and exercise, things don't improve but worsen.
Does your difficult child see a counselor ?

Does your difficult child sleep enough ?
Lack of sleep can more often than not trigger overeating so obesity.

Don't get me wrong, you are a great mom by being concerned about his being overweight.
But you focus only on food and exercise. If you want to tackle the problem, you need to have a broader picture of it. Otherwise, as hard as you work, it will go nowhere.

If sport becomes a chore, you can be sure that everyone gives up, and not only a difficult child.
So think about hidden exercise, like gardening (yup, gardening, you heard it).
Don't drive him to take the bread whereas the baker is only at 300m, he can go by foot.
Encourage him to go to school by foot.

About food, why not having him taught how to cook ?
If he does not know how to cook healthy meals, no wonder he will get on junk food !!
If you have no money, you can propose a service exchange, like one hour cooking lesson = one hour computer using lesson.

If I were you, I would stop the power struggle right now. The more you get into a power struggle, the more he will put on weight. Classical but unfortunately, the most frequent situation between parents and obese children.
It's hard to break old patterns. It takes time. But it works where everything else fails. I've been there done that with my family and my friends. It's hard and sometimes, painful.

So you can let him know that he will manage this situation with his doctor, and that you are not here to police him. He does not have to lose weight to please you, he has to lose weight for his health. So turn the situation in something about himself, for himself, not for you and for his dad. He does not do it for you, he does it for himself, for being healthy, he does not do it to obey someone or society.
Give him the control over it, and more control than he already has. Like he manages his appointments with the doctor : if he didn't go to the appointment, he can blame only himself, not you, not anyone else.
If he eats too much and put on weight, he can blame only himself. etc etc....
Also, let him choose with which doctor he wants help. He may not feel very at ease with his pediatrician about that. He needs to feel at ease with the doctor he sees.
The only non negotiable thing is that he has to see a doctor to monitor his condition. He cannot choose not to see a doctor.
But he can choose the person. He is not too young to make such a choice. And he needs to make such a choice.
(it is also a non negotiable rule at home for me : I cannot refuse the medical care, but I can choose with which doctor I want to be. As young as teenagehood, mom knew that she cannot oblige me to see someone that I don't like. But she has stayed firm about the non negotiable rule which is the obligation to get medical care. It was not too hard to follow because I had and still have the choice with whom I want to be followed by. Otherwise, I would not have accepted the medical care)

Stop the power struggle right now, right now, right now. For his sake and for your sake.
You do your best, and you want to do so well, that you feel you need to control his eating, exercise and such. But your son opposes himself with you.
If you stop controlling him, and let him the duty to carry on his weight loss, you don't give him up. Instead, you show him that he has the power to lose weight, and he does not do it for you.
Also for the sake of family.

 

[InsaneCdn]

If you treat the weight problem as the problem, you lose. The weight is a symptom. Somehow, you have to figure out why...

Food is frequently used to self-medicate for depression, anxiety, lack of quality sleep.

Ravenous hunger can be medications-induced, but if there are no other triggers around food, frequently the person can still self-regulate. Our difficult child is "always" hungry, but has learned to take a logical approach... and when he's had his share of higher-calorie items, he is allowed extra raw veggies - low in calories, high in fiber, and they take time to eat.

Getting to the bottom of the source of the problem, though, is NOT easy.

 

[Giulia]

You summarize my lengthy text, Insane

Do you have any other solutions to suggest other than what I already proposed ? You may have ideas that I didn't think about.

medications induced hunger, yup, I also know it with Zyprexa (and it was the wrongest medication for me, yuck).
It is hard, but sleeping 15 hours/day because of it was even harder (we had to scream over psychiatrist to make her change medication, and she bit her fingers for not having believed me about the hypersomnia triggered by Zyprexa. She could not believe that it could be triggered by Zyprexa, and it lasted one year. psychiatrists say that am tenacious to accept such side effect for one year and a half...).


(by the way, my problem is opposite, and is called lack of appetite. It's not better at all, nor worse, it is the end of the spectrum)

 

[sjexpress]

difficult child does not take any medications. He does not get enough sleep in my opinion...difficult child will tell you he is not tired and fights us every nite about going to bed on time. Although he can't verbalize it, difficult child does struggle with anxiety and worry and of course there is more going on with him I am sure as this is what make him a difficult child!

 

[Giulia]

Figuring out the way you did is a very good start.
Now, what solutions do you think about ? How will you implement them ?

 

[DaisyFace]

sj--

I understand that he is overweight....but 12 seems like a weird age for a boy to start a diet. Their hormones are surging...their appetites are out-of-control...they are building their adult bodies - putting on muscle and bone mass (not to mention all that manly hair!). He needs to eat foods that satisfy the hunger and give his body what it needs.

Also - some people are just never, ever going to be "thin"....but they can be healthy.

Would it make more sense to get him involved with something where size would be an advantage - like football? And then talk in terms of eating healthy and building muscle instead of weight loss and fat.

 

[keista]

in my opinion he's missing a "switch" which most normal weight ppl have.

the problem lies in the fact that difficult child just loves to eat and is never full or satisfied.

This is not just your perspective, but 100% REAL. My son is missing that switch, and so am I. Doesn't help that we eat fast. Does difficult child eat fast?

At 12, he's old enough to know that he can't have two opposing things at the same time. He can't eat all he wants and loose weight. HE needs to want to do something about it. First thing he needs to do is change his eating patterns. Essentially he needs to learn to eat with his brain instead of his stomach because his stomach never tells him when he's had enough. Not what he eats, but how he eats. He has to slow it down and savor each bite. He needs to cut his portions. I make son take a 20 minute break between his dinner and seconds. Usually he'll forget about it and then have those "seconds" as his dessert. These two things alone will go a long way. He can also keep a food journal. Would he be shocked to see how much he really eats? What if it were translated into calories?

 

[Liahona]

I have heard of people who just can't feel full. Maybe your son has this problem?

We had the opposite problem. difficult child 1 wouldn't eat, and yes, it was a control issue. It wasn't one we could let go of though because he would die. What we did was set an amount that he had to eat and times he had to eat. You'd have thought we were torturing him. We had many meltdowns. Believe me it wasn't enough food (people who didn't know the situation thought we were being cruel) to keep his weight up. It was something I was willing to provoke meltdowns for. After a few years (and the Residential Treatment Center (RTC) stay where being able to have 2nds at dinner was envied) we don't have the power struggle anymore. I don't know why. Now he is actually a little bit over weight. I don't know if this helps. I hope it does.

If your son feels like food is being restricted his body will hang on to more calories from the food that he eats. That is why he is eating the same and gaining weight. Even people who want to lose weight have a hard time with this. They have to figure out how to restrict calories without the sense of "I'm starving."

Good luck.

 

[SuZir]

Emotional side is of course important. But weight problems are also nutritional problems. If you want to look that side, look first to veggies. Is your son eating at least pound of vegetables and fruits a day? And more doesn't hurt at all. Also drinking enough water helps to keep hunger in control (people often mess up if they are hungry or thirsty.)

How serious your son is with his sports? if any, you can tell him, that if he wants to do great on them also next year, it is not an option to just lie around whole summer. He is the age there many start to train and differences will come huge very quickly. I have two sons who are serious athletes and when they were 12 or 13 they started to train seriously on their own even though they had some sport in season around the year. And in year or two differences were huge in their age groups between serious ones and ones who just came to meetings and did sport there and kids were split to very different level teams. In fact I once googled my difficult child and found out, that first time his name was mentioned in public message board for the fans of his number one sport as 'a talented kid worth keeping eye on' was when he had just turned 14 few weeks earlier. Professionals had heard about him earlier. I'm not saying that being a pro athlete is something parent hopes for their kids, but it is a dream of many 10 to 15 year-old boys. And may well motivate them to exercise and keep active.

And with the serious sport the nutrition problem change. For me it is basically how to carry from store and prepare the amount of (healthy) food my easy child consumes. And difficult child is worse, but he is luckily out of home. Do you have any idea what amount of (healthy) food it takes to come up to 5000-7000 kcal per day?

 

[Giulia]

Daisy, it depends on how much overweight he is.
If he is slightly overweight, it is not the same as if he is morbidly obese.

Also Daisy, sj said that he is really going off charts. The pediatrician said it can improve, but sj is concerned because it becomes now a major issue. not a slight overweight which outgrows by itself, it is getting major.
So yes, we have to tackle it because of health risks you know even better than me.
Daisy, sj does not ask her child to be thin, but to be at a healthier weight for his height than he is now. She is already aware that he may never be thin.
At least, this is what I understood, that she does not ask him to be thin, but to be at a healthier weight than he is now. A big difference.

I agree about the fact we have to bannish the term "diet" and having a healthy lifestyle, without any forbidden food. And exercise, and good sleep.

 

[DaisyFace]

Daisy, it depends on how much overweight he is.
If he is slightly overweight, it is not the same as if he is morbidly obese.

Also Daisy, sj said that he is really going off charts. The pediatrician said it can improve, but sj is concerned because it becomes now a major issue. not a slight overweight which outgrows by itself, it is getting major.
So yes, we have to tackle it because of health risks you know even better than me.
Daisy, sj does not ask her child to be thin, but to be at a healthier weight for his height than he is now. She is already aware that he may never be thin.
At least, this is what I understood, that she does not ask him to be thin, but to be at a healthier weight than he is now. A big difference.

I agree about the fact we have to bannish the term "diet" and having a healthy lifestyle, without any forbidden food. And exercise, and good sleep.

OK - This seems a little patronizing....but perhaps I misunderstand you....so let me explain where I am coming from:


My husband is "morbidly obese" according to any chart in any physician's office. He is a big guy. BUT - he is healthy as a horse. Low blood-pressure, low cholesterol, normal blood-sugar, etc. He struggled with being "the fat kid" his whole life. He was bullied and picked on...

until he joined the football team. All of a sudden his size was an ASSET. Plus - he got into a sports diet and added weight training. Still - he never really lost any weight....he just got healthier.


I'm saying the numbers on the scale aren't everything....and sometimes we focus too much on that.

 

[Giulia]

oh, I misunderstood you before.
Said as you say, I understand better (as says my ENT doctor).

I was more about the sj's concern.

I understand what you mean. But as far as I know, it is more the exception than the rule. I may be wrong though.

 

[keista]

OK - This seems a little patronizing....but perhaps I misunderstand you....so let me explain where I am coming from:


My husband is "morbidly obese" according to any chart in any physician's office. He is a big guy. BUT - he is healthy as a horse. Low blood-pressure, low cholesterol, normal blood-sugar, etc. He struggled with being "the fat kid" his whole life. He was bullied and picked on...

until he joined the football team. All of a sudden his size was an ASSET. Plus - he got into a sports diet and added weight training. Still - he never really lost any weight....he just got healthier.


I'm saying the numbers on the scale aren't everything....and sometimes we focus too much on that.

I'll echo this with my own example. My sisters and I are all considered morbidly obese. The two of them are single with no children. the get to spend money on nutritionists and gyms and personal trainers, etc. Not to mention they have the time to devote to this. Due to all this effort, they are indeed smaller than me, but not by all that much. One size maybe? (in those upper sizes one size is a really big deal) they are still HUGE. BUT they are HEALTHY. Me - not so much.

 

[sjexpress]

thank you for all the input so far. I agree that my difficult child is missing some "switch" that tells him he is full. I think it is the same "switch" that is missing that helps him control his anger! difficult child does eat fast no matter how much we remind him to slow down, which grates on him because then he gets mad at us for saying that to him so much.
I am not trying to put him a diet as much as teach him portion control without denying him any food he enjoys. That is what weight watchers focuses on for kids his age with a doctors note. He just can't take not getting how much of what he wants when he wants it! Yet, he tells me often that he wants to lose the weight! I feel bad for him because I know it take discipline and restraint which he is lacking! We all know he will never be thin and this is why although he is way over 20lbs over weight, the doctor only set 20lbs loss as his goal. It won't make him thin but he will be healthier and have less aches and pains from sports which he loves. it will also teach him good eating habits if I can get him going on a program!
We keep lots of fruits in the house and make veggies with every meal and encourage difficult child to eat those if still hungry after normal portion of main meal but nope... he wants more of what he wants or look out!

 

[InsaneCdn]

And until you know WHY... it's hard to make a dent.

Examples:
1) Lack of quality sleep: the body craves sleep, but if it can't get it, it takes many extra calories to keep an over-tired engine going... so, if you force yourself to keep going, the body turns on the major hunger signals. Real answer: fix the sleep problem.

2) depression and anxiety: simple carbs release certain hormones in the brain that reduce stress. It works - very well. The problem is the side-effects of self-medicating with carbs... finding real solutions to depression and anxiety can really reduce the carb cravings.

The problem with depression and anxiety is that often they are not the real problem either... but secondary to some other issues not being caught... so this can take a lot of digging.
For that matter, sleep issues are just as complex.

But... there's also genetic stuff that messes up with the hunger trigger, and I have no idea how to deal with those kinds of issues.

 

[BusynMember]

My son, who is on the autism spectrum, has the same problem. At first I thought it was the medication for his non-existant bipolar. But he's been off medications since he's been 11 so it's now all these years and he is still obese. I have taken him to endocronologists and nutritionists and probably a few other doctors I forgot about, but nobody found any cause for him to always be hungry and he still overeats. And because of his sensory issues, he hates the textures of fruits and vegetables and won't eat them. If forced, he gags and throws up. It is not deliberate.

We have very little to no junk food in the house, but he manages to overeat anything he finds and he's too old to monitor. There is nothing we can do when he is at work, plus his age alone makes it impossible to follow him around wherever he goes. He has never really cared about his weight and I can't seem to make him care. He does exercise a lot...and I do mean A LOT. For that reason, he is in good physical shape and has some muscles, but he is still too heavy. I have a feeling, some of this is genetic (he is adopted).

The neuropsychologist told us that many Autism Spectrum Disorders (ASD) children/adults don't have the same "off" switch to food or feeling full that other people do so they think they are hungry all the time and unless they are highly motivated it is hard to get them to lose weight. In the end, this is up to them. We can't do anything about it (trust me, nobody tried harder than we did...in a quiet, compassionate, lighthearted way). He never heard the word "diet" or "overweight." Not from us.

Could be that other disorders also cause lack of ability to know when you are filled up. I don't know. Son was tested for Prader-Willi, but that came back negative. The entire genetic screening was negative. Like many people here have stated, he is healthy...he has had every blood test and heart test known to man.

If you come up with something that works, let me know Sorry I couldn't be of more help. I don't believe there is any one answer.

 

[Giulia]

MWM, I agree that there is not one answer.

You talked about the PWS test for your son.
Could you tell me which analysis technic they used : FISH or methylation ? The FISH test detects only the deletion (when it lacks of material) type, but if the person has PWS due to maternal uniparental disomy (two chromosoms 15 from the mother instead of one from the mother and one from the father) or imprinting defect (when the material didn't pass well from parents to child. Like unbalanced translocation), it won't show on the FISH test. It will show only on methylation.
The deletion type is the most frequent, but it doesn't account for all PWS cases.

Hope it helps.

 

[lmf64]

Okay, I am not a doctor and cannot offer medical advice, but my difficult child went from being a very slim, healthy young man to doubling his weight in one school year after starting Abilify. I know you said your son is not on any medications so that is not your problem, but the same solution may work. My son's psychiatrist decided that to get his weight under control he needed help and that we should treat it as a metabolic disorder. She started him on Metformin (used to treat diabetes) and it has helped him tremendously. Okay, so he grew about 8 inches since beginning it, but he has also lost about 50 pounds in the same amount of time. He's not skinny now, but is much healthier. Also, vitamin D needed to be added to his daily regime of medications. 1000 units a day. The endocronologist we saw insisted on it because he was slightly low.