Approaching Weight Gain with Your Child

Hi there, is his height going up consistent with his weight? If his height is staying in the same percentiles as when he was five, and only his weight is going up, then I think I'd be more worried. But if he is growing taller as well as heavier then I'd say it's probably less of a concern. Also, my middle DD was diagnosed as hypothyroid at age 8, and my mother at age 13. We caught my daughter's early, but one symptom my mother had (that finally forced my grandmother to take her to the doctor) was weight gain without corresponding growth in height, along with lack of energy/tiredness. Once she was put on medicine, she grew 5 inches in a year. So I'm thinking if you're still concerned after reading all the advice, blood work is definitely in order.

It's always so awesome to read a post by such a tuned in and caring mom. As serendipity would have it, I just heard a piece on NPR that kids who drink 2% milk tend to keep their weight more regulated than kids who drink skim. The theory is that the added fat helps them feel sated and can extend those periods between meals and snacks, along with decreasing portion sizes of meals and snacks. I see he doesn't really drink milk. but if he's willing perhaps introducing some 2% as part of a meal or two a day could have a positive effect?? Just a thought. best of all to you!! S.

I don't have any solid answers. I mean, you know discussing this with his doctor is really what needs to happen. You could call and arrange a consult without your son present, if you think it would help to discuss it, without additional testing.

1) he's about to be 11? Or 12? That's the right age for boys to have their hormones start kicking in. My always washboard, solid but not skinny, son, went from flat stomach/washboard style, to fairly chunky, with a round face, and the chubby look, around that age. It lasted about 2 1/2 years... now, he's 5'9" and 130 lbs. Barely any body fat at all. His pants have a 29" waist. So, while maybe he was getting heavy from being snack indulgent and more couch potato than normal for a few years, but he's adjusted his lifestyle some, right? So now, maybe this latest gain is from puberty. Really, that is normal...

2) He also is at the age where it wouldn't be out of the ordinary for a routine physical for him to include a round of blood work. Cholesterol tests, etc. They will do it fasting, and can also check for diabetes, if there is any possibility that that could be an issue. Did the doctor do blood work back in February? If not, maybe you could set that up, and say, "oops, they forgot to do it in Feb" and go from there.

We are kind of going through this with our nearly 17 year old. He is special needs and was always SO underweight that he wasn't even on the chart (he is abnormally small for height already due to his special needs). Back in December we had a med change and in just 6 months, he is nearly in husky size clothing!

I do think that having a conversation with your son AND the doctor is totally appropriate. Why is everyone so scared of being honest with their child about weight problems? It is a problem . . . problems get discussed . . . sometimes with doctors . . . problems get solved. No one thinks shaming a child for their weight is a good idea. Good parents can have a discussion about weight WITHOUT shaming. You are a good parent, you can, too. We simply said to our son "hey, the weight that you are at is not good for your heart, it isn't good for your knees and other joints, and we love you and want you to be the healthiest person you can be."

We are doing increased exercise that includes raising heart rate every day (if you aren't raising your heart rate, you aren't really getting much benefits) and reducing meal portions. Our son isn't a big snacker but was going all out at meals. We limit portions, but allow 2nds on his most favorite meals (we figured out in advance and make sure that we don't have a favorite more than once a week). I also looked at the lunch I was packing him and reduced both portions and calories there, too. Remember, kids are literally sitting for 7 - 8 hrs a day during a school day (unless he has phy ed this quarter) - they don't need TONS of fats and calories they have no way to burn off. Your kiddo is a bit different than mine since he is going into puberty so does need a few extra calories for those growth spurts and hormones to work right, but he probably doesn't need everything he is getting (which is showing up as extra pounds right now).

I think sitting down with your son and being open and honest about what is going on is the best way to start the road to healthy eating. How else is he ever going to learn if someone doesn't tell him. Right now, all he is hearing is probably shaming words from peers and siblings. Isn't it your job to bring this all into focus?

Good luck.

Fiber. Less snacking. Bigger meals. Water. More physical activity - daily.

That's what I was told.

I have a relative who is a pediatric dietitian. That's her advice. Puberty happens earlier and some kids get a noticeable weight gain. If they eat snacks close to meals, they won't fill up on the right stuff. And most kids don't eat enough fiber. I don't think there's much in a bagel for example. Or pancakes. Or nachos.

So I'd look at ways to increase fiber in his diet. I did it by adding a salad to our evening meal and baby carrots and just switching cereals, and making sure we had that whole grain/whole wheat bread. Otherwise it's just empty carbs - that don't fill them up. And up the water as they up the fiber.

My grandson was always round and chunky. His Dad wanted to do something about his weight. When he reached 12, he grew several inches in height. He is now 5-9, very slim and well proportioned.

Perhaps this son has a different body build and metabolism. I suggest you relax and accept this is the way he grows. If the doctor isn't concerned, I would not be concerned. He may grow several inches in less than a year, as my grandson did.

Often, people don't understand the growth chart. Being in the 8th percentage only means that when compared with other children 82% weigh less than him. Has nothing to do with health. Also there is no ideal percentage. The chart only compares the height and weight as it is compared.with other children. The chart was made many years ago by measuring a large number of children and graphing the heights and weights. Over time the child's chart develops a pattern showing growth. The chart indicates need to intervene. When babies are in the very low numbers consistently it only means he is growing in a pattern. If, however, the numbers stay the same, this is a situation that needs addressed. Why isn't baby growing?

Your son's doctor would have told you if his numbers were of concern. I think you can google growth charts to see an explanation.

It sounds like you're doing an awesome job.

The only thing I can see that may be missing is healthy fats. They are key to satiety, and will hold him longer. He seems to be getting very hungry very often. Can you add more nuts, avocado and olive oil? If he took a baggie of almonds or walnuts instead of chips and crackers, perhaps mixed with fruit (dried fruit maybe?), it might satisfy him longer. He's eating PB but it's maybe not enough. How about celery filled with almond or cashew butter? If you are doing salads, use olive oil and vinegar. Maybe mashed avocado on the bagel or slice avocado on a salad or on Mexican-style food like an open-faced taco?

A lot of people go for low-fat, and studies are showing that our obesity rates have gone way up. We need to go back to more healthy fats to sustain us, since the carbs tend to be stored as fat and kick up the glycemic index and insulin production.

And you can certainly have a conversation - phone or in person - with the pediatrician without your son there.

I know it's hard to get his brother to lay off the comments, but I'd work on that and tie it to privileges. There's no reason kids can't be kind to each other. Also, you may not know what's going on when your child is with his father. And the stress and upheaval of this past year on the family front could be a contributing factor. And if your son is playing a sport like hockey, you might work with a coach on developing a weight lifting program during the season or the upcoming summer. A lot of gyms have summer memberships for kids, and maybe the high school has equipment he can use. My son's coach developing lifting programs for any kid who wanted it. Combining that with increased water and healthy foods for muscle development and endurance can help.

It sounds like you feed him very well. So one possibility is he has a food intolerance. I was just speaking to a nutritional MD who has helped my family tremendously in the past about one of my children. She has so much gas I wonder if she has trouble with some foods. And she always is hungry and always wants carbs and isn't overweight but is at the upper end of healthy BMI. He said if there is a wheat intolerance, wheat eaten doesn't get digested right so the person is always hungry and craves more carbs. I'm not sure about this but we are going to explore it so thought I'd mention. I worry a little about her weight too but also think of kids who were super skinny and then gained lots of weight as teens or young adults. So I hope if we continue to give her a good diet, she'll just stay steady. Not a waif but also not balloon later. Curious to see other answers.

If you observe one thing he can easily change, then you might lightly comment on it. For example, when my daughter was younger, she put on about 10 lbs. over a couple of months, mostly from a new habit of consuming spoonfuls of peanut butter. One day I just casually told her that she was gaining a bit of weight, and that peanut butter was highly caloric and she might want to limit herself to a couple of spoonfuls a day. She minimized that habit and dropped the weight.

But if you can't isolate the reason for this gain, I'm not sure what to suggest. I don't think we need to be so afraid of commenting about weight that we remain mute about it. Like anything else in our children's lives, we as parents can sensitively guide our children on this subject.

It's usually easier for boys to drop or grow out of excess weight.

I would call and go see the pediatrician without him. Ask her all these questions.

That way he isn't there to hear and you can really question what is going on and how the doctor and you can make a plan to help him.

I would guess the doctor will want to run some blood work to see if anything is out of balance.

I will offer up my DH as an example...he gained big time through 7th and 8th grade...his pictures are of that chunky (back in the 70s) fat kid wearing "husky" boy clothes.

The summer between 8th and 9th grades he shot up to 6'4". He went from fat to super tall and was put on the basketball team. He was then tall and thin until we got married.

Then he started packing on those pounds again...up to over 300 of them.

Now I know he isn't a kid...but as he decided to start eating healthier, he went through phases....low carb (he dropped a lot of weight), vegetarian (he put weight back on too many carbs), paleo (almost no carbs and he is at a healthy weight he can maintain).

He realized that eating healthy...what we were doing all along organic and clean food way before it was mainstream wasn't going to get the weight off. It was what worked for his body and metabolism and for HIM. He just can't eat too many carbs or they go right to fat. And if he stops eating healthy fats he craves carbs like no tomorrow so he needs the avocados, bone broth, healthy oils in salad dressings, and fatty meats.

He also found out his IBS went away when he stopped eating grains...probably a sensitivity he had his whole life.

I have discovered for me that I drop weight on any of the above styles of eating. I need a more traditionally balanced diet. And I can eat sugar on occasion, he can't or wham five pounds up.

So I guess what I am trying to say in my long long way is your son may have sensitivities that are causing the weight gain and he hasn't had that growth spurt yet to off set them for a period of time. If he can find them now (and no 10 year old will want to) he can stay healthier his whole life rather than have a growth spurt save him from his weight but only for a while).

So ask the pediatrician for a blood allergy panel for foods when she does the blood work.

Good luck!! Big hugs!!

My cousin was always quite pudgy growing up. Then in the middle of high school he shot up to over 6 feet and suddenly was not pudgy anymore. He looked so different I did not recognize him when I saw him. Really, I would simply model an active, healthy life for your son. Don't criticize him or make him feel self conscious...he knows. Kids at school let you know, believe me. In the evenings and weekends go for a family walk, hike, bike ride, play sports together, throw a ball, shoot some hoops with him. Watch his portion control. You say he is not eating junk: tons of baked goods, processed foods, chips, soda, juice, sweets...I would not worry too much about it if his eating is fine and his activity levels are up.
PS - I just reread this and your convenient snacks you say he likes to eat are all not very healthy...pancakes, breaded chicken, french toast, and nachos are all things that cause most people to gain weight if they are not careful! Instead what about an apple, hard boiled egg, hummus and veggies, an orange, yogurt, banana, nuts, a turkey roll up, dried fruit.

If he has been active and is now a bit pudgy it sounds like puberty. It seems like some kids put weight on before they begin and then lose it as they begin. Another thing might be family genetics -- he could be taking after a distance grand parent. You can change up the snaps to veggies and fruit. Is the skating rink open in the summer for practices? Perhaps he could skate more of something to help him burn off some calories.

I had a chunky childhood and did not lose all my "baby fat" until high school. It is hard to find clothes for the fuller girl and it did make me feel bad but I did lose.

Whatever you do, don't talk to him about his weight in a way that makes him feel bad about his physical being and cause mental issues. (He probably won't because his friends are the same way.)

the other S.

To me, the most valuable purpose of the ped is to put my child's current health condition in context for the parents--and almost always, I think it's to help us not worry. For example, the greatest quality of our son's ped was that she didn't tell us to worry about his weight (he was born tiny and continued to be under the 10th percentile until around age 7 or 8). He has grown in a consistent curve, hit developmental milestones, and was clearly healthy and strong. So, she modeled not worrying for us. It does sound like you might benefit from a chat with the doctor about whether his weight is of concern. A phone consult should be an option, right? If the doctor says, hmmmm, maybe his weight is a bit high, you could use Isn'tthisfun's idea of getting him into the office again for routine tests and the doctor or a nutritionist can suggest small changes to make sure his body is not getting many more calories than it needs. However, he is approaching big growth spurt time, so it probably isn't when you want to restrict calories.

My one thought, if the doc says some reduction in his weight rise is appropriate, is perhaps he can redirect his snacking from cheese and wheat/grain carbs towards veggies. Raw veggies can be quite satisfying and they don't have the calorie count of his current snack foods. But that would only if his ped says there is a possible issue. Good luck with it!

I don't understand I guess. Is he fat or in the healthy range but since he was skinny when he was younger you just think he's fat now???

Is he overweight? Like age 10 and can't get a kids 16 around his waist and they're a foot too long? Or he's 10 and wearing a size 10 or 12 pant that fits okay but he's not skinny anymore?

I used to be a nanny for a lady who has 7 kids. All of them were on the up side of normal. They weren't fat but were hefty. Not 2 sizes too big or anything like that but solidly built.

There was one that was normal size. Her mom would worry about her and tell everyone that she looked like she was from a refugee camp. She was normal size. Age 8 wearing a girls 7/8. Fit fine. Normal height and normal weight.

Her mom had a skewed idea of what she was supposed to be like and she didn't fit in that pigeonhole.

I have friend that was thin and all her kids were normal size kids until she had a kid with her new husband. This kid was HUGE! I'm talking about being age 6 and not fitting in kids clothes anymore. She couldn't get a girls 14/16 over her hips. The mom was frantically worried about her but her husband's family kept telling her that all their kids were just huge. That she'd even out once she hit puberty. This girl finally got old enough to start the change. She's about 5'3 now and wears maybe a ladies size 8. She is a normal size teen but even a year or two ago she was pudgy and heavy looking and just had rolls everywhere.

This mom cooked everything from scratch. Never let the kids have much sugar if any at all. She fed this kid salads and minimal calorie foods. She was just genetically huge.

So, is your child really really fat with rolls of skin hanging everywhere and jiggling when he walks or is he just a big kid? If he's obese then your doc isn't doing his job. He needs to do testing to see if this boy's thyroid is working right or if something else is going on. If he's eating this healthy and not obese then he's probably okay.

Sounds like you're really on top of this. Glad you're able to evaluate it honestly.

The things that stand out to me in his daily food intake are: hidden sugars.

Even in all natural peanut butter, there can be an awful lot of sugars. Could you try either the peanut butter grinder that they have at many health food stores (you just dump peanuts in and peanut butter comes out), or if you have a Vitamix or other powerful blender, you can make your own peanut butter in seconds. Nothing but peanuts. Or switch his PB&J to peanuts and other healthy nuts, fresh fruits and whole grain no-sugar-added crunchy crackers.

The all-fruit jam is frequently sugar-packed, too. Try encouraging him to simply put some fruit on his peanut butter sandwich - sliced bananas or strawberries or kiwis (not raisins or dried fruits).

Greek yogurt is a great choice, but only if it's plain and preferably organic, with just fresh berries stirred in, or a drizzle of raw local honey. Many Greek yogurts contain lots of flavors and sugars. The same goes for milk and cereals. We recently discovered flax milk by Good Karma Foods. All those almond and soy milks contain sugars and artificial stuff (the ones commercially available, not homemade).

And the whole grain breads are often loaded with sugar. We use Ezekiel sprouted grain bread that has 0 sugars.

Make sure that the syrup on those pancakes and french toasts aren't filled with high-fructose corn syrup. Raw local honey or organic maple syrup (in moderation) are better choices.

Don't ever use artificial sweeteners or highly processed sweeteners like stevia (not the actual plant leaf but all those stevia sweeteners on the grocery store shelves) or agave nectar.

And be sure there are no dry ranch dressing mixes (they contain about 4 kinds of sugar in each tiny packet), bottled salad dressings, and other convenience foods with sugars. Look up all the words for sugar online and read all your labels.

Just evaluate the sugars hiding in your foods and you might see a pattern.

I have very solid kids and have to regulate their portions carefully. I also need to watch carbs and cut back on them if they seem to be gaining weight. They are both very active, but they take after family members who gain easily. I remind my son to only have one piece of pizza and one piece of cake before parties. I limit his snacks at home. It helps, but if we aren't careful, it adds up quick for him. I wish exercise was enough for him, since he plays two sports at a time and it doesn't seem to keep him in check. He will need to learn very careful skills to maintain a healthy weight. He has learned how to cook a few simple things like eggs, so he can have protein instead of carbs in the morning. He's not much of a sweets eater, but I try to limit the breads and jams and other surgary foods. After my daughter hit age 11, she started to grow long and lean, so I'm hoping that also happens for my son.

This is a tough one. You both want him to feel good about himself and strong enough to withstand taunting, and also want him to change towards thinner and healthier. The ped can both help guide that conversation and his weight/ health.

Best
F. B.