This Ask Maryann post is hosted by Katie Mulligan MS, RD, LDN, practicing pediatric dietitian since 2003. She received her undergraduate degree from the University of Rhode Island in Dietetics and completed her Dietetic Internship at the prestigious Weill-Cornell Medical Center at New York Presbyterian Hospital in New York City. Katie runs a successful private practice in pediatric nutrition.
Q: How do I ensure that my bigger-than-average kid doesn’t gain too much weight or overly focus on food?
A: If your child is “bigger-than-average” the LAST thing you want to do is panic and put them on a strict diet. Instead, request their growth charts from their pediatrician and take a look at your child’s growth trend over the years.
If your child is trending on the same high percentile line since birth then he is likely okay. Childhood overweight and obesity become a problem when children grow “off their curve”. This is when kids follow a nice line on their growth chart for a few years, but then begin to trail upwards into the area of the growth chart where there aren’t any lines to follow. They may also be jumping percentile lines, which means they go from the 75th percentile to the 90th to the 110th and so on. That pattern is not supposed to happen, kids should stay on relatively the same percentile line throughout their childhood.
So, let’s assume you know your child is jumping lines and that his or her weight is, in fact, going too high too fast. You probably want to stop this upward trend, but without causing your child to be to obsess over food and weight or affect their body image. This is a very common concern for parents and I hear these concerns weekly.
Children will become “obsessed” with food when they feel like that aren’t getting enough to eat or they are being restricted. Trust in feeding begin to breakdown, children don’t trust their parents to give them all the food they need to feel full and as a result, they find sneaky ways to get it themselves.
Having reliable access to a variety of food will help your children learn that there will always be something to eat, you will never let them starve and you will always provide them with tasty food choices. A few simple steps and parenting techniques will help you help your child. If you find that you are still struggling or can’t do it alone, seek out the help of a registered dietitian who works with childhood obesity.
- Continue to offer meals and snacks at regularly scheduled times. A typical pattern is breakfast, lunch, snack, dinner and sometimes evening snack.
- Narrow down your children’s food choices and allow them to choose between options you are comfortable with. For example, “Today’s snack is grapes. Do you want chocolate pudding or a cheese stick with that?”
- Help your children focus on their hunger and fullness. When you see them rummaging through the cabinet ask them if they are hungry or bored? Likewise, when they finish eating, ask them if their hunger is gone. If so, it’s time to stop eating for now, they will have another eating opportunity in a few hours.
- Make a “kitchen is closed” rule. When it’s not snack time or meal-time the kitchen is closed.
- Remove sugary drinks from the home.
- Allow access to “treat” foods. For example, you add 2 cookies to each school lunch.
- Occasionally bake homemade treats or take kids out for ice cream to teach them that these foods are OK to have and can be part of a healthy diet when eaten in moderation.
For more information on helping your child regulate his eating, check out Maryann’s book How to Raise a Mindful Eater.
My kid is off the charts for both height and weight. This makes sense as both myself and my husband are over 6 feet tall (and neither are over weight)… However, she apparently hit a growth spurt right before her 2 year check… and jumped from the 75 to off the top by a small bit. Our doc assured us that she wouldn’t stay at that percentile as growth goes in spurts, literally, first weight then height… That said, we looked at the growth chasrts for Europe just because we both are mainly ethnically from that region. For their charts, she’s well within normal. I think that the US charts are skewed as we have a wide array of ethnicities… and if your child is predominately one or the other (like ours is) they may not fit the US model.
Genie,
Your doctor is correct in that growth comes in spurts and often height and weight do not”spurt” at the same time.
You are also correct in your observation that US and European charts are not the same. This is exactly why in the post above I emphasize a “trail upwards” this trend is easy to spot and is consistently trailing upwards for several years. Whether children fall at the 50th, or 95th percentile isn’t necessarily a concern of mine, if that’s where they’ve always trended. The concern comes in when they “jump percentiles” several years in a row; not for just one year and then settle back into their curve.
Thank you for the comment.
Katie
Hi! I am a 100 pound ,14 year old about to turn 15 in 6 months and my dad is 6’5 and my mom is 5’8 and i am 5’7. I have been dealing with an eating disorder for about two years and loss of menstrual cycle I am now trying to gain weight because i want to grow to my potential adult height. I want to be a least 5’9. i have also recently started taking a multivitamin to get me back on track. can you give me some advice on how to gain weight, to have my menstrual cycle again, and find out my projected height and if i am going to reach it. I will surely appreciate your answers.
HI Kim,
I’m so glad to hear that you are overcoming your eating disorder – bravo! First and foremost, if you are dealing with an eating disorder you should be receiving counseling from a dietitian, counselor and being followed by your doctor as well.
Regaining your menses requires a balanced diet, especially getting enough fat. Fat is not a bad thing, it is essential for life and it helps your body make hormones necessary for your menses. Your menses will come back when you reach an appropriate weight for your body. Again I recommend talking to a registered dietitian about what you should be eating, you can find one in your area at this website: http://www.eatright.org
Good luck!
Katie
my daughter is 7 years old her weight is 123 lbs what should i do to control her eating habits
Dear Kim,
You are right to be concerned about your daughter. Your first step should be to contact her pediatrician and see if he/she can recommend a pediatric dietitian in your area, especially one who specialized in pediatric weight management. Controlling your daughters eating probably won’t work since most people, even kids, don’t like to be controlled. Your efforts might result in sneaking foods and other behaviors.
First, get the whole family on board towards a new way of eating. Everyone needs to have buy in, even if other family members do not have weight problems.
Then pay close attention to everyone’s portion sizes and where and when they eat. Have appropriate snack and meal times, but limit grazing in between meals and snacks – what I call boredom eating. Serve fruits and vegetables for snack instead of granola bars and snack packs.
Evaluate the drinks in your house too. Is your daughter drinking caloric beverages? If so, make it a point to get rid of all those drinks and have everyone in the house switch to 1% milk and water.
In addition, encourage more physical activity and make if fun by joining in with your child and having competitions. Get everyone pedometers and compete to see who can log the most steps!
Every child and every family is different and when you work with a dietitian he or she will be able to set up a personalized plan of action that works specifically for your family. Don’t give up! Make healthy eating and moving more a family affair and everyone will benefit.
Thank you very much! I am working on a childhood obesity intern project and understanding how to educate/communicate to parents at a level where terms will not be harmful but yet be effective. Your blog is a great help.
Hi Kim my step son is eleven and fairly chubby for his age though he is talk. My problem is he drives me mad over food I
feed him well and give him good portions but know matter how much is on his plate he looks around at our plates to see if we are leaving anything even though he has not finished. It drives me mad and if he has a piece of cake he will ask for another within ten mins . I cook healthy and fresh. He is always sneaking into the kitchen to see what we have in the cupboards. Help it drives me mad . Thanks val
Hello.
I have a 5 year old daughter who has hovered around the 100th percentile on both height and weight for her whole life. While I don’t have worries about her size at the moment because she has kept on pace, what does concern me is the (1) the way she eats and (2) her seeming fixation on food. She can be picky in what she eats, but when she is eating something palatable to her, she eats so quickly she is barely chewing, and she is asking for more before she has even choked down her final bite. We have encourged her and set the example to eat slowly and take breaks to listen to our signals, but we can’t seem to slow her down. And beyond that, she is always asking about food – wanting more, wanting to know what we’re having for dinner 3 days from now. I can’t send her on playdates because she won’t leave the kitchen and the other moms don’t know what to do. I am desperately seeking any resources. Does anyone have any suggestions at all???
Hi Ray. You don’t mentioned about how feeding goes. How often does she get sweets? Do you allow her to eat as much as she wants at meals?
daily need of protein wt 95kg male with kidney problem.also tell me how much proten required by male person wt 95kg with kidney problem ,but doing muscle building?
My 10 year old daughter is 4.10cm and 54kg. Obviously above the usual weight of a child. What must we do?
How has her growth gone for the last few years? Doctors usually have a growth chart they show and you can when or if she’s grown off her chart. I’d recommend reading more about it. My book How to Raise a Mindful Eater can be helpful.