Weight control in kids

[Mrs Tiggywinkle]

DS11 is 4’10 and 135 pounds; the 99th percentile.  He was always very underweight until going on Abilify two years ago.  He’s gained 85 pounds in those two years.  His new pediatrician is not concerned, he’s gained so rapidly that I am. Diabetes is rampant on my side of the family which is a concern as well. 
He has extreme sensory issues to the cold, which makes outdoor time in NY right now miserable.  He loves to swim but we don’t have a Y close that has an indoor pool.  He has autism and organized sports are never going to work. He likes to run but has exercise asthma and it gives him chest pain. He loves riding his bike, but the cold. This time of year he is on screens way too much, but we’ve moved to a smaller house and there’s not much running around room inside.

We already eat diabetic friendly and gluten free, but since Covid a year ago I’ve been buying a lot of processed food because it’s all that tastes good to me now.  He does not have sensory issues with food and is not a picky eater, so that’s good.

I don’t want to tell him to lose weight or that I think he weighs too much, but I feel like I need to do something. 

[Carol in Cal.]

Personally in that circumstance I would set a high priority on establishing an indoor exercise capacity at home, for health reasons beyond just weight control.  I’ll bet you have a basement or garage.  Can you install a treadmill and a rebounder and maybe a pull up bar there?  Maybe with a little space heater in the area?  That would be good for everyone; arguably crucial in your circumstances, and I’d prioritize it higher than most other possible uses for such an area, pronto.  Then I’d assign amounts of daily exercise to the kids and lead by example myself.

[Katy]

Do you have space in the basement to make a small indoor jungle gym/American Ninja warrior sort of course? Could you get him interested in something like that?

Otherwise I would focus on less processed food and not on weight.

[KSera]

Is the Abilify helping him such that staying on it is high priority? It might be difficult to do much about it as long as he’s on the Abilify, unfortunately. I know many people drop the weight gained on Abilify and similar medications when they go off it, but because it can cause actual metabolic changes, it’s super hard to address while on it. Did the doctors warn you about the possibility of this side effect and is his blood sugar monitored?

[theelfqueen]

Would he like playing with Nintendo Ring Fit? 

[Laura Corin]

Would an indoor stand for his bike work?

[maize]

Do you have space you could put a 6 foot trampoline? More fun than the little rebounders; we've used them for indoor physical activity and our house isn't big.

My boys also tend to chunk up at about that age, then thin out as they shoot upwards.

[J-rap]

Assuming the Abilify is critical, and I assume it is, I'd work hard to put in place healthy habits for the entire family.  This may be difficult for other family members who maybe don't need to lose weight, but I think if it becomes the natural family environment it'll be so much easier for him (and better for everyone!).  

I'd work very hard to remove processed foods from the family diet, and replace them with healthy but filling options.  I used to keep a big pot of cooked legumes (lentils, black beans, etc.) in the refrigerator and make them into soup, burritos, veggie patties, etc.  My kids went through phases where they ate a LOT (mostly due to competitive swim), and it seemed like they were eating all the time.  I think if you make it about everyone eating better food instead of making it about your ds losing weight (I know you weren't suggesting that, I'm just using that as an example), is a better and more positive focus.  

I also agree with others that setting up some kind of easy indoor work-out is a great idea.  Would he be open to a daily family walk?

Edited November 7, 2021 by J-rap

[freesia]

Do you have a wii?  My kids do Let’s Dance sometimes in the winter. I also let them do Wii Fit Plus. I make a certain amount of exercise mandatory and point to the NYS law PE requirement as the reason. Three of mine put on weight around 11, too. That’s probably why the doctor isn’t concerned. Building the habit and expectation of exercise is the goal. 
 

Can you put the processed food somewhere private?  At about that age I got more involved in providing healthy snacks and making sure they had good breakfasts and lunches ( meals my kids eat on their own).  I found middle school kids get a bit picky—they want food autonomy, but don’t always have ownership of why they should eat well. That comes around 16 in my kids. 

[Mrs Tiggywinkle]

So—we do have a basement. While it has a concrete floor, it’s not finished. We do plan to finish it; but first we have to put a new sump pump in and that probably won’t be affordable this fall. We do have an unheated garage as well.  We are working now on cleaning it out and heating it, and are going to hang an indoor swing for him.  
 

He loves gamified things. We have a Nintendo Switch; I’ll check out the Ring.  He loves Pokémon Go and Pikmin Bloom, which both involve walking.  
 

I don’t think he’ll use a treadmill.  Since running causes chest pain he gets all anxious about that now.  I don’t think he’ll use a stationary bike either; he likes to ride his bike and look at scenery and enjoy the silence. He actually loves being outside, but the cold really bothers him.

I knew about the weight gain with Abilify but not the blood sugar component. As the majority(75%) of people on my mother’s side became diabetic as teenagers, and my paternal grandfather in his 20s(most of whom were not obese) it’s a huge concern for me.  I do question now whether the Abilify is worth it.  He was off for about 8 weeks over the summer due to prescription errors and a provider suddenly leaving, and he was actually very pleasant to be around and not moody at all.  He has an appointment in two weeks and I plan to bring it up.  I am wondering if a low dose anti anxiety med would be better, as now most of his behaviors seem to stem from anxiety.  I posted on here a while back about how negative he was constantly—his school did a functional behavior assessment and found every behavior, including the negativity, seemed to stem from anxiety.  

Edited November 7, 2021 by Mrs Tiggywinkle

[Mrs Tiggywinkle]

Also, to be fair I am also diabetic.  But I am down to underweight numbers from not being able to eat thanks to Covid.  It ruined my smell and taste and everything either tastes rancid or like sand.  Highly processed foods seem to taste mildly okay.  But they aren’t good for me either, and I have to figure that out too.

DS11 is actually pretty adventurous with food, so that helps. 

[KSera]

19 minutes ago, Mrs Tiggywinkle said:

He has an appointment in two weeks and I plan to bring it up.  I am wondering if a low dose anti anxiety med would be better, as now most of his behaviors seem to stem from anxiety.  I posted on here a while back about how negative he was constantly—his school did a functional behavior assessment and found every behavior, including the negativity, seemed to stem from anxiety.  

This sounds like a really good direction, especially if he had a trial off of it over summer and did okay. Was he able to go off cold turkey without any bad withdrawal symptoms? Withdrawing from those can cause a lot of anxiety. Of course, some of the anti anxiety medications have weight gain as a side effect, but not to the extremes like the atypical antipsychotics do, and it’s by a different mechanism. Of course eating a good diet and getting good exercise is important for everyone, and those things are good to implement, I’m just saying that it sounds unlikely in this case that this would’ve happened if not for the Abilify. That sudden very rapid bulking happens in a significant portion of kids when they go on it. 

[Mrs Tiggywinkle]

18 minutes ago, KSera said:

This sounds like a really good direction, especially if he had a trial off of it over summer and did okay. Was he able to go off cold turkey without any bad withdrawal symptoms? Withdrawing from those can cause a lot of anxiety. Of course, some of the anti anxiety medications have weight gain as a side effect, but not to the extremes like the atypical antipsychotics do, and it’s by a different mechanism. Of course eating a good diet and getting good exercise is important for everyone, and those things are good to implement, I’m just saying that it sounds unlikely in this case that this would’ve happened if not for the Abilify. That sudden very rapid bulking happens in a significant portion of kids when they go on it. 

Not that I would ever, ever recommend going cold turkey off anything—but he had no ill effects.  I plan to discuss that with his new psychiatric NP here in two weeks.   All my kids, and myself, need to do better with exercising over the cold months.  We’re pretty active when it’s warm, and in years past we swam at the YWCA a couple times a week, but the pool needs repairs they can’t afford and won’t open this year. I took the kids to the mall today to play Pokémon Go and walk, but I need to start thinking creatively this winter.

[kbutton]

58 minutes ago, J-rap said:

Would he be open to a daily family walk?

I wondered this too--if he's not suffering alone, maybe the walk would be daily most of the year, and then just sucking it up once or twice per week in the winter but with other exercise (the Nintendo thing, etc.). I have one that doesn't have sensory issues to cold, but he's very cold sensitive so we make sure we have a wide variety of layers he can don, winter face mask, etc. It's not always as cold here as there, but we get SO MUCH WIND when it's cold (and never when you want it to sweep away some heat).

We have an old Wii--picked it up at a yard sale for next to nothing, and then we hit the used game store for games. If they are doing exercise, we definitely don't count it as screen time. They get active enough it sometimes smells like a locker room, lol! 

41 minutes ago, Mrs Tiggywinkle said:

DS11 is actually pretty adventurous with food, so that helps. 

Would he enjoy helping with the cooking or food prep? (I hear it helps instill healthy habits. My kids are the type who can eat what they want and still be super thin, which they did not get from me.)

[Elizabeth86]

You say he is sensitive to the cold (totally get this, but can he do it in small doses? During the school day, I send my boys to the trampoline for 15 minute breaks. Do you have a trampoline? My boys hate being outside, but they love the trampoline. None of this may work, just thinking. Pokémon Go and family walks? Daily family workout video? 

[prairiewindmomma]

What about strength training?  I think building muscle mass and flexibility is important in addition to cardio.  We are in similar constraints with a rainy season that makes being outside challenging at times and with covid making group exercise not an option for Youngest.  We are playing kid yoga and kid exercise videos on YouTube and doing it together (at age 9).  By the time they are twelve, we move into hand weights and therabands and stuff also. I'm looking into getting a TRX suspension system anchored into the garage as well. 

 

[freesia]

My friend’s kids do something on YouTube called The Seven Minute workout. 

[Mrs Tiggywinkle]

4 hours ago, kbutton said:

I wondered this too--if he's not suffering alone, maybe the walk would be daily most of the year, and then just sucking it up once or twice per week in the winter but with other exercise (the Nintendo thing, etc.). I have one that doesn't have sensory issues to cold, but he's very cold sensitive so we make sure we have a wide variety of layers he can don, winter face mask, etc. It's not always as cold here as there, but we get SO MUCH WIND when it's cold (and never when you want it to sweep away some heat).

Would he enjoy helping with the cooking or food prep? (I hear it helps instill healthy habits. My kids are the type who can eat what they want and still be super thin, which they did not get from me.)

It’s taken years of occupational therapy just to get him to tolerate pants and a coat.  He can’t deal with anything on his face, either a scarf or the cold air.  
I think cooking and food prep is a great idea. I hate cooking and I’m not good at it, but he’d love to cook with me. He’s happy to eat anything; the healthy food problem lies with me.  I grew up cooking for a large family(cooking was my chore once I hit about 13) and we rarely had meat due to money. We ate a lot of beans and pasta casseroles, and that’s what I know how to cook.  So I married someone who can’t have gluten and hates beans, but loves meat.  I don’t know how to cook it so I just don’t.  I need to work all of us eating healthier. 

 

55 minutes ago, prairiewindmomma said:

What about strength training?  I think building muscle mass and flexibility is important in addition to cardio.  We are in similar constraints with a rainy season that makes being outside challenging at times and with covid making group exercise not an option for Youngest.  We are playing kid yoga and kid exercise videos on YouTube and doing it together (at age 9).  By the time they are twelve, we move into hand weights and therabands and stuff also. I'm looking into getting a TRX suspension system anchored into the garage as well. 

 

I asked him what his favorite things in PE are, and going to the weight room at school was high on the list. I’m going to talk to DH about getting weights. He likes to weight train too and that might be a good thing for them to do together.

[kbutton]

38 minutes ago, Mrs Tiggywinkle said:

It’s taken years of occupational therapy just to get him to tolerate pants and a coat.

Ah, so not a problem with wind in his face, etc. I am sorry. That's difficult.

39 minutes ago, Mrs Tiggywinkle said:

So I married someone who can’t have gluten and hates beans, but loves meat.  I don’t know how to cook it so I just don’t.

It's not super difficult, honestly, but I can understand not being excited about learning a whole new category. Especially things in the oven or crock pot. Sauteing, broiling, or grilling is a little more of a learning curve. A meat thermometer helps for medium to large pieces (I have less luck checking temps on thinner items). 

Roasted things are super easy. Meatballs are super easy in the oven, and you could technically do burgers this way too. 

[kiwik]

On 11/8/2021 at 6:49 AM, Mrs Tiggywinkle said:

So—we do have a basement. While it has a concrete floor, it’s not finished. We do plan to finish it; but first we have to put a new sump pump in and that probably won’t be affordable this fall. We do have an unheated garage as well.  We are working now on cleaning it out and heating it, and are going to hang an indoor swing for him.  
 

He loves gamified things. We have a Nintendo Switch; I’ll check out the Ring.  He loves Pokémon Go and Pikmin Bloom, which both involve walking.  
 

I don’t think he’ll use a treadmill.  Since running causes chest pain he gets all anxious about that now.  I don’t think he’ll use a stationary bike either; he likes to ride his bike and look at scenery and enjoy the silence. He actually loves being outside, but the cold really bothers him.

I knew about the weight gain with Abilify but not the blood sugar component. As the majority(75%) of people on my mother’s side became diabetic as teenagers, and my paternal grandfather in his 20s(most of whom were not obese) it’s a huge concern for me.  I do question now whether the Abilify is worth it.  He was off for about 8 weeks over the summer due to prescription errors and a provider suddenly leaving, and he was actually very pleasant to be around and not moody at all.  He has an appointment in two weeks and I plan to bring it up.  I am wondering if a low dose anti anxiety med would be better, as now most of his behaviors seem to stem from anxiety.  I posted on here a while back about how negative he was constantly—his school did a functional behavior assessment and found every behavior, including the negativity, seemed to stem from anxiety.  

I am a reasonable severe asthmatic and running has been impossible for me except one period where I trained myself to ruin using a treadmill.  I started walking slowly then over months sped it up.  I then added like 15 seconds jogging.  So if you could borrow a treadmill and convince him to walk slowly 5 minutes a day he may find it OK - especially with an audio book.

[kiwik]

On 11/8/2021 at 9:38 AM, Elizabeth86 said:

You say he is sensitive to the cold (totally get this, but can he do it in small doses? During the school day, I send my boys to the trampoline for 15 minute breaks. Do you have a trampoline? My boys hate being outside, but they love the trampoline. None of this may work, just thinking. Pokémon Go and family walks? Daily family workout video? 

My ASD kid does 15 minute trampoline breaks.  He doesn't do anything fancy, he just jumps and bounces.  But it doesn't get that cold here. He also does tap and ballet but that probably won't interest your son.

Edited November 11, 2021 by kiwik

[PeterPan]

Ok, so my ds is ASD2 and I cannot *compel* him to exercise. I know some people can, but I have not been successful in that. I also agree that it's counterproductive to harp on the need to lose weight or even bring it up. He will *grow* and as he grows vertically you want him to use up some of this stored reserve. My ds is not overweight, but he has that happen every time where he shoots up, gets dreadfully skinny (because his weight is like 25th percentile during that but 95th percentile for height) and then he balances back out and puts the weight back on. So you don't need to so much lose weight as to stop gaining. He's going to hit puberty, add muscle, grow vertically, and slim down. I think that is why your doctor is saying not to fret right now.

You're saying your cooking is an issue and that you're buying processed food. Even healthy people gain weight on processed food, so you're not doing yourselves favors. Maybe what you could do is talk with a nutritionist yourself to get some counseling on realistic foods that you could make easily with your family, things they would eat. What did you eat when you were pregnant? They say that the dc likes what you ate when you were pregnant, and anecdotally I've wondered if it's true. My ds is this insane salad eater (I ate a lot of salad when pregnant with him!) and I've talked with others whose kids craved the junk food they ate when pregnant, etc. It could give you ideas. 

I tend to have some easy staple plans for food because I do have a lot of life happens, sigh. Like I'll go to Trader Joes and buy frozen fish and bags of their (very delish) quinoa melange. Now you're working within the vacuum of what he'll eat, but I'm suggesting you find *healthier* convenience versions so you can make better food happen realistically.

I also tend to keep pretty trim snacks around. Snacks are an easy way to pack on calories or trim them down. We like rice cakes with hummus, peanut butter and celery, apples with hazelnut spread or caramel (splurge), bananas, dried fruit, guacamole with corn chips, grapes, carrots with dip, etc. Again, all that is at Trader Joes. TJ is your friend if you can find one. 

Will he eat salad? Salad is my super power for dinners. Just cook ground meat to throw on, boom done. 

You mentioned beans and casseroles. If you're making your casseroles with canned soup, it may have MSG, which affects glutamate levels and mood. You could switch to an organic canned soup to get out some of the junk. I've been doing casseroles like that with brown rice, a bag of frozen veges and a bag of frozen broccoli plus that can of soup all thrown in a crockpot. My ds will eat the entire thing himself, lol. And really, there's very little harm in that many frozen veges. 😄 

I think your diabetes concern is legit. I find when I am on the heavier side of my weight that I'm more reactive to sugar, so I think you're right to be concerned. I think the idea of getting more veges into diet and dropping white flour and things that raise blood sugar in favor of more whole foods will stabilize the blood sugar as bonus, making it easier to slim. Did you see that trick @ktgrok was talking about with the potatoes being left to chill a day to turn the starch to resistant starch? Kinda nifty. 

Do you have any *group* fitness/active things you can do together? Like if you just say hey we're all going to the park to walk, and you do that every day, then he's getting exercise in a social motivating way without any stigma or angst. Walking is a prime, prime way to get in that exercise. You could get a recumbend bike to put in your home in front of the tv, but is only he doing it? Hard for everyone to bike in the winter. Just walking together could be enough. I just wouldn't single him out. 

My ds went from being very active (swim team, gymnastics team, like really a LOT) to nothing, cold turkey. I hated that and it's true he sits around more. But I'm just saying because he is who he is, it has not worked to *command* him to get on the exercise equipment I own. Now I'll try again, because I want him to "train" for our cruise, haha, to be ready to walk a lot. But for him, a socially motivating situation, like where we're all going for a walk or all going on a bike ride, is much more successful. You know what motivates your ds, but it doesn't work here to make it oppositional.

On 11/7/2021 at 12:50 PM, Mrs Tiggywinkle said:

Also, to be fair I am also diabetic.

Ahh, I see why you're worried. So do you eat properly for your blood sugar? If you take care of yourself and then bring in *small* changes with him, he'll probably slim down naturally. He's off the Abilify now or he's back on? If he's off, I would think with small provocations, small increases in exercise, he'll grow and take this down. 

Also, you're saying it's bad that he gained 85 pounds, but how old is he? Check old threads, but I'm pretty sure about 6 months ago I had a thread asking whether it was possible to get my ds (who then weighed around 85-90 pounds) to gain 10 pounds to be able to go ziplining at a place with a minimum weight requirement. Know what my ds weighs now? About 115. 😉  So 85 in two years might have a fair chunk, especially if he's going into puberty, that should have happened anyway. And if he can convert that stored energy to muscle with his puberty growth, it may just even out. 

You could *try* going high on the beans. I did more beans and guacamole with my ds after that thread on how to help him gain weight and he LOST 5 pounds, I kid you not. Someone said that beans can do that. So I wouldn't be all down on the beans, lol. Beans are filling, nice protein, who knows. 

[alisoncooks]

If he likes games and loves riding the bike, I’d look into getting an indoor trainer for his bike and sign him up for something like zwift. It used to be free for kids. 

https://zwiftinsider.com/kids-ride-free/