Morbidly Obese Weight Loss, No Surgery

Question: I am a 42-year-old morbidly obese woman (145 kg), who has passed on my terrible eating habits and negative metabolism to my 13-year-old daughter (125 kg). I am desperate. She eats reasonably well and although she could be more active, nothing seems to work. I have brought her to doctors and none of them seem to want to help us because of her age. Weight Watchers and similar programs are cost prohibitive for us. Please, please help.

Answer: Your problem is all too common… and growing. Roughly a quarter of Australian kids are overweight and more than one in twenty are obese. Your daughter and thousand of kids like her share psycho-social struggles along with the risk of future diabetes, heart disease, arthritis, certain forms of cancer and even infertility as a result of our latest national epidemic.

Important: At 13 years old and 125 kg, your daughter’s weight suggests severe pediatric obesity, which can involve current medical risks (not just future ones). That makes it important that any weight-management plan is medically supervised and includes screening for complications (for example blood pressure, sleep issues, liver health, glucose, and orthopedic problems), alongside family-based lifestyle changes.

Could It Be a Medical Problem?

While most obesity does not have a single underlying medical disorder as its primary cause, it’s still important to find a doctor who will evaluate the problem thoroughly.

Some families explore assessment for less common medical conditions, sometimes involving an endocrinologist, a specialist in hormonal disorders who is familiar with unusual causes (and consequences) of obesity. It’s unlikely the search will shed light, pointing only to the usual suspects: Genetic tendency, too many calories and too little activity.

Statistically, if both parents are overweight, their children have an overwhelming chance of repeating the story. But there’s hope even with no surgery.

Face Up to the Challenge

Let’s assume both of you have been dealt a “pair of deuces,” genetically speaking. Why not have a family forum, discuss the problem and its ramifications, and then decide how to play your hand most effectively? Specifically, lean on lifestyle… it works!

Recognizing our weaknesses and adjusting to them is a common strategy, so use the same techniques here. And consider involving a developmental pediatrician or child psychologist to help navigate the emotional storm that can sabotage your efforts.

Model a Healthier Lifestyle

It helps most when the whole household shifts toward healthier routines, with a focus on a supportive environment rather than blame or intensity. Identify eating cues like TV, successes (or failures), buffets and boredom, and then develop strategies to deal with them. To lessen temptation, avoid high-risk environments and substitute activities involving family play. Encourage activity and promote family harmony.

Many families aim for regular movement most days, whether it’s walking, swimming, gardening, tossing a Frisbee or whatever she suggests. Research often points to regular exercise as a difference between long-term success and failure.

It can also help families understand what everyday activity actually does. Even gentle walking uses a measurable amount of energy over time, and seeing a simple example such as how much energy walking a mile uses can make activity goals feel more realistic and less intimidating.

Good Food Choices

When it comes to food choices, develop a “Mediterranean” pantry and fridge, favouring vegetables, fruits (fewer juices), fish, beans and unprocessed grains. Just don’t have fat and starch-rich, nutrient-sparse foods in the house.

Instead, keep healthy and convenient snacks available: baby carrots, melon chunks, berries, seeds and nuts, low-fat cheese and yoghurt. Involve children in food choices, having contests for the healthiest chef or dinner. A dietician can also be part of the broader support network.

Many households move away from sweetened drinks and toward water, and some people choose to flavor drinks with lime and a small amount of sweetener. And don’t force kids to eat all their food, or use foods as a behavioral bribe or soul-salve.

Set Attainable Goals

It took you and your daughter a while to gain the weight, so plan on losing it slowly too. The most common mistake is to set unrealistic expectations. Remember my universal acronym for wellness. “A.I.M.” for success:

• ADD good foods and activity before taking away nutrition-poor snacks and eliminating TV.
• INCREMENTALLY change habits. Quantum leaps are much, much more daunting than small steps.
• Be MINDFUL as you and your daughter share the challenge and excitement of creating and enjoying your berry-yogurt parfait, bite-by-bite, or reveling in landscaping a small corner of the yard.

Like you, I “picked the wrong parents,” when it comes to weight. But with dedication to a healthy lifestyle, I’ve triumphed over obesity. Employ these tips with conviction… and love. You and your daughter can succeed, too.