Concerned about your child’s weight?
What is the best dietary approach if your child is underweight or overweight?
I regularly talk to parents who are concerned about whether their child may be overweight or underweight and are not sure what to do about it.
This can be a sensitive issue - and a source of stress for parents (and children) - but it is important to remember that children vary in their metabolic rates, genetic predispositions, and rates of growth. Even within the same family, siblings can have significantly different body shapes and metabolisms.
What to do if your child is underweight
To help your underweight child gain weight, aim for meals and snacks to be high in protein and healthy fats
✅ Increase their caloric intake so that the amount of energy (kilojoules) they are consuming is greater than the energy they are expending.
A good way to do this is to increase their fat intake by adding healthy fats to their meals and snacks, e.g. add avocado to their usual smoothie, mix grass-fed butter into their mashed potato, drizzle oil over cooked vegetables, use nut or seed butters on toast or crackers
✅ Serve regular meals and snacks
This is an effective way to increase a child’s energy intake, particularly if they have a reduced appetite and don’t like to eat big meals.
✅ Include protein with each meal (and preferably snack), e.g. lean meat, chicken, turkey, fish, seafood, dairy, nuts, seeds.
Protein is crucial for underweight children as it supports muscle development, provides energy, and aids nutrient absorption.
Note: protein powders are generally not necessary, or recommended, for younger children as it is relatively easy to meet their protein requirements through food.
✅ Create a positive attitude around food and mealtimes
It is important not to put pressure on the child at mealtimes and to create a positive and stress-free eating environment that promotes a healthy relationship with food.
✅ Make sure all meals contain nutrient-dense foods, e.g. whole grains, fruit, vegetables, lean meat, poultry, dairy products and legumes.
Nutrient-dense foods are crucial for underweight children as they provide essential vitamins, minerals, and energy, promoting healthy weight gain and overall nutritional well-being.
What to do if your child is overweight
Encourage children to snack on fruit and vegetables instead of processed foods
✅ Serve regular healthy meals and snacks (containing a balance of protein, healthy carbs and good fats)
Providing protein-rich meals and snacks regularly throughout the day helps to stabilise the child’s blood sugar levels and prevent excessive hunger (which can lead to overeating)
Avoid processed snacks (e.g. biscuits, cakes, cookies, chips, flavoured crackers, jelly) and try these options instead:
Hummus or guacamole with wholegrain crackers or carrot sticks
Rice cakes with peanut butter (additive-free, 100% peanuts)
Fruit salad, Greek yoghurt and a drizzle of raw honey
Bliss balls/protein balls
Whole grain crackers with sliced cheddar cheese
Hard-boiled eggs
Smoothies
Chia pudding
Homemade wholemeal muffins or cookies
Click here for more healthy snack ideas.
✅ Keep an eye on portion size and provide balanced meals
As a guide, a healthy plate should be ½ vegetables or salad, ¼ healthy carbohydrates, a palm sized serve of protein and a small amount of good fats.
In contrast, many children (and adults) often load up their plate with carbs, usually with a bit of protein and possibly a few veggies. The problem with this is that large amounts of refined carbs (e.g. white pasta/rice/bread) can contribute to weight gain in children due to their rapid digestion and absorption, leading to increased insulin levels and potential overeating. Meals containing mostly refined carbs (and not enough protein) also do not make children feel full for long so you will often find them asking for more food not long after the meal.
✅ Stop buying soft drink
Soft drinks are a known contributor to obesity as they generally contain high levels of added sugars and provide excess calories without any nutritional value.
Water is the ideal drink for kids, however if your child is used to drinking lots of soft drink or fruit juice, you may have to slowly wean them off by switching to naturally-sweetened drinks, e.g. Golden Circle Refreshers, Sodaly or Nexba.
Please avoid diet or zero-sugar drinks as they are full of harmful artificial sweeteners and have been shown to contribute to blood sugar imbalance and insulin resistance.
✅ Encourage your child to do at least 60 minutes of physical activity each day.
Hopefully your child is already doing some exercise at school but it is also a good idea to incorporate opportunities to get outside and do some sort of physical activity every afternoon and at weekends.
If your child is a reluctant exerciser, try to make it fun and get the family involved, e.g. dancing to Taylor Swift, playing a game of tip in the garden.
✅ Avoid negative language
Unfortunately overweight children and teens are often exposed to derogatory comments about their appearance so it is important that we protect their self-image and self esteem by avoiding negative language associated with weight gain or physical appearance.
Instead of discussing "losing weight” or “going on a diet”, consider framing the conversation around "being healthier" or "improving health and fitness."
✅ Get the family involved
This is a big one. It is not really fair to expect a child to adopt a healthier diet while other family members continue to eat junk food and sugary, processed snacks. Try to get the family involved in being more active and planning and cooking healthier meals.
If you have preschool or primary-aged children, you could try using one of my reward charts to get the whole family to increase their veggie intake 🙂
✅ Reduce screen time and sedentary behaviour
Many children are spending way more time on screens than the amount recommended in the Australian national guidelines (no screen time for children under 2 years, 1 hour for 2-5 year olds and 2 hours for 5-17 year olds). Several studies have found an association between screen time and increased obesity risk.
✅ Avoid using food as a reward or punishment
Avoiding the use of food as a reward or punishment is important for promoting a healthy relationship with food, preventing emotional associations, and developing balanced eating habits.
✅ Implement changes gradually
This is perhaps the most important piece of advice I can give you!
Using a small steps approach is more sustainable and is less likely to be met with resistance from your child. As an example, if you currently have McDonald’s or Dominos once a week, reduce it to once a fortnight, then once a month, and at the same time introduce healthy homemade hamburgers or pizzas and get the kids involved in making them.
Similarly, if your child currently has lots of packaged food in their lunchbox, I don't recommend suddenly getting rid of all the packets. Instead, gradually introduce healthier packaged snacks (e.g. Cobbs plain popcorn or Table of Plenty Mini Rice Cakes) while at the same time trying to add in more wholefood options, e.g. bliss balls, fruit, veggie sticks and dips.
References
Haghjoo P et al, 2022, ‘Screen time increases overweight and obesity risk among adolescents: a systematic review and dose-response meta-analysis’, BMC Primary Care, vol 23.
Ramirez-Coronel AA et al, 2023, ‘Childhood obesity risk increases with increased screen time: a systematic review and dose-response meta-analysis’, Journal of Health, Population and Nutrition, vol 42 no 5.
Joshi A & Hinkley T, 2021, ‘Too much time on screens? Screen time effects and guidelines for children and young people’, Australian Institute of Family Studies, viewed 27 February 2023, https://aifs.gov.au/resources/short-articles/too-much-time-screens