Expert Case Review

CHILDREN’S WEIGHT MANAGEMENT

Harry and Chloe are 8 and 9-year old boy and girl who were referred to the Tier 3 Child Weight Management service in September 2019 by their social worker. Initial contact was made with the family in September and intervention begun on April 2020.

Harry & Chloe8 & 9 Years Old

Background

 

When referred both siblings were subject to Child Protection Plans under the category of neglect and were moved into foster care in December 2019. At this point the family were invited to attend the tier 3 service however they were unable to join at this time due to family pressures and commitments, they later commenced 1:1 sessions in April 2020.

Both children were morbidly obese children were morbidly obese (Harry – 54.4kg BMI 29.98kg/m2 (SDS>+3.33) and Chloe – 64.4kg, BMI of 30.21kg/m2 (SDS>+3.33). Harry also suffered with asthma.  The Foster carer noted that they are being provided with a healthy diet whilst with them but when in contact with parents they have been given junk food.  This was an emotional and distressing time for both children, having not experienced being “in care” previously. Soon after commencing their foster placement it was Christmas, and Harry and Chloe found themselves receiving lots of food and chocolates from their parents and family, on top of celebration meals with their foster family. During this time, their favourite activity was on the sofa watching TV.

Intervention

 

Harry and Chloe joined our 1:1 programme online, Harry and Chloe engaged well with the programme and attended 6 out of 6 of the core sessions and 4 out of 4 sessions in the maintenance phase.  These sessions covered a range of topics including food labels, a balanced diet, physical activity and sleep.   The children set their own realistic goals each week and tried new foods and activities enthusiastically, taking on regular exercise sessions, walking, swimming, trampolining and much more outside playtime. Challenges around their relationship with food was found to be much more difficult to address as both children had different challenges in this area. Harry loved crisps, fizzy drinks and any meal involving chips and sausages or pasta with cheese and that was his limit. Chloe had a real love for any food, would “live to eat” and could never recognise when she was full up.

 

As we embarked on the OneLife programme, an awareness around food soon developed. Chloe soon discovered that she loved fresh fruit as much as other foods and was happy to eat an abundance of fruits and vegetables within her diet. Porridge became her new favourite breakfast with a sprinkling of blueberries some days. The family were given a poster of The Eatwell Guide for their fridge to help with their goals and the children developed a curiosity towards where foods came from and how to make different meals. Green food indicators were searched out when shopping for Harry’s breakfast cereal and he also became more aware of the no sugar rules and enjoyed his breakfast without it.

The children found the interactive games especially interesting as we were in lockdown and they could not interact with other children facing similar challenges with their weight etc, we kept a folder to look back on previous learning and goal setting. The paper tools, such as the Eatwell plate and pamphlets were a good way to engage the children which was better than just electronic device information. The sessions were well spaced and child friendly, I would recommend this course whole heartedly.

Outcomes

 

Both children have made positive changes to their diet and have an increased understanding of healthy eating and their own relationship with food. They are more aware of foods and the effects that these have on their body, for example Chloe no longer drinks fizzy as she is aware it upsets her tummy and is happy to miss her dessert after dinner as she realises she is feeling full. Both children are now able to stop eating without being sick and Harry will limit his packets of crisps and is more open to having snacks such as fruit. The sessions gave the children the knowledge to make different choices in life and encouraged them to explore and speak openly about their emotions more, as well as how this influences their eating behaviours when discussing emotional eating. Both children report an increased level of confidence and positive attitude to food and life in general.  Improvement in wellbeing scores (Good Childhood Index) were seen within both children.

 

Sleep, screen time and relaxation were also emotive subjects that have become easier to enjoy and manage and the children reported feeling fitter.  Harry’s asthma, is now less problematic and his breathing has significantly improved.

 

Within 10 months on the programme both children have reduced their BMI SD scores (Harry – 57.2kg, BMI of 27.21kg/m2 (SDS>+3) and Chloe – 63.5kg, BMI of 28.22kg/m2 (SDS>+3)).

 

The family are very thankful to Onelife Suffolk for their continued support as the family have enjoyed achieving a healthier, active and motivated summer despite the dreadful COVID-19 restrictions. Both children have learned to swim which is a major activity achievement as neither had ever been in a swimming pool before this programme. Walking, scootering, holidays and fun have all been aided by the new lifestyle they have been made aware of, and Harry and Chloe have much more confidence to join in with these activities. Both children will soon be moving home, they are excited to continue with their journey and rightfully proud of their progress so far.