Skip to main content

When One Child Needs to Lose & One Needs to Gain

More and more families are managing the challenge of having one child who is overweight and one child who is struggling to gain.  Many factors can contribute to this discrepancy, including individual genetic factors that affect metabolism, medications that may suppress appetite (i.e. ADD/ADHD medications), disordered eating or an underlying medical disorder that is affecting the body’s ability to absorb or process food and nutrients.

If you are trying to help one child gain weight but another child lose weight, it is still important to feed the entire family the same meals, rather than cooking a different meal for each person.  This prevents any child from feeling favored or punished.  However, here are some other strategies that can help you provide for children who have different nutritional needs:

  • A child who is underweight may eat the same meal as the rest of the family, but he may get more frequent healthy snacks throughout the day.  This way, no meal is large in portion, and he gets adequate calories at regular intervals.  The goal is to avoid other members of the family feeling deprived at the family table.
  • School-age children are at a perfect age to understand nutrition and healthy eating.  Therefore, sit down and discuss nutrition openly with your children – teach portion control for everyone in your family, and explain why one child might be getting extra snacks during the day.
  • Teach kids to recognize feelings of hunger and fullness.
  • Do not pressure or lecture kids to eat or not eat. Instead, provide a variety of healthy choices, and don’t make only favorite foods.  Focusing solely on weight or rationing foods may lead to negative outcomes such as low self-esteem or an eating disorder.
  • Do not categorize food as good or bad.  Instead, focus on the nutrients we get from certain foods.  Give hands-on examples such as a candy bar versus an apple and peanut butter – which provides a healthy balance of nutrients?
  • Let children help with grocery shopping and experiment with cooking.  Meanwhile, teach healthy eating for everyone in your family.

Helpful resources:

Fearless Feeding: How to Raise Healthy Eaters
By Jill Castle & Maryann Jacobsen  
Great recipes and information about how to incorporate fruits and vegetables into daily meals
How to Avoid Portion-Size Pitfalls 
Confused about portion sizes? Play the CDC’s portion control game. 
Provides a tailored explanation of how to balance your meals and includes an interactive game for kids.
We Can! 
This national education program is designed for parents and caregivers to help children 8-13 years old maintain a healthy weight. Families Finding the Balance: A Parent Handbook offers easy-to-use, practical tips and tools to help children and families eat healthy, increase physical activity and decrease screen time.

Hillary Lockemer, MD, is a pediatric endocrinologist with WakeMed Physician Practices – Children’s Endocrinology & Diabetes.  Parul Kharod is a clinical dietitian at WakeMed Cary Hospital.