Healthy Weight Guide A Guide for Parents of Children With Special Needs

These suggestions can help your child reach and stay at a healthy weight. (The consistency of the foods listed may be changed to better meet your child’s needs.)

What does it mean to be overweight?

Being overweight means there is too much fat in the body. People are said to be significantly overweight when their body weight is 15 - 20 percent over the normal height-weight standards.

Why do some children with special physical needs have a higher risk of being significantly overweight?

The physical activity of children with physical disabilities may be limited because of muscle weakness or paralysis. Being overweight may be due to too little exercise or too much food for body requirements or both. Children with special physical needs may also be short for their age.

How can I help my child?

Forming good food habits early in life is important to healthy weight maintenance. Children depend on parents to provide food habits and they also start very early developing attitudes, feelings and habits about foods.

What kind of food — and how much — does a child need?

A child’s daily diet should include:

• 3-4 cups of milk
• 2 servings of meat
• 4 servings of breads/starches
• 4 servings of fruits and vegetables

High-calorie, low-nutrient foods such as soft drinks, candy and chips should be eaten in small amounts. The food recommendations listed in this guide can be given to your child pureed if that better meets your child’s needs.

• Offer the same foods to the entire family so the overweight child won’t feel deprived or singled out.
• Serve meals “restaurant style.” Dish foods in the kitchen rather than at the table to help control the serving size.
• Encourage eating slowly.
• Serve foods only at the table. Do not eat in front of the TV, directly from the refrigerator, or in any other room besides the kitchen.
• Try to eat only at planned meal and snack times.
• Do not skip breakfast. Offer breakfast cereals and other low-fat foods. Children who skip breakfast are more likely to snack on higher- calorie foods later in the day.
• Serve fruit or angelfood cake for dessert.

• Fresh fruit 
• Make your own frozen juice pops
• Canned fruit packed in juice 
• Chunks of bananas
• Whole wheat crackers, saltines 
• Skim or 1% milk
• Popcorn (air popped, “light” microwave, no butter) 
• Raisins, dried fruits
• Ice milk 
• Low-fat cheese cubes or slices
• Nonfat, low-fat yogurt 
• Fresh vegetables

• Use a non-stick frying pan that requires little or no fat. Cook foods over low heat.
• Low-calorie cooking spray may be used for frying foods without fat.
• Remove fat from soups, stews, and gravies by chilling them first and then skimming off the fat with a spoon.
• Use non-calorie sweeteners, available in liquid or granular form, for sweetening cereals or fruits.
• Avoid gravies or cream sauces.
• Season foods with herbs and spices rather than with fats. Lemon or lime juice is a good addition.
• If making chocolate milk, use skim milk flavored with chocolate extract or cocoa, or use sugar-free chocolate milk flavoring instead of chocolate syrup.
• Baking, broiling, boiling, roasting and grilling are the best low-fat cooking methods.
• Remove all visible fat from meat before cooking.
• Use butter flavors, available in powder or liquid form, on vegetables or starches.
• Sprinkle Parmesan cheese on potatoes, vegetables or salads to add zest without adding many calories.

Recipe substitutions to lower fat, cholesterol and calories

Sit-down restaurant

• Order food broiled, roasted, poached, steamed or baked.
• Avoid casseroles and food with heavy sauces.
• The best protein choices are poultry, fish, veal or lean beef.
• Order salads without cheese, eggs, meat, bacon or croutons. Ask for salad dressing on the side so you can control the amount used.
• Order a baked potato or seasoned rice instead of mashed, au gratin or fried potatoes.

Fast-food restaurants

• A good rule to follow is to order the cheaper and smaller items to save calories. For example:  
  • Hamburger – 275 calories
  • Small cone– 85 calories
  • Whopper– 640 calories
  • Small shake– 291 calories
• Skip the French fries and onion rings.
• Remove excess sauce or mayonnaise from the buns, or order burgers plain.
• Instead of a fruit pie for dessert (300 calories), try animal crackers.
• Select a fast-food restaurant with a salad bar. Use low-calorie dressing.
• Don’t order extra cheese on pizza.
• Order rice instead of refried beans.

The best way to lose weight and keep it off is by following a balanced lower-calorie food plan. Weight loss may seem slow, but the general rule of thumb is “the faster the weight loss, the faster the weight is gained back.” Generally, children should not be on a strict low-calorie diet. Good weight loss is usually easier to achieve if you choose low-fat and low-calorie foods for meals and snacks.

Goals for overweight children should include stopping weight gain and aiming for a weight loss of ½ pound per week. If children slip occasionally, just help them get back to the low-fat, lower-calorie eating plan as soon as possible. Encourage your child to start
(or increase) regular exercise. Check with their doctor for guidelines.

Record your child’s intake for three days. Please bring this record with you when your child comes back to the clinic. This information will help to better assess your child’s diet and nutrition.

A food diary can be a good tool for managing your child’s weight. Record portions as teaspoons, tablespoons, cups or ounces. Recording each time your child eats rather than once at the end of the day helps to ensure accuracy.