If you haven’t read this post by lazydad you really should.
I’ve been asked this same question by OlderTwin. And it’s heartbreaking because I don’t know if it’s coming from us or his classmates.
OlderTwin’s chromosomal disorder is responsible for his intellectual disability, as well as, his behavioral issues. Medication and therapy are the best remedies for his behavioral issues. Unfortunately, the medication has a weight gain side effect, resulting from an increased desire for carbohydrates; a general increase in appetite; and a changed metabolism.
To prevent an unhealthy weight gain (some kids on this medicine have gained 20 lbs in a month) we closely monitor his food intake and, in consultation with his psychiatrist and psychotherapist, have routine conversations about food moderation in an effort to help him understand why he can’t have 5 servings of macaroni and cheese or a dinner consisting of all carbohydrates.
We also consistently offer fruit, fruit, fruit when he’s experiencing an increased appetite episode. We use these moments to explain the value of snacking on fruit (e.g., it satisfies hunger without pushing caloric intake through the roof). Thankfully, he loves fruit so these offerings are greeted with happiness.
We also have to monitor his weight on a weekly basis to ensure there hasn’t been a significant change.
It’s a heartbreaking and a painstaking process because we have to make every effort to help him understand all of this food and weight monitoring isn’t because there’s anything inherently wrong with him or being overweight but that any weight gain brought on by his medication would most likely be unhealthy due to the rapid pace at which it would occur as well as it being most likely triggered by the over consumption of unhealthy food.
To this point, we’ve been fairly successful at preventing any significant weight gain. However, while he’s the same height as YoungerTwin and only weighs a pound more, he appears to have a belly whereas YoungerTwin has a six-pack. This appearance difference is attributable to OlderTwin’s low muscle tone, another side effect of his genetic condition, which causes his belly to pooch out a bit.
So, I don’t know if he asks, “Am I fat?”, because he heard that at school from classmates who’ve noticed his slight belly or infers it from our conversations about food intake and weight maintenance. It’s a frustrating and extremely guilt inducing topic for me, which is why we enlist the help of his psychiatrist and therapist to make sure our messaging is a positive one and not one likely to produce shame. But, f*ck, it still produces a lot of worry on my part that we’re to blame for his question.
He’ll always crave starchy, sweet foods because of his medication so he has to learn how to effectively deal with those cravings. That’s no easy task when you’re mental disability makes it difficult for you to grasp and recall routine concepts, meaning even though you’re nearly 8 years old you still ask every Saturday and Sunday morning, “Do I have school today?”