We too have struggled with weight. Our son is almost 6 and weighs 81 pounds. After years of analyzing our eating and exercise habits, I firmly believe he has an unfortunate combination of genetics and CAH working against him. Although his Dad is average weight now, he too struggled with weight as a kid.

Our son was pretty oversuppressed as an infant. His height has always been good, but his weight has been a difficult. When I had complete control over his diet (age 2 and under) he stayed around 95%. As soon as he was in preschool his weight ballooned. He simply cannot eat what other kids eat and not gain weight. I think of him as the canary in the diet coal mine. In the U.S. I think we feed our kids horribly - lots of refined sugars, carbs, and highly processed foods. Most kids can survive that diet without outward affects - at least until puberty. My son can’t.

Two years ago we started making some changes. We have always been pretty healthy eaters at home, and very active. Our big area for improvement was eating out. We cut down take out or eat out from 3-5 times a a week to 1 or 2 (often Subway). We increased our activity level. My husband lost 40 pounds, I lost 25, our son gained. Very disappointing.

Next we tried circadian rythmn dosing. This seemed to really help. Jack just wasn’t so hungy, and it wasn’t such a battle to keep him from eating. His weight gained slowed considerably, almost to zero.

Other things we have found to be helpful . . . His endo gave me some diet suggestions she gives to her diabetic patients e.g. Spendla in kool-aid instead of gatoraide or juice. Some simple changes like that have helped. 

We try to stick to lower carb, higher protein diet (not Atkins or anything, I believe is balance). I know many kids have a bowl of cereal for breakfast. For our son, that lasts about 30 minutes then he is hungry again. I really have to get more protein and fiber in him to keep him from snacking too much. Apples are huge in our home. Also, I have noticed if I let him get too hungy, he craves high carb foods. This makes sense because carbs are quickly converted into energy. I try to catch him as he starts to get hungry not when he is starving.

And finally, like Judy W, we focus on his choices. He detests any hint of control on my part, so if I am too directive he just rebels. On my good mom days, I try to "help" him make good choices. I’ll remind him he chose to go for ice cream with his Dad in the afternoon. If I offer an alternative e.g. strawberries after dinner, he will usually make the choice himself without me forcing the issue.

And finally, I think it is very natural for all kids to gain weight just before puberty. I can’t remember all the reasons for it, but docs consider it normal.

-Chris