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[quote=Anonymous][quote=Anonymous]OP, what a challenging situation, you sound like you're trying so much!  I agree that the situation when you're managing 2 different chronic illnesses can be really complicating.  My child has severe asthma and is borderline obese, and the two conditions conflict frequently? Do I have him take those steroids that impact his growth and appetite so that he can breathe?  Do I sign him up for the outdoor sport during pollen season, knowing he'll need way more meds to participate?  Do we cancel soccer so we can do allergy shots?

Your situation is far more complex than ours, and I imagine it's 10 times harder. You need to make choices that put her mental health first, an punitive strategies like taking away her allowance, or restrictive ones like powerstruggling over food are going to do damage.

Based on our journey (my son is doing well with his weight, holding it steady during his adolescent growth spurt which is resulting in dropping BMI percentiles), here are some ideas.  None of them are probably powerful enough to work miracles, but they might help her stabilize her weight gain while you work on the mental health issues.  Once she's ready to be your partner on the weight loss she won't be in such a bad place.   They might also lay the foundation for some skills that she may be able to use when she comes through the pangs of adolescence which are probably exacerbating the mental illness, or when you find a medication that works.

Here are some ideas, some of the based on what has worked for us.

1) Go see a specialist without your daughter.  I saw this person: http://www.drdaisy.com, for my son and really liked her.  She's got expertise in both mental health and diet, and gave us lots of good suggestions.  Generally when she works with children and preteens she just sees the parents and gives them suggestions.  Once kids are in their teenage years she likes them to come, but I bet she could use the younger child model here.  She can give you great answers to questions such as "what do I say when she says 'Do you think I'm fat?", and also on how to present meals.

2) Change your pediatrician.  Children's Hospital has a childhood obesity program.  Even if she wouldn't comply with the program, perhaps she could see one of the pediatrician who works in that program as her general nutritionist.  They might be able to help.  We actually happened to see one of them (pediatrician/orthopedist who is on the obesity team) when my son had a problem with his knee.  It was really refreshing to have a Dr. who knew how to talk about weight.  Other specialists we've seen have treated it like the elephant in the room.

3) She likes fruit and pasta.  That's a great place to start because they are both healthy foods.  One thing that has worked for us has for me to put out an unlimited portion of low calorie foods my child likes   So, for example, my child comes to the table for dinner.  Before him is a salad, some sliced kiwis and a bowl of mixed berries, all cut up and looking appetizing.  He can help himself while I'm finishing cooking the main course (pasta, for example).  Then I serve a small portion of the pasta to each of us, with some green beans.  My child eats what he wants.  If he wants more beans or berries or kiwi or salad than is on the table, I say "Of course" jump up and get it.  If he wants more pasta I say "the pot's on the stove, please help yourself" or "I'm afraid this is all I made, you're welcome to fix yourself some more".  I never limit the unhealthy food, just make it a little harder for him to get it.  Doing this has really changed the proportions that my child eats without me needing to get into power struggle.  I also notice that when we go to a restaurant or something, because he's used to fruit and salad with meals he's more likely to ask for them.  It's the beginning of a healthy habit.

4) The fact that she's willing to choose diet soda is promising.  It seems like on some level she's motivated enough to make the choice she thinks of as healthier (note: she may be wrong, there's a lot of controversy about that, but she is making some effort). Rather than focusing on getting from "bad food" to "good food" focus on making the better choice.  Realistically you will never have much control over the diet of a teenager, they're out in the world too much for that.  And frankly, if you do all the controlling, she's not going to learn any skills anyway.  For my kid, he wasn't going to choose a food he didn't like when he's out on his own, but if there were two foods he did like he'll choose the healthier one. My kid was willing to learn to read labels.  He won't pick steamed broccoli over french fries, given the choice, but he will happily substitute half soda/half seltzer for a soda, or get grilled chicken on his caesar salad instead of fried.  It's not perfect, but every little bit helps.  You can also help her out by buying a variety of "not quite as unhealthy" substitutes and keeping them around so she's experimenting and learning things she likes.   So instead of soda, keep gallon jugs of super diluted juice or lemonade in the fridge.  It's worse than water, but way better than soda.  Think of them as transitional foods.

5) If there are certain tastes or sensations she likes, experiment with increasing the intensity of those sensations in what she eats to satiate her more.  I know my kid loves really spicy things, and if I accelerate the flavors he'll feel full happier and come back to the healthy food.  So I can replace 4 scrambled eggs with cheddar (a previous favorite) with 3 scrambled eggs whites with a smaller portion of really sharp cheese and a lot of tabasco, and he's just as happy.  For your kid it seems like sweet is the trigger.  Are there healthy/healthier ways you can up the sweet factor in her meals, like a bowl of fruit salad with every meal, that might make her seem more satisfied.

6) What's her "currency".  The thing she'll work for? Can you connect it with exercise in some nonjudgemental way? Not "I'll bribe you for exercise" but "I moved the video games to the attic, so you'll need to climb the stairs each time you want to play" or "Sure, we'll go to the movies but I'd like to save gas" or "You'd like some money, I'll help you set up a dog walking business".  In the summer, will she do amusement parks?  A six flags season pass was one way I got my kid more active in the summer.  Lots of walking there!

7) Are you using food as an "I love you" language?  This was hard for us.  I am a single parent, working crazy hours, and sometimes I'd stop on the way from work (usually, to be honest to get a snack for me) and pick up a candy bar for him as a way to say "I'm thinking of you".  Now, I'll pick up an itunes card instead a pack of cards for a game he plays, or my son likes the singing greeting cards from "hoops and yo yo", so I'll get one and leave it on his pillow for him.  Of see if you can get her collecting something that you can use as a reward: nailpolishes, beads, (for my kid it's Magic Tricks, but I don't know what a girl might like), and that might entice her to spend her allowance in a healthy way. .  Think about establishing a pattern.  If you're out together and she wants to use her money to buy unhealthy food she can (again, stay far away from power struggles), but if she wants a "healthy treat" which can be something that's not food, or something that's healthier like a flavored water or a package of nuts, you'll go halfsies with her.

8) Advocate for her.  Overweight kids get so many negative messages, from the world.  I'd be very careful about any kind of comments about weight that aren't in the context of a planned discussion (maybe facilitated by her therapist).  Stay away from "drive by" comments, and react forcefully in front of her if others make them so she knows you're on her team.  If her teachers are sending emails criticizing her diet, they may be making negative comments to her too.  I'd reply very clearly that you understand that the comment came from a place of caring, but that you feel strongly that her eating is a private thing, you're aware of it and addressing it with medical professionals, and that you would like them not to involve themselves in it.

Good luck![/quote]

Not OP- but Wow. It's really nice of you to take the time to type all of this info. We moms have to stick together. Makes me feel better about being a DCUMer. [/quote]

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