To be upset with NHS over DDs weight?

[Fudgefudgefudge]

DD is 4 and is in reception. Recently she had her vision, hearing, weight etc measured at school and yesterday I received a letter from the NHS saying that they are referring her to Morelife. Having googled it I'm mortified, I had no idea my child was that overweight! I checked the NHS site which measures their BMI and using the measurements they provided it shows DD being obese and on the 99th percentile

Now I breastfed DD up until her 1st birthday and she was a big baby back then but over the years she's slimmed up if you know what I mean and to me she just doesn't look overweight. She has a healthy appetite and I am well aware of how to eat a healthy balanced diet etc but I do allow a treat for good behaviour. And DD is a very active, she would rather run than walk and I don't drive so she's used to walking places.

AIBU to be upset about this? What do I do? Ask the GP their opinion? It's made me doubt my abilities as a mother as I never even considered she could be obese.

Hecantbeserious

The menu this week at DD's nursery is
Tuna lasagne with raw cabbage salad
Chicken in sauce with rice and green salad
Herring fillets with mashed potato and grated carrot
Vegetable soup with bread
Ham and potato bake with 'colourful' vegetables and beetroot

They always have fish at least once a week and a veggie meal once a week

Natsku even though DS would quite happily eat most things on that menu, I can't imagine many children from his primary school class eating them.

Jacket potatoes were a daily option at his school along with a meat and a veggie option. They used to offer a few toppings every day, but in a bid to cut costs they reduced it to one a day, with a different one each day. They still offered a meat and veggie option as well. Fruit and salad were also available. The uproar from parents when only a tuna topping for the jacket potato was offered was amazing . Can't imagine what they would have thought if herring was on the menu.

My understanding is with primary school dinners in England is that the menu is based on the principle that this may be the only substantial meal some children will have so that it is bulked up with carbs but I may be wrong.

No idea what the principle is here in Wales but our LA seems to be stuck in some kind of time warp.

The children have no choice, they start eating menus like this from daycare onwards so they all get used to it, no packed lunch allowed and no other options (except for dietary reasons for which they need a doctor's note - DD has to have gluten free so occasionally has different food from the others, no blood sausage for her!). There's always bread served on the side so that bulks up the carbs a bit. Water, milk or sour milk to drink.

Assume you're not in the UK, Natsku?

No, in Finland. I did quite like school dinners in the UK on the occasion I had them in primary school but they were definitely not healthy!

One of my SGC is by far the tallest in his year and, yes, you can see his ribs. My SIL got a call from someone who told him the child was seriously obese.

On questioning her it turned out that she only had my SGC's weight in front of her, not his height. The same sort of thing has happened to other people I know.

My house is on the route to the park for our local primary school so I often see large parties of kids walk by. OK, I live in the affluent South East, but only a couple of the kids I see are visibly chubby. It's certainly not the epidemic I read about. If methods of obtaining data are as sloppy as in my SGC's case I wonder how real the supposed crisis is.

The obesity crisis can't just be all a mistake and there isnt one really, surely.

The point is that children don't have to be 'visibly chubby' through clothes to be overweight.

And, as in much of the western world, we've lost sight of that, and see children who are overweight or bordering on overweight as 'just right'.

The point is that children don't have to be 'visibly chubby' through clothes to be overweight.

And a thin or normal weight child may not be healthy. They may be drinking soda all day and surviving on chocolate bars and crisps. Or they may eat well but get no exercise, whereas an "overweight" or "obese" child may be very active and eat healthy foods, but in large portions. They may be carrying extra weight because they are going to be tall or broad.

Overweight does not equally unhealthy. Proper nutrition and exercise, especially in childhood, is far more important.

Overweight does not equally unhealthy.

But it is always better for a child to not be overweight, than to be overweight. Exercise and nutrition notwithstanding.

If a child is obese, then the obesity is a problem. Even if they got that way from eating healthy foods, and even if they do hours of exercise a day.

Absolutely. Overweight doesn't automatically equal unhealthy, but the lifestyle factors that contribute to children being overweight ie lack of exercise, more food consumed that they are burning off, are likely to lead to poorer health outcomes.

It's also very hard for many children who are carrying extra weight to be as active as they need to be. I've seen plenty of children who are too overweight to be able to run, which is heartbreaking.

I live in the affluent South East, but only a couple of the kids I see are visibly chubby.

Well, that'd be why.

You barely see any chubby kids walking to school in the affluent beachside suburbs here, either. It doesn't mean the obesity crisis is bollocks.

Go to a shopping mall in a low socioeconomic area and it's a very different story.

"If a child is obese, then the obesity is a problem. Even if they got that way from eating healthy foods, and even if they do hours of exercise a day. confused"

Not necessarily. Visceral fat, nutrition and fitness levels are the issue.

Visceral fat is the fat found around your organs. Generally it's what gives people a chubby belly, although often it doesn't show at all. Fatter arms, legs, bums are Subcutaneous fat that is stored directly below your skin and is the type of fat where you can “pinch an inch” from your belly, arms, thighs or just about anywhere else on your body. A lot of where and how easily you gain subcutaneous fat is down to genetics.

Visceral fat is dangerous. It's linked to Type II diabetes, cancer, high cholesterol and blood pressure, Alzheimers, etc etc etc. All those life style diseases related to obesity are actually all related to high amounts of visceral fat.

Generally, if a person has a lot of visceral fat then they have a belly, but this is not always the case. There are lots of "skinny fat" people have a lot of fat around their organs, but are a healthy weight. Those people are at just as much risk for lifestyle diseases as someone who is obese.

Also, someone who gets fat eating lots of chicken and spinach is going to be healthier than someone who gets fat eating Big Macs. Because there is so much more sugar, salt and bad fats in Big Macs than there is in chicken and spinach.

Exercise has been shown to be incredibly beneficial in so many ways, that I can't begin to list them here.

However, its a hell of a lot easier to say that fat=bad, rather than an unhealthy lifestyle + genetics+ fat in certain areas =bad. Especially since for much of the population, if you are obese, then chances are you are living an unhealthy lifestyle.

It's also very hard for many children who are carrying extra weight to be as active as they need to be. I've seen plenty of children who are too overweight to be able to run, which is heartbreaking.

Again, highly dependent on why they are carrying "extra weight", are they carrying it because they eat poorly and don't exercise, or are they carrying it because they will grow up to be tall, broad and athletic. I swam competitively and played ice hockey growing up, the girls with the fastest times and most endurance were the ones who would be classed as overweight or chubby on this thread. When they hit puberty they generally grew up, thinned out, grew wider in the shoulders and the "fat" turned to muscle, but the athletic ability was always there.

I was always praised for how thin I was, but in terms of fitness I sucked big time. I just didn't have the muscle or the energy I needed to compete properly.

The issue is whether they'd be classed as overweight by official measures though, isn't it?

This thread has repeatedly shown why just looking and saying children 'they look alright' or 'they might be a bit heavy' isn't helpful.

The issue is whether they'd be classed as overweight by official measures though, isn't it?

Official measurements are BMI. BMI is not a measure of health and shouldn't be used as such. In many ways, looking at a kid and saying "well they don't have any rolls of fat so they don't look chubby" is a better measurement of health than BMI.

Which is why I said if the OP is worried she should discuss her DD's weight with her GP. Not just assume her child is unhealthy because she didn't fall in the right category on the BMI chart.

Although OP has said that the official letter about her dd's BMI, in conjunction with her own research, reflection and reading, has been a useful wake up call regarding her dd's diet and size.

Given the comments on this thread I'm not surprised. There are posters calling a picture of a 5 year old with a healthy BMI chubby.

Thank goodness threads like this weren't around when I was a kid, and our BMI wasn't calculated at school, or my eating disorder would have been worse.

Just because some normal weight children are unhealthy still doesn't mean children being overweight is ok. Ideally everyone should be in the healthy range, especially children as being overweight generally makes it harder for them to exercise. There's a girl in a gym class me and DD go to, the class is for under 7s only but this girl is so large she looks older, she is definitely obese and struggles with the activities even though she comes from a family that exercise and play sports - its the weight that limits her and its very sad to see.

Re the ribs thing - when I was a toddler (I'm 51 now) the GP told my mum that a healthy child was one where you could count the ribs from the opposite side of a good size room...

Just because some normal weight children are unhealthy still doesn't mean children being overweight is ok.

Just because a child comes in as overweight on the BMI scale, it doesn't mean they are unhealthy or even physically limited. The children you are talking about will undoubtedly be categorized as very obese. Most children who are overweight on a BMI scale are probably not even noticeably chubby. You would see them on the street or at the pool and not even categorize them as overweight, you might call them stocky or healthy, just not skinny skinny.

The normal range is an average, not a marker of health. So saying that there are a range of taller, large framed kids, who may be healthier at the higher end of "normal" to the lower end of "overweight". There are also a range of shorter, small built kids who are healthier in the lower normal to underweight category.

There are always outliers but they are rare, the vast majority of children will be healthier in the normal range, which is a range like you said but once they cross into the overweight range they are at an increased risk of health issues. I wouldn't call them stocky or healthy, those are euphemisms meant to downplay the problems of the overweight issue in children today.

IME of school sports days -many over the years- the fast, agile ones are not the chubby/overweight ones. I realise that some big children can be fit and healthy, but I don't believe they are in the majority.

We can recognise that there will be outliers to the BMI test - but it is a good indication that a child's body mass is too much for someone of their height, so worth flagging up.

There are always outliers but they are rare

Not if you look at it in terms of health. If you go by health measurements (blood pressure, insulin resistance, cardio-metabolic rate, etc) 30% of people in a normal weight bracket are unhealthy, 47% in the overweight bracket are healthy, 29% of obese are healthy and 16% of morbidly obese are healthy.

That's simply in terms of cardio metabolic rate and overall health. Most of these people will not suddenly become unhealthy either, they will remain cardio metabolically healthy unless they have a genetic per-disposition to certain illnesses.

In terms of wrongly classifying people due to frame size. Height by weight squared doesn't make sense because people aren't two dimensional. Height by weight cubed is a better measurement, but even then if you have a large frame (for a woman over 5 ft 6 with wrists over 6.5 in circumference) this BMI chart should be used:
Below 20.35 BMI is underweight
BMI 20.35 to 27.39 is normal
BMI 27.4 to 32.89 is overweight
BMI 32.9 to 43.89 is obese
BMI 43.9 and over is morbidly obese

So how many over 5 ft 6 woman are wrongly classified given that 5 ft 6 is the national average? People are evolving to be taller with larger frames.

Finally, in terms of children, their bodies are still developing, and it's hard to predict where they are at in a growth cycle. Immediately signing them up for diet classes may have a long lasting negative impact on a child going through a difficult hormonal stage or preparing for a growth spurt.

As for stocky and healthy being used as euphemisms for fat, give me a break. There are more body shapes in the this world than thin and fat. We need words to describe them.