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.

If that's to me, a solid child looks quite different from a fat child. I was a fat child. Big bones, solid muscle looked different. I was a small-boned, sedentary fat child (same weight now as a medium sized adult).

"Today 20:39 HeCantBeSerious

What about sporty/muscly kids then?"

Is it really likely they'd have so much muscle they'd weigh the same as an obsese child though?

Young children cannot put on sufficient muscle mass to skew the results. Children are not mini adults. The proportion of muscle mass an adult needs to change the result falsely is the level of an elite athlete. It is also a fallacy that children or adults can be 'big boned' to the degree they are miscaregorised.

Just looking at my daughter's build. There's not an ounce of fat on her but since doing swimming and gymnastics she's put on about 5 kilos in 8 months (and grown over 10cm). She's by far the fastest child in her year and can play sport for hours. She's on the 75th centile for weight and 50th for height. She doesn't eat that much but you can see the strength in her arms and legs. And yes, her ribs are visible and tummy flat. She's almost no bottom.

She's just naturally slim but muscly I guess.

Looking at the charts to be in the overweight section of bmi you have to have a weight about 2 centile places higher than height.
Eg height is 25% weight would be 75th+ to be overweight.

But being above 75th for weight doesn't automatically place you in I er weight catagory. Those on 96th for both are in normal range.

But that muscle can't weigh enough to make her obese? Im not sure if that's what you're suggesting

Her height and weight have varied so much (as detailed in an earlier post) that I think at points (e.g. before a growth spurt) she could have been 75th/25th at times. But she's never ever been visibly fat.

Is there an easy test for muscle mass?

Exceptionally tall young children are often overweight. The extra calories make them grow up as well as out.

Fudge - take this as the wake up call it is. Accept all the help that's offered and get your DD's weight back on track. She's young enough to really not notice and for you to embed healthy eating.

Good luck

My DS is properly tall and skinny. You can see his ribs all round. Trousers are never narrow enough at the waist. His arm and leg muscles are visible, as are his abdominals (he is sporty). He is 50th centile height and weight.

DD has a sticky out tummy and I can't see her ribs. She is usually 75th centile height and weight, but clearly a different build to DS at the same age. I am positive I will be told she is overweight when she starts school next year.

My point is that I am clearly rubbish at judging when kids are overweight. I think that's not unusual.

Sorry this had come as a shock to you op.

Like others have said, sometimes you can't see it because you are too close to the person involved. If she's not overweight - fab. But if she is, I hope dietary changes will help her.

One mum I know was adamant her daughter isn't fat but doesn't understand why the school dresses are too tight for her daughter. Turned out she was overweight when she got measured.

It's called Goldilocks Syndrome and it's a recognised phenomenon that the parents of overweight and obese children are often the last to see it. They usually assess them as "just right" even when weight gain is quite considerable

Link to media coverage of the research here

If you don't like BMI as a measure for health, and it is not robust for everyone (although the exceptions are much rarer than implied), look at functional measures of health and fitness.

The "we walk to school and DD plays football club once a week" is a pretty delusional idea of what a healthy level of exercise for a human child is.

Things like
Can the 5 year old do monkey bars comfortably.
Can the 5 year old run a mile comfortably in well under 20 minutes.
would be possible functional measures since a heavy child who is "all muscle" would have no problem doing those things.

I think it's upsetting because we've all seen these dc in the news or whatever, they don't obviously appear overweight.

I had one friend who was disgusted, it's obviously rubbish type of thing and ignored it.

Another friend thought ok then, leaner meals (i.e. less pizza and lasagne, more chicken/fish and veg), more walks/bike rides, less sweets.

The first friend has an obese 11 year old. She has developed breasts and had periods long before her friends. The 2nd friend has a dd at age 11 of normal weight. She looks slim and fit and enjoys various sports.

They didn't look massively fat to me at 4. Slightly chubby. But by the age of 11 it's very obvious.

My advice would be don't take offence, take heed. Have leaner meals as a family, regulate treats and get loads of exercise built into your routine lives.

It's upsetting but you do have to face it head on. I did and now when I look back at my photos of son, I'm surprised that I didn't notice it. He was too chunky.

Be kind to yourself and when you've got over the emotion of it, have a good look at what changes you can make. For us, it was the snacking. I also think he was thirsty and I offer him a drink first and then see if he's really hungry.

HeCantBeSerious I'm curious, does your DD still come up as a healthy weight on the NHS calculator or is she misclassified?

Actually something else I wanted to add. My dc are slim because they have no interest in food and never have had. It's absolutely nothing to do with my parenting. Friends have had dc who love food. It's just a different thing to manage.

"The first friend has an obese 11 year old. She has developed breasts and had periods long before her friends."

Starting puberty is not an indication of obesity I don't think. My DD2 started her periods at 10. She is now 13, nearly six feel tall and built like a bean pole. I think that is muddying the issue

*feet

But obese girls do start puberty early.

So do girls that aren't obese. My DD2 was actually underweight when mesaured by a peadeatrician (for an unrelated issue)

And I agree that obese girls may start puberty earlier, I was just concerned that that comment muddied the waters - especially when we are talking about a 4yo

HeCantBeSerious I'm curious, does your DD still come up as a healthy weight on the NHS calculator or is she misclassified?

She comes up at 81st centile on the calculator, which I'm surprised by.

This is her at 5. You can see the muscle developing in her legs. The swimsuit is age 4-5 at most and baggy on the bum. No visible tummy.

At 6 she could do a 5km parkrun in 32 mins.

Is part of the problem not the way in which the letters are worded? Baldly stating "your child is obese" is bound to get a parents back up and, as others have stated, the More Life referral is patronisingly phrased. There must be a better way of notifying parents that doesn't come across as judgemental or scolding.

I also think that in the case of young children, those who test out as overweight or obese should be measured again say a month later and only of both measurements put them in the lverweight/obese category should parents then be contacted. When DS1 got measured his came back that he was overweight. I got the letter around five weeks after the measurements were done. I can't remember the centiles or the figures now, it was a good few years ago, but I weighed and measured him myself. He was roughly two pounds lighter than stated and a good few centimetres taller. He had a GP appointment for something unrelated and I got the GP to check too, their measurements were on par with mine and put him back into the healthy range. GP concluded he'd been measured at the start of a growth spurt (when DS is due to shoot up, he gets a little bit of podge around his tummy and his face that very quickly vanishes once he goes upwards. When I see the podge, I know it's going to be time for longer trousers!). GP said to ignore the letter.

I think DD will test out the other way, she'll be getting her check soon and I think she'll show as slightly underweight. She's always been a titch and is aged 5yo but wears age 3-4 clothing and isn't much taller than her 2yo brother. Do underweight children get flagged in the same way as overweight ones, I wonder?

BMI doesn't work for 'outlier' kids. Kids can more muscle mass if they're taller, super active, or going through an early puberty.