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.

Bear - yes, they do get flagged in the sense that when DS was weighed/measured at that age, he was 50th centile for height and 9th for weight.

He's nearly 10 now and I've managed to get him up to almost 50th centile for weight (his height has remained bang on average) but like user1470 said, I can't take any credit for him not being fat, he just has very little interest in food.

Sorry - didn't finish my first sentence properly - yes, they told me he was underweight (but not that I had to do anything about it).

Yes I've been told my dc was underweight but no advice what to do about it. You just have to manage what you've been given I've think. But to ignore the message I think is taking a risk.

I took ds (11) to the GP and asked for help with his weight.

I had weighed him at home and used the NHS child BMI checker and he was measuring 'overweight'. He also looks overweight when you see him undressed. Big bottom. Love handles. Extra weight on his chest. Dressed he looks lime a rugby player - tall and broad, rather than just fat, but he is overweight.

The response was disbelief from the doctor - she said 'are you sure he's overweight?' She referred us to the HCA to discuss diet and exercise. This appointment involved the HCA telling me that she was sure that ds wasn't overweight. I told her that he was, that we'd had a letter back from the school saying he was overweight, and that he was 11 and couldn't fit into Gap trousers made for 16 year olds. She told him to eat cereal for breakfast and stop eating crisps. Also to go cycling sometimes.

So there you go. That's how much help you get from the NHS when you try to be proactive as a parent.

I suspect they're waiting for my ds to become morbidly obese and develop diabetes before referring him for proper help.

They tell you your child is over or underweight if there are more than two centile lines difference between height and weight on the centile charts. Personally, with measurements implying the OP's dd isn't just overweight but extremely obese, I would be checking the measurements given. My ds's paediatrician once recorded his weight as double his actual weight, miraculously turning him from an underweight child to an overweight one... Inaccurate measuring devices plus human error mean that if a result is hard to believe, it's worth checking before you panic!

It's all about the ribs op . Can you see her ribs ?
My DS1 was overweight - but we got him down and he grew up

Now we can see his ribs
I bin the letters - but I do target exercise

hecantbeserious

Sorry to say it, but your dd does not look particularly lean or excessively muscly on those photos to me. Yes, she has muscles, but also a covering of fat all over, including calves and across shoulders. Lean children look a heck of a lot more wirey than that.

Being fit and having muscles does not mean a child cannot be overweight as well.

The 'eyeball' test is nonsense, however. The key is what do the numbers say?

It's not just about the ribs.

My friend's DD is very overweight and carries it mostly on her stomach.

The fat kind of pulls her stomach downwards so her ribs are still very visible.

Therefore she thinks it's nothing that a growth spurt wont sort out, except she's almost 11yrs now and just taller and fatter.

Ignorance is bliss, eh mini?

You say your kids are "chubby, not dying"...I suggest you research the long-term effects of obesity.

I can't easily see either of my DC ribs but both of them are well inside the healthy range on BMI.

I can understand why this is a confusing and upsetting area for many parents. DOI: I'm involved in research into children's (and adults') eating and weight.
It's really vital that weight and height data are gathered from as many children as possible, because this helps the NHS and other services shape and budget for the needs of the public in different areas, and plan national health strategies.
If you're wondering about how all of this is calculated - because it's not as straightforward as adult BMI - then the National Child Measurement Programme website gives some useful information:
content.digital.nhs.uk/NCMP

First off, it's not just done on the basis of weight. Children's heights and weights are measured and used to calculate a Body Mass Index (BMI) centile. Instead of using fixed BMI thresholds to classify individuals as having a weight in the overweight or obese range (as used for adults) children’s BMI is categorised using variable thresholds that take into account the child’s age and sex.
The datasets against which each child's BMI is compared are derived from weighing and measuring a large sample of children to identify how BMI varies by age and sex across the population. As well as showing the pattern of growth, these data also provide an average BMI for a boy or
girl at a particular age, and the distribution of measurements above and below this value. This means that individual children can be compared to the reference population and the degree of variation from an expected value can be calculated.

The BMI classification of each child is derived by calculating the child’s BMI centile and assigning the BMI classification based on the following thresholds:
Underweight is defined as a BMI centile less than or equal to the 2nd centile
Healthy weight is defined as a BMI centile greater than the 2nd centile but less than the 85th centile
Overweight is defined as a BMI centile greater than or equal to the 85th centile but less than the 95th centile (i.e. overweight but not obese)
Obese is defined as a BMI centile greater than or equal to the 95th centile

... and if anyone's a bit geeky and is interested in the specific growth reference cohort on which the centiles are based, I believe it's the UK90. Link to 14/15 NCMP report in pdf form is here

BMI is a completely outdated measurement for being overweight.
It simply relates height to weight without accounting for muscle mass, etc. I'd be considered overweight bordering on obese my whole life based on BMI but most of my life I've had very low fat and am very sporty so the weight is from muscle. You know how active/healthy your daughter is, so base it on that and forget another outdated activity of the NHS!

I was b

hecantbeserious

Sorry to say it, but your dd does not look particularly lean or excessively muscly on those photos to me. Yes, she has muscles, but also a covering of fat all over, including calves and across shoulders. Lean children look a heck of a lot more wirey than that.

I did say that those photos were from when she was 5. She's now 8 but I don't have pics of her in a swimsuit to compare. She looks more lean now but weighs significantly more. In the last 8-10 months she's started swimming and doing gymnastics for several hours a week and park run at weekends and she's definitely building muscle.

Being fit and having muscles does not mean a child cannot be overweight as well.

I get that. She's not anywhere near being overweight.

The 'eyeball' test is nonsense, however. The key is what do the numbers say?

Numbers don't always work in any other area of health for us. My dad is almost 70 and can cycle 50 miles uphill without breaking a sweat but has allegedly high blood pressure. Perhaps his normal is just higher than average measurements.

I suspect my DD would be closer to the 60th centile were she not so sporty. She wears clothes at least a year younger than her age while her best friend who is the same height is in age 11-12 pants!

They have to have BMI though as people are unable to sensibly judge their/childrens weight

I wish they weighed them more, in DDs school they are done in first and last years. Her BF was very skinny a year ago and has put on a lot of weight in the last year, she won't get weighed for 4 years now!
Her mother and all her family are all very overweight/obese - I'm sure they have a strange idea of what normal is.
Her mother said she was skinny as a kid, I've seen photos, she really really wasn't.

I try to keep an eye out on my own DDs weight - I will notice she looks 'podgy' occasionally but it is a growth spurt and the weight is only there for a week or two and then she gets really skinny.

According to her BFFs mum she's been having a 'growth spurt' for about a year.

Thanks Penguin!

There's no way a 4yo would have so much muscle as to be in the 99th percentile for weight. If they're in that weight percentile, and aren't equal in height, they are definitely overweight.

Best to address it when they're young, rather than sit there in denial and have it cause more problems later on.

hecantbeserios
From those pics I think your DD looks a picture of health.
She looks like she should at that age.

I've just looked at a beach photo of my boys - granted they're a little bit older - about 10 and 12 - but they are constantly called skinny, when really they're just normal.

They have next to no flesh on their arms (no squidge under their armpits) you can very clearly see their collar bones, sternums, ribs, and they have muscular legs - ie, you can see the muscle/sinew, not just chunky. They are not remotely underweight, but both probably under the 50th percentile. DS2 was 20th percentile in his reception weigh in.

I agree we've lost sight of what is normal.

Photo here.

She looks lovely and entirely healthy in those pics...

hecantbeserious's dd looks a bit too chunky to me. thewoodlander's boys loom what I would consider normal.

HeCantBeSerious Your DD looks absolutely fine. Exactly how a child of her age should look

Thanks for posting this OP. I have a chubby 3yr old who would eat all day if we let her. Just calculated her BMI on the NHS calculator and she's overweight. I have to say I'm not wildly worried but am going to cut her portions down from today as I'm sure that's where the problem lies and make sure we do a few more bits of running around on our laziest days. I probably wouldn't have looked if you hadn't posted this so thank you.

Anecdotally, those I went to primary school with who were overweight, or "robust" (eating wholesome food) are "normal" sized as adults, whereas the ones who were very skinny as kids are larger now... (There were also 3 of us in secondary who were close friends and should have been in some kind of study as we were radically different sizes despite v v simiar lifestyles/eating!)

So... hoping someone might explain the science behind this cos I have a theory! Apparently the body sort of remembers famine and it seems can even pass this info through genes to the next generation . Also a lack of resources/perceived lack of resources/intermittent resources have an effect on women's bodies (not sure about men) . So I was wondering if the well-nourished but overweight children's bodies are sort of aware food is plentiful and so crack on with metabolising (obviously I'm not talking about eating junk). Whereas for those who are undernourished - either from not eating enough, or not eating the right sorts of things - the body sort of goes "need to hold onto every scrap of nutrition". Something like that! Is this pure bollox?

Not defending feeding kids crap, or not doing something about weight issues, just wondering about the effect of weight vs nutrition in the longterm. I bet there's a lot of overweight but technically malnourished children.

"Numbers don't always work in any other area of health for us"

Ok, guess your family are bizarrely special then if evidence-based medicine 'doesn't work" for you.

Out of interest, did the numbers classify your dd as overweight when she was 5yrs? There is obviously no way of telling from the photo.