To be horrified the NHS classes 5yo DD as overweight?

[mommathatwearspink]

DD (5) had her school night and weight check at school earlier in the week. Received a letter today saying that she is on the 94th percentile and classes as overweight for her age and height.

Im horrified! She doesn’t look overweight, does gymnastics and swimming each week, doesn’t over eat, treats are limited and I cook healthy meals from scratch most days. What the hell am I doing wrong???

It's not perfect and perhaps the formula should be re-worked, but I think it's pretty important that kids have regular weigh-ins by some means, and I guess it has to be the school.

Growing up in the US we had yearly paediatric visits which covered this sort of thing, so issues were less likely to spiral out of control.

Obesity happens to most people in later life. I hardly know anyone over the age of 50 who is still slim. The only ones I do know eat almost nothing.

This has absolutely blown my mind - everyone you know over 50 is overweight?

@soapona a whole pizza and tub of ice cream - I'd stop that immediately.

This thread makes depressing reading. It's not some government conspiracy: yes the letter may be wrong for a minority of children but generally it's telling you they're heavier than they should be, which might lead to problems in the future. You don't need to suddenly put them on a diet but just look at how much activity they're doing and what they're actually eating (portion sizes) and think about tweaking it.

With so many children overweight nowadays, the fact they look the same as others in the class doesn't mean much!

As others have said, an hours swimming lesson a week actually involves very little activity. It's a great thing to do, and an important life skill, obviously, but it's not a great deal of exercise.

today he had 2 baked potatoes, a 12 inch dominos pizza to himself and ate a 500ml tub of ice cream and well as plenty fruit. This is typical and it's stayed stable his weight. Over weight kids must eat more and never skip a meal

Not going to add to PP’s comments on the food. But why would any child skip a meal unless unwell? Normalising skipping meals is another shade of fucked up relationships with food.

Sorry if it's been said already but on the BMI front- it's not only a bad tool because it considers your weight all fat without taking anything else into consideration, it also doesn't account for where your fat is stored.

So two children could weigh the same at the same height. One, you would look at would seem overweight, if they eg store excess fat around their mid. The other could store fat evenly over their body and look a perfectly healthy weight. One is at risk, the other is not, but they would both be given the same results.

We fed our DC healthy diets and they all competed in sports (and still do).
They were skinny little things with stck man arms and legs. Compared to the rest of their classes they looked like malnourised waifs.
I used to hate weigh ins at school but they always came back as perfectly normal. I began to relax when I realised that it was the rest of the class were overweight, mine were practically the only ones with healthy BMIs.
Interestingly whenever we went to France, Spain, Italy, the majority of the kids looked skinny too.

Redo the calculation using the NHS BMI calculator.

For young kids, small errors in height measurements or entering the wrong birth date can lead to big errors in BMI.

We once go a "your child is overweight" letter telling me DS was on the 98th percentile. He was actually around the 25th - the nurse either got the calculation wrong or used another child's statistics.

Having a tall child is not a free pass for them to be as heavy as they can be. My 8 year old is the height of an average 11-12 year old (he's on the 99th centile for height). But he is about the 50th centile for weight. I have to get extra long trousers and still use waste adjusters - aged 6 shorts fit him. T-shirts are always too short long before they are too tight. I was worried we might be getting an under weight letter when he was measured in reception. We didn't but they did measure him as 5cm shorter than he actually was so it is worth checking the measurements are correct. If they are subtly decrease portion size and get the whole family moving more. Its much easier to change now than trying to undo ingrained habits later.

Can someone explain to me why birthdate matters when calculating children’s BMI?

I thought it was just a ratio of height and weight which returns a fig - 18-24 ok (for adults and anything outside needs attention.

What’s with the centiles? Like, there may well be places where all children are a healthy weight so centiles wouldn’t mean a thing. I find it all very frustrating.

My son was either overweight or fine at the same height and weight - overweight if I put in his actual birthdate and fine if I made him a year older but didn’t change the measurements.

Seems utterly rubbish.

Serin see that’s what mine are like. I find myself explaining that you’re supposed to be able to see a child’s ribs. Also have to explain to people that the fact my kids are visibly very muscly is not because I’m some kind of nutcase that feeds them a diet of steroids and raw eggs, but that they eat a high in good fat, high veg and protein diet and this is the result. I agree about the Italian kids at least, my kids always fit in (looks wise) more in Italy and I often buy them Italian clothes on eBay as it’s the only stuff that fits their long and lean body shapes.

For the nhs calculator can someone explain if the bmi is taken across the whole population at a given age or the population for a given height?

My 3 year old is tall and comes out overall at the 59th centile. If I add a year to her age but keep the measurements the same, it becomes the 51st. i then started playing with the numbers. Taking off 3 cm made her jump to the 82nd so presumably she’s quite heavy for a 3 year old but ok because she’s tall?

Ignore. Ds also 5, on the 91st centile.

I had a letter and a phonecall. Was offered healthy eating and exercise advice by a well meaning HV.

Told HV we eat healthily (we do, not gonna list each meal, but it's healthy as fuck) and ds gets plenty of exercise. She then suggested as a family we attend some walks they have organised to get families moving more. Said again we already exercise. She again said we could always do more and we should come for an hours stroll around the park.

Told her we would come if she wanted to spend a week with us. Monday to Friday he walks to school and back (weather permitting). It's just under a mile each way.

Monday night he rides his pony. Approximately 2 hours outside by the time we have done catching, grooming etc.

Tuesday swim lesson followed by 2 hours kayaking.

Wednesday he rides again.

Thursday 2 hours kayaking.

Friday he rides.

Saturday morning kayaking. Followed by riding and/or long walk with dog, and/or 2 or 3 hours on allotment.

Sunday he rides, does allotment, maybe dog walk.

She still wittered on about weighing him again in 6 weeks then again in 6 months. Told her I didn't consent to this, I wasn't worried and didn't want him weighting again. He's fit, strong, healthy and not a skerrit of fat on him.

His sister was the same, over the BMI that the nhs recommends. Had a similar schedule to ds, but dance instead of kayak. She's 15 in 2 weeks and a size 6/8, 5ft 3in and 7st 6lbs. Definetly not overweight.

Children's weight is such a tricky subject. My ds has always been between the 5-10th centiles for weight and the 50-60th for height. However last year he went on some medication that caused massive weight gain 2 stone in just 2 months and he is now on the 75th centile. Everyone I know thinks I mad to worry about his weight, they claim he has gone from too skinny to a nice healthy weight. He hasn't, he is fat, he has extra fat on his stomach and bum and his face looks puffy. I am very aware that if we aren't careful the weight gain could continue. I spoke to one friend who said she didn't think he was fat at all but could understand my want to be careful with his diet and she was glad she didn't have to worry about anything like that- all her children are overweight, her youngest is probably obese and she just can't see it at all.

sometimes dc are tall because they are overweight.

I live in forrin, dc (and adults) tend to be tall and slim here. the main difference to uk is that people cycle and walk everywhere.
sports activities are longer (90 min or more) and very rigorous, i.e. a child who doesn't come out sweaty and red faced is unusual.

the recommendation here is that growing children need 90min of vigorous exercise a day to be healthy.

Birthday is important because at a young age where you have just turned 5 or are 6 next week is a huge difference a year is a fifth of their lives. The fact that a couple cm height difference massively changes BMI shows that at this stage it is relatively easy to turn over weight into healthy when they are so young. Stabilize their weight and a small height increase will shift them down the centiles.

Why would the NHS waste money on deliberately making people feel crap.

So two children could weigh the same at the same height. One, you would look at would seem overweight, if they eg store excess fat around their mid. The other could store fat evenly over their body and look a perfectly healthy weight. One is at risk, the other is not, but they would both be given the same results.

This is very skewed logic. BOTH children are overweight in your scenario, BOTH are unhealthy. BMI takes body type into account as it is a RANGE not a fixed number.

User8888etc I looked into the children's BMI calculations. They are based on the average height and weight of children at each age some years back (80s?). So the 50th centile for a 3 year old is only the average height and weight of a 3 year old in the group that was measured in the 80s (?). So being 98th centile just means your child is bigger than 98/100 of the children who were measured. This may indicate they are overweight, unless there are reasons why (ie all the relatives are very tall).

Because the control group that children's BMI is based on was measured some time ago, I wonder if earlier puberty might be screwing up the BMI for girls who have reached puberty before year 6.

Please note. I am not medically qualified and this is me guessing based on googling. I also think that if you get a letter saying your child is overweight, whatever year group or sex, you should take it seriously.

This is very skewed logic. BOTH children are overweight in your scenario, BOTH are unhealthy.
The child who stores fat around their mid will be at much greater risk though, so unhealthier than the child who carries weight equally spread. It works two ways, the children in this scenario could be fine on a BMI chart, but because one carries weight in a dangerous place, they aren't actually fine at all.

That's why hip to waist is used more frequently now and measuring in inches is more affective than weighing on scales.

BMI is only really good for judging general trends in large groups of people. There are lots of other health factors that are ignored when using just a scale or number to determine your health and fitness.

Hip to waist ratio isn't appropriate for children though as their waists are proportionally bigger the younger they are.

I didn't think BMI was used for children,certainly the centile charts in the red books give you the range.

@GrumbleBumble

I don’t understand - this doesn’t make sense to me still. I read maths at university, I’m an accountant; the maths doesn’t make sense and I’m a more than averagely numerate individual.

Why is my son overweight at 5, but not overweight a year older at exactly the same weight and height?

THIS is what I don’t understand.

My son is a particular case I know - he was 5kg and 60cm at birth and continues to be very tall - and my GP laughed at the suggestion he was overweight at all let alone obese.

But still, the principle remains the same. Same weight and height at 18 vs 50 = same results.

*Can someone explain to me why birthdate matters when calculating children’s BMI?

I thought it was just a ratio of height and weight which returns a fig - 18-24 ok (for adults and anything outside needs attention.*

There’s a completely different BMI chart for children compared to adults though and 22 is overweight till about aged 12 (for girls).

It’s commonly graphed with BMI on y axis and age on the x but I don’t think it makes that much difference though - a 7 year old with a weight of 25kg and a height of 125 has a BMI of 16 which is just above the 50th for BMI. A 9 year old which the same stats is just on the 50th for BMI.

BMI for children is used by HCPs a lot - as seen in this thread! It's not in the red book presumably because a lot of parents would get the calculation wrong.