The letter finally came. I’m really upset

[Hell0G00dbye]

Long story short DD has followed the 98th centile for weight since my 37 week growth scan. She has followed it perfectly and consistently which was applauded for the 6 months I breastfed and since then has been a big issue with the HV team. She’s at school and I’ve just received the letter saying she’s very overweight.

What can I do? She eats good, home cooked food, has the odd treat but generally healthy and normal child portions. She’s very active both structured (does dance, swimming and gymnastics) every week and unstructured (walks the 40 minute round trip to school daily, parks and long walks on a weekend, runs around the garden. She doesn’t look fat (to me) but she is solid and does feel heavy to pick up.

The letter says contact the doctor or HV but I’ve taken her before. GP says she’s absolutely fine and will grow into her weight and had no concerns. HV just weighed and said she’s still overweight and to watch portions. Day to day I don’t worry about it as she looks fine and is super active but the letter has taken me right back to her 2 year check and being made to go monthly to the HV for weight checks and their disapproving looks when she continued along her centile.

NB: she has followed the 98th centile but I think the issue is she isn’t 98th for height so her BMI puts her at very overweight.

[quote EdenFlower]@MrOllivander You don't look particularly fat in the picture, but you do look heavy for a just turning 16 year old. You were certainly not 'skinny'. A 16 year old should not be their full adult weight yet and I would expect one that looked like you on their 16th birthday to be on track to become an overweight adult- it would be interesting to know if you are still slim or now overweight?[/quote]
I was never "skinny" - I started my periods at 9 and was 5ft 6 age 12 with boobs and hips and always mistaken for much older
There's another photo of me on my 12th birthday and everyone else is chest height on me I've consistently been taller and broader, except when I was born as I was 4lbs
I just happen to be built more less petite woman and more... power lifter?!

Now? I'm overweight. Chronic illness, thyroid issue and unable to exercise

Sorry @MrOllivander I agree with @EdenFlower that you were not a normal weight 16yr old here, despite your height, you're carrying too much weight in this photo for a teenager. Understand that this may have had something to do with your now-identified health issues, but my point being, we've (society) have lost sight of what being a "healthy/normal/trim" weight should look like.

overweight=she is unhealthy.

But being overweight does bring a set of risk factors on its own. The strain on joints, organs- just because others may or may not be storing up future issues due to their diets and lifestyle doesn't mean it counteracts the issues stemming from being overweight.

Just try not to beat yourself up about it if you know you are giving healthy food and being active.

It is frustrating and hard not to worry if you have a child who is naturally heavier / stockier.

My DC and I went round a friend's recently and the children were stick thin, not tall either, and I couldn't believe the amount of (fairly calorific) food they put away. Even the 5yo ate more than my tall DH would! The mum let them eat as much as they wanted as obviously was keen for them not to be underweight...

I've detailed DS' weight issues on this thread already. What we're struggling with now is that he seems to have gained a bit again. Not a huge amount but he's definitely a bit heavier. But what I can't work out is whether it's part of a growth spurt - his feet have just jumped a size seemingly out of nowhere and he has definitely already gained a bit of extra height - or is it a return to more weight. He HAS been eating more recently - partly because he does so much exercise that he's constantly starving.

But I honestly am not sure. And am concerned about how to deal with it.

My point is that children's weight and what's right/wrong/normal can be difficult to properly and objectively assess. For now, with DS, I do feel he's got into a habit of more sweets because him and his friends like to go to the shop so I'm cutting that. I'm also trying to be a bit more thoughtful about what to feed him after his sports activities - alongside normal busy school/life/play he does 3 x 2 hours sessions of high impact sport a week and is, understandably, hungry as a result. He's also coming home from school and having a small snack but then ravenous at supper so again, I need to think about how I can reduce the calories at supper time without reducing the amount of food. eg tonight we'll have tuna with lots of veg and rice. This will be fewer calories than the chicken and butternut curry we had last night but he will be as full.

OP - the centile screening is simply that - a screening tool that indicates there might be a problem. The data for the centiles comes from measurements of children in the UK in the late 1980s. One of the things I'm interested in the whether different ethnicities are taken account of properly in the screening tools. There is a lack of information about how the data was gathered for the growth charts (or at least I haven't been able to find much) and I have read research that shows that certain ethnicities are likely to come back as overweight / underweight.

Whatever you do be very careful how you approach. I was an overweight pre-pubescent child who became normal weight when I fully entered puberty - I changed nothing diet wise, if anything I did less exercise as I stopped swimming because I was embarrassed about my boobs.

Remember kids are very good at picking up on stuff - even if you don't talk about things in front of her. My childhood experiences have affected me throughout life.

I always expected the letter as I have broadly let my DC eat whatever they want - biscuits if they asked for them, sweets on a Friday etc etc.
None of mine have been overweight at any point to date (now all mid teens onwards).
The eldest is thin but not skinny at 16 - you can see all his ribs. DD is a powerful build - I would say little chunky (NHS child BMI calc = 56Th centile) youngest is 60th centile and chunky.

I think metabolism plays a part as does perception.

I'm with @AgeingDoc My bmi is 24 - I am a stone overweight though - there is more fat around my middle than is acceptable.
As a history, I have been tall and am built like a carthorse - my hands are bigger than most mens and have been since I was 10, my feet are big and wide. I have very wide hips. So "big boned" "chunky" etc . Now as a teen I shot up and was a then size 14 from the age of 14 (by comparison that is a modern size 10-12 as I have kept some of my clothes!!). I was never fat, you could always see my ribs at a size 14, I carried all my weight on bum and thighs.
I was a bigger adult - with bmi 24-26 for years. Then I got fat. Really fat - size 20.
As an adult i lost weight down to a size 6 (at 178cm). I still had chunky thighs despite a bmi of 15. This shocked me though. How I had been carrying so much extra weight with me. I put weight on and it didn't stop at the planned bmi of 21 - it's 24.

I consider myself a proper fatty at the moment despite being slimmer than I was when younger. I may exercise 12 hours a week (all very aerobic) but I eat too much. I also don't have a great metabolism.

That is the second point. My Dc's dad has a super fast metabolism and can eat whatever he wants and never puts on weight. Another observation - he never ever snacks.

I think we are all individuals, some will have larger frames than others, some will just burn off calories faster but it's very easy to deny some obvious facts - snacking is just not needed at all. (I love it though). Exercise doesn't burn off as many calories as people think and often makes think we can treat ourselves. Our relationship with food is personal and complex. Food should never be used as a reward but we all do this sometimes and there is a mult-billion pound industry built around treating ourselves.
All that said, OP is doing her best. She's not just thrown the letter in the bin but she's questionning and thinking about food. If you are prepared to have those conversations, that's always a really good start.
(I know it would be easy for me to think I'm ok my bmi is normal but in reality I have to change to get back to a healthier me with less fat. )

If you and DH are healthy weight and you are aware of issue I think it will be fine. Far more damaging is the chuck it in the bin he’s just a big lad like his (overweight dad) response. That’s one reason why it jumps to nearly double overweight children between reception and year 6. There’s a big correlation between overweight parents and children. I was obese when daughter was at primary school and was very aware of that fact.
One thing that jumps out at me in my 40s is children being allowed to have large portions of treats. It would have been unheard of to buy a small child a big muffin, fancy doughnut, big chocolate bar, big icecream etc. Treats would be shared or children would have things like a small gingerbread man, one scoop of ice cream or a few penny sweets.

@GrannyBloomers
With respect it doesn't sound like you have a great relationship with food. Going from size 20 to size 6 sounds a little extreme especially when you weren't able to maintain it.

Anyway, we are talking about a child here who is still to go through puberty. And at the end of the day, the height and weight has been taken at one point in time. If I were OP I would be aware and monitor but not make radical changes.

@2022HereWeCome respect is not needed, I don’t have a great relationship with food. I maintained a size 6 for 5 years with a bmi of 15. Not healthy. I either eat or I don’t.
But my point is the key is examining the relationship with food and being honest. It applies to kids too. If hand on heart you can take step back and examine and there doesn’t appear to be an issue, then maybe there isn’t. In my case, you’d always take a step back and identify issues of you were being honest. (Annoyingly my sister and I ate the same , same habits, she was always skinnier than me but same shape. Age has evened us out a bit).

@Weekendtobegin it was the health visitor at his 7 month check.

@GrannyBloomers

I always expected the letter as I have broadly let my DC eat whatever they want - biscuits if they asked for them, sweets on a Friday etc etc. None of mine have been overweight at any point to date (now all mid teens onwards). The eldest is thin but not skinny at 16 - you can see all his ribs. DD is a powerful build - I would say little chunky (NHS child BMI calc = 56Th centile) youngest is 60th centile and chunky.

I think metabolism plays a part as does perception.

I'm with @AgeingDoc My bmi is 24 - I am a stone overweight though - there is more fat around my middle than is acceptable.
As a history, I have been tall and am built like a carthorse - my hands are bigger than most mens and have been since I was 10, my feet are big and wide. I have very wide hips. So "big boned" "chunky" etc . Now as a teen I shot up and was a then size 14 from the age of 14 (by comparison that is a modern size 10-12 as I have kept some of my clothes!!). I was never fat, you could always see my ribs at a size 14, I carried all my weight on bum and thighs.
I was a bigger adult - with bmi 24-26 for years. Then I got fat. Really fat - size 20.
As an adult i lost weight down to a size 6 (at 178cm). I still had chunky thighs despite a bmi of 15. This shocked me though. How I had been carrying so much extra weight with me. I put weight on and it didn't stop at the planned bmi of 21 - it's 24.

I consider myself a proper fatty at the moment despite being slimmer than I was when younger. I may exercise 12 hours a week (all very aerobic) but I eat too much. I also don't have a great metabolism.

That is the second point. My Dc's dad has a super fast metabolism and can eat whatever he wants and never puts on weight. Another observation - he never ever snacks.

I think we are all individuals, some will have larger frames than others, some will just burn off calories faster but it's very easy to deny some obvious facts - snacking is just not needed at all. (I love it though). Exercise doesn't burn off as many calories as people think and often makes think we can treat ourselves. Our relationship with food is personal and complex. Food should never be used as a reward but we all do this sometimes and there is a mult-billion pound industry built around treating ourselves.
All that said, OP is doing her best. She's not just thrown the letter in the bin but she's questionning and thinking about food. If you are prepared to have those conversations, that's always a really good start.
(I know it would be easy for me to think I'm ok my bmi is normal but in reality I have to change to get back to a healthier me with less fat. )

A BMI of 15 is severely underweight. As in severe health risk territory. And that, at that weight, you were saying you had chunky thighs?

And that you consider yourself a 'proper fatty' despite having a BMI of 24 and being naturally of larger build?

I mean this nicely but to me this sounds like serious body dysmorphia and eating disorder territory that you've been dealing with. Your body perception sounds very askew and it sounds like you need to be a lot kinder to yourself. If you had a BMI of 15, you had way more serious problems than the size of your thighs.

Haven't RTFT, but unless the DC is tall for her age surely the obvious check is whether she fits comfortably into relevant-age clothing.

My DD 6yo is around 20% heavier than a similar age and height relative--the relative is elfin and my DD scores marginally higher on BMI centile than on height centile. However, she still fits widthways into clothes for 4yos.

Clothing isn’t a good measure. Shops vary with their sizes and children’s clothes are mostly measured on height. My 7 year old is average height and needs age 7-8 clothes but they are massive around her waist and she can’t even really wear trousers as they fall down . She’s absolutely 50th centile for weight too.

www.next.co.uk/style/st179631/195989#195989
Clothing isn’t a good measure. Lots of shops very generous sizing. Joggers and leggings stretch. Even more formal clothes like school trousers now have elastic. Plus size options in lots of childrens ranges. In link waist is 2 inches bigger. Other option is called slim. Easy to think he’s fine he’s 8 in age 8 trousers he just needs that option as he’s not skinny.
Obviously good options are available but lulls people into sense of it’s normal.

A 16 year old should not be their full adult weight yet and I would expect one that looked like you on their 16th birthday to be on track to become an overweight adult

This is so wrong. I would suggest (looking at DD's set), that most of her cohort are indeed fully grown at 16. I think this could also be an issue in the modern world. These charts have not been updated since the 1950's. Children and teens are completely different from that era. There will always be difficulty in using "averages" as well, as there will always be outliers. From personal experience again in both DD's cohorts (and in leafy Surrey), more girls are underweight than over, and many of them are 5'10" and completely fully formed adult women by 16.

I never understand how kids get so heavy.

My DS is 95th% for height, 40% for weight. He eats more than me etc but is a healthy active boy. I think some people can't see just how chunky their kids are.

I'd ignore the letter. It sounds as thought your DD is active and healthy to me.
I had the same with me two DC, born on the 98th centile and have stayed there. Both really tall for their ages and like you say they are solidly built. After my sons came through he had a hospital appointment (about something unrelated) and I brought it up with them. They weighed and measured him and said he was still on the 98th centile (at 5 years old) so all was fine but they said the school system use BMI which isn't accurate. I have to agree it's a stupid system for adults as well!

Clothing isn’t a good measure. Lots of shops very generous sizing.

This. Kids waistbands are huge from almost all shops these days. They size for fat kids.

Those of you that are saying "but my child is tall!" I think it is important to remember that overweight kids do often grow more quickly and reach their adult height earlier. So the 'height' may be due to being overweight/overfed

How much does she weigh?

Theycallmejune I used to worry about that as DD in primary was much taller than peers. It wasn’t an issue ultimately she’s 5ft 10 age 16 and healthy weight. But very tall genes in family she was never going to be short. I think it’s probably if child is much taller than you’d expect.
I’ll also add that they wouldn’t come into DD’s primary school to do these checks or reception vision check etc as it was private so I do wonder if stats are just based on state educated children.

Drinks are huge issue by yr6. I have Guides routinely turning up with bottles of sugary milkshake or Starbucks Frappuccino or hot chocolate drinks. Hundreds of calories on nothing much.

The parent I knew buying age 9-10 yr trousers for her 6 & 7 yr olds -- that parent said she paid £8/pair to shorten the trousers.

I do an activity where I help kit kids out (non sport activity). I wear (loose fit) a men's medium size shirt -- there are yr6s & yr7s who need larger size shirts than me . They are much shorter than me. We struggle to keep larger sizes in stock.

There's a bit of misinformation about growth charts on this thread - not updated since the 1950s, all based on formula fed babies etc.
That is no longer true, and hasn't been for over a decade now.
From the Royal College of Paediatrics website:
all our growth charts are based on WHO Child Growth Standards, which describe the optimal growth for healthy, breastfed children
The WHO Child Growth Standards were derived from the WHO Multicentre Growth Reference Study, the data for which were collected between 1997 and 2003.
There is a huge amount of publicly available information on the study available on the WHO website if anyone wants to know more.
They are probably not perfect - what is - but the charts are definitely not based on data taken from only white, formula fed babies from the middle of the last century as is sometimes claimed.