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.

I don't have children (yet). I do have a fiancee with a significant and long-standing eating disorder, contributed to by being raised in an environment where 'fat' was feared and degraded.

She has been battling her own brain telling her to fear weight gain, to restrict food, that her body is something that cannot be trusted and must be controlled and that hunger is not a neutral signal but a dangerous trick that is going to ruin her if she listens to it.

Her BMI is in the 'healthy' range, yet she is exhibiting symptoms suggestive of being in a chronic semi-starved state. Her BMI has never dropped low enough that she ever met the criteria for ED services, yet she has done possibly irreversible damage to her bones.

BMI is bullshit as a way of measuring health, all it does is provide a ratio between height and weight. It was designed as a tool to measure averages, and the population it was based on was adult white men...and not many of those.

Children are born naturally intuitive eaters, with body trust, able to respond in a natural way to hunger and fullness cues. Unless there are medical conditions that disrupt those cues (Prada-willis, ADHD/ASC etc...) their bodies will, when provided with a healthy and varied diet that does not restrict any food groups, regulate themselves.

Restriction, whether that's a 'diet' or just banning certain foods, will lead to inevitable craving of those things and then likely lead to a level of bingeing. That's if you're lucky, unlucky people with a genetic predisposition to an ED could end up triggering that by an initial innocent period of restriction which might not seem that bad to other people.

Diet culture, fear of food, mistrust of our bodies...it's so incredibly damaging. Food should be joyful, fun, can fulfil a ton of different requirements in life both to nourish our bodies and in a social capacity,

Bodies naturally have a set point range that is different for everyone, that's true for children and babies too...otherwise all babies would be born the same weight would they not?

Weight /= health

If the diet being provided to a child is varied and in appropriate portions, and they are active and taking part in varied activities then the likelihood is they are healthy even if their body is larger than someone else's body.

If 100 people were given the same diet and had the same amount of exercise they would not end up all the same size, and some people would have a 'normal' BMI but not be healthy.

I'm actually amazed that BMI is still around. It's quite dangerous when used wrongly.

It escapes me how so called medical professionals don't acknowledge that muscle is heavier than fat

That's because it doesn't. It's denser than fat.

Still return to very few children being muscly enough for it to skew a BMI chart. Rugby) swimmer kids have broader shoulders by puberty but ore puberty kids are really not so muscly it's making their BMI falsely fall into an overweight category.

Stocky kids are pretty much always overweight. Parents just prefer the term solid to fat. If a child's tummy is up against its t shirt it's fat not stocky.

OP - disregard the letter as long as you know your child is eating healthy with potion control in place and exercising that is all you need to do.

No wonder youngsters suffer with mental health issues and weight problems when letters like this are sent out !!!

I can’t believe people are writing “muscle is heavier than fat”. Did you not go to school?!

A pound of muscle weighs the same as a pound of fat. A pound. It just takes up less space as it’s denser.

No wonder we have an obesity crisis…

:33NochocolatE

The best thing you can do is throw these letters in the bin. You know your child. You know what she's fed and how active she is. If they want regular HV weigh ins, do them, smile, nod and quietly tell them to FO in your head and carry on as you were.

This 100%

[quote Hell0G00dbye]@user1471457751 she’s between the 50th and 75th for height I think.
She’s in the correct size clothing (mainly 4-5 currently and moving into 5-6) and doesn’t have any rolls or anything anywhere. To those saying don’t talk about it to her/in front of her- I am very careful to never mention anything to do with weight with her. We talk about eating healthily To be fit and strong rather than to do with weight.[/quote]
Based on this, plus your description of her diet and exercise, I'd throw the letter away and never think of it again (Specialist Paeds & Public Health Nurse).

@pixie5121 because very very few 5 year olds have significant enough muscle mass to skew their weight and BMI. The children you train are the minority and even then will likely have normal BMIs as they are not overweight.

Your average reception aged child that does gymnastics and swims means 30 minutes spent bobbing around in a pool once a week with very little active swimming, and usually a gymnastics class that is based on fun and activity, not squad training…

Nowhere near enough intense activity to increase muscle mass beyond that which is likely to fall within the bounds of normal.

I used to work in this area. Not one child I saw with an elevated BMI at age 5 was an athlete funnily enough but many had parents in denial about their child’s weight.

Why oh why does everyone put their children onto skimmed or semi- skimmed milk?
The vitamins (A, D, E and K) in milk are fat soluble, which means they need fat in order to be absorbed by the body. Also, calcium absorption is enhanced by Vitamin D, but the Vitamin D needs fat, so skimmed milk breaks the entire chain of absorption and becomes nutritionally empty. I'm not advocating that children who are weaned should drink a lot of cows milk, they should only consume small amounts of milk, but that which they do consume should be full fat or where's the point?

I was told for years my DD was overweight. She looked fine - upper end of healthy slim to me. Ate healthy, very few sweets/sugary things etc, very active (swimming, gymnastics, ballet etc). At 16 her whole body shape changed and even though she didn't get taller, 2 yrs on she's very slim. Only major change is she's been pescatarian about 16 months. Some children 'grow into themselves' IYKWIM, especially girls

Again agree with PP. DD who hit puberty early and interestingly has wide shoulders and a 32 E bust at 14 has not changed weight or grown in 12 months. Hence her peads team saying she has matured. To the poster commenting about not reaching adult weight till your mid 20's as a woman I think you will find that is incorrect and depends on hormonal changes. Son has been the same weight since he was 15 another early matured. He's 22 and still the same height and weight just asked him! He did say it goes up a couple of pounds after a night out

At her age, absolutely the best thing to do is ignore the letter completely. She’s active and she’s eating good food. She’s fine.

Looking at what you have said about her diet and activity levels you have no major concerns. She is following her centile - as a mathematician that is how it should work! If everyone was average then they would all be equal - they are not. My DD has the opposite problem for my GS - he is on the bottom centile, has always followed it consistently, eats plenty but is always on the go and is small - she is smaller than me. The amount of times she has had HV’s refer her to dieticians and other services because he’s underweight and she has been referred now several times to paediatricians. Thankfully she saw a sensible one who said as long as he is following his centile then it’s just how he is - as is your daughter. If she suddenly spikes and changes diet then that’s another matter all together but at the moment - she’s just how she is. I also remember meeting Matthew Pinsent when he was at his peak fitness. During a conversation he said he was classed as clinically obese because of his muscle mass based on BMI - he couldn’t have been fitter! I wouldn’t worry and enjoy having a healthy and fit child. 💐

Throw it in the bin. We had that with our string bean daughter. Letter said she's overweight, I ignored it. Few months later we got another letter saying that the height measurements used were incorrect as the equipment hadn't been set up properly so to disregard the letter!
She's 15 now, tall and a size 6 in clothes. She is still in the overweight BMI category! BMI is not a good tool to use.

@pixie5121 yeah that was my point with the pic - no matter if I lost 2 stone in that, I would still be broader than the girl next to me and I'm towering over her
Always struggled with fitting my shoulders into coats as well

*Brieandcamembert

Good grief. None of you have heavy bones. There is not a group of people trotting about with a Titanium armoured skeleton.

I'm a size 10, am often described as petite, I go to the gym a few times a week and yet I'm nine and a half stone.

What is it then, if not heavy bones? Am I somehow desperately overweight while somehow squeezing into size 10 clothes (and sometimes 8 in dresses)?*

No I wouldn't say you had big bones. I would say you were normal size. 9.5 stone, size 10 is a normal slim woman.

The excuses
It’s fascinating

If you know she is eating a good balanced diet she'll be okay.

My DS was off the scale born and continued growing much bigger than his peers, he's a head above them.

I remove one piece of food from his plate each meal and he has lost weight without realising he is hungry.

He's often hungry.

My niece was same once she stopped after school activities she piled on the weight, now aged 20 she is a size 8.
I didn't think it was possible for her previous solid frame to be a size 8 so it shows she wasn't actually solid she was an overweight DC.

@Booboobagins "You can see if people are overweight by looking at them. Noone needs a measure."

I don't think you can apply this to a lot of the population nowadays. Especially parents of overweight kids.

We now have a completely unrealistic view of what healthy looks like. And when it comes to overweight children there's such denial. Phrases like "puppy fat" etc.

I'm currently half a stone overweight. But I can still buy a size 10 in some shops (which would NOT have been a 10 a few years ago! I'm wearing some old 14s!) so my head is firmly in the sand until I can be bothered to stop eating crap.

Thank you for all your mixed responses. @opalescent it’s nice to heard a HCP isn’t worried- that’s DHs POV i think. You’d never walk past her in the street and think she was overweight and we know she’s active and eats well so there’s not much we can do anyway so just to relax and see how it pans out.