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.

@2022HereWeCome HCP’s are trained to spot problems and give advice not model behaviour for you?! That’s hilarious 😂

My ds was 99.6th centile at birth and came out at overweight on his reception weight check. He was slightly pudgy as a young child and I did worry about it. He's now a very strapping 12yo rugby player with broad shoulders and big thoughts but not an ounce of fat on his tummy. He is built extremely solidly, and is probably still heavy for his height.
If your dc eats healthily and is active I really wouldn't lose too much sleep over it.

*thighs, not thoughts! (Although he can be profound at times...)

@Booboobagins

I don't understand what you mean

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

Anyone can see someone's overweight. If you're saying people are in denial that's another matter.

Health professionals should use visual checks ref people being overweight and stop relying on an antiquated BMI system that does not account for muscle mass. Overweight people don't have muscle they have fat. It's simple!

You btw are not overweight as a size 10 unless you're under 5ft tall.

Yes. I am.

5'3"

M&S size 10 jeans

BMI of 26

Laughing at the HCP- do as I say not as I do

@2022HereWeCome

Sorry I think there is something a bit hypocritical about a HCP lecturing someone about weight when they clearly have weight problems. In the same way i was a bit aghast when my GP informed me that she only breastfed her kid for 2 weeks after lecturing me about the need to breastfeed for longer. I wasn't rude but I did think that surely you are supposed to model healthy behaviour as a HCP?

Umm, no. Their job is not to model the behaviour, their job is to advise you based on the best evidence and research. HCPs are humans, they have all the demons and difficulties the rest of us have. Loads of doctors smoke and drink. It's still good health advice from them if they advise you not to smoke regardless of what they themselves do. It's for your benefit, not theirs. Your GP may have had a million reasons why she only bfed for 2 weeks, maybe she was trying to show you that while it's better to bf, it's not such a big deal if you can't? But it has no bearing on the advice she gives you.

Similarly, an overweight HCP can most certainly advise you that your health would be better if you lost weight. And even more so if you are responsible for an obese child. That the PP insulted a HCP for doing her job and tried to bully and shame her into not using her best judgement is outrageous. If the HCP had behaved inappropriately, raise a complaint. Her weight has zero bearing on her competence.

Interesting this question of the large (overweight?) HCP offering advice about a large (overweight?) child. It may not be her job to model behaviour, but how would any of us feel about a smoker advising us not to? The advice would be just as good, but not necessarily as easily taken. And certainly not if followed by advice on how to give up smoking. And we can only assume that the HCP in question would next have given advice on how the child should reduce weight (or how the parent should accomplish that). Again, probably good advice, but if the HCP was blatantly displaying a lack of following that advice, it might not sit well with either child or parent.

Alternatively, if there was another reason for the HCP being overweight (other than calories over exercise, that is) then perhaps she should have demonstrated a little flexibility in "diagnosing" the child!

I think how well a health message goes down from someone who isn't 'living' that message, depends how they present it. If they just present it matter-of-factly, I wouldn't hold it against them. If they gave it while acknowledging they weren't exactly modelling it themselves, I'd warm to them. But someone delivering it in a moralistic way, yes that would rankle.

The thing about having a HCP who is clearly overweight/ out of condition, can actually be the opposite problem--that they lose sight of what 'normal' is supposed to be.

I saw a consultant once, where I recapped that I'd been fit and active but then gradually lost stamina: I'd had to give up running then most cycling, until by the appointment I was having to rest between flights of stairs.
He was completely "meh" about this. Rightly or wrongly, I couldn't help link his low expectation of what an apparently healthy 40-something should be able to do, to the fact that he physically had to unwedge himself from the armrests of his chair when he got up to examine me.

I do think BMI assessments can be misleading. In my family we've had the opposite problem - we all have very small builds. My mum remembers her mum being called into school when she was little as they thought she might be underweight - in reality she was just a very small slight child who grew up into a small slight adult.

I remember myself going for a job interview as a young adult and having to go for a standard medical assessment where they told me I was underweight according to my BMI. In reality I eat loads and have never dieted, but I am average height with a very small build (narrow hips, narrow shoulders) so my BMI comes out low. It's not as brilliant as it sounds, as any extra weight on my tummy seems to stick out more than on my friends with wider hips!

I think if someone is flagged up as being under/overweight it's wise to take a look at it, but you have to use common sense too - if your child has a healthy-ish diet, plenty of exercise and doesn't look overweight, it seems likely there isn't much to worry about!

Do as i say not as i do. Probably true for MOST drinking, smoking, insomniac, sedentary healthcare person i know. It's advice. It's also good. You have NO idea why they themselves might struggle with advice. Or are you the patronising sort that think smokers don't know it's bad for them? I know I'm overweight. But I also know living well into my 90s with my family history would suck. So sometimes I kind of think so be it.

Rip the letter up and think no more about it, I did. I don't want my child to find it when i know she is fine for her age

@Daffodilz

Laughing at the HCP- do as I say not as I do

But they're not telling you do as I say. They're advising you what the health risks are of being overweight. I've never had a HCP tell me 'you need to lose weight' but they have said 'your back pain is probably caused by the extra weight' or 'your weight puts you at higher risk of diabetes' it's not judgemental it's just true and they'd be negligent if they didn't point these things out.

@GatoradeMeBitch

BMI is bullshit.

It really isn’t …

My daughter (who is 16 now )had the reception height and weight check and we were told she was obese .
I phoned as requested and the nurse told me that with children , unlike adults there is a very small variations of weight within heights that are classed as OK/ heathy .
She also added that as her parents (me and her dad) were tall , she would likely be tall too .
As she sprung up she slimmed down .

Your daughter sounds absolutely normal. Your GP has checked her, your partner is a doctor, you are feeding her healthily and she’s exercising enough. As you’re still worried, think about stopping HV appointments. Maybe add in family bike rides at weekends when not doing the school walks. She needs occasional treats, which you are doing. Give yourself a break! Ignore people who say that if she weighs x and is y high, she’s overweight. Don’t get sucked into limiting her food, except the red labelled fatty/sugary ones.

My daughter got the same letter when she was in reception. She is tall and solidly built but there was no way she wasn’t a healthy weight. She’s also very active including dancing and out of all of us she’s always had the healthiest diet as she loves fruit and veg and isn’t keen on fatty food. No one I told could believe it. I can only assume BMI isn’t always the best way to make decisions about healthy weight, I completely ignored it at the time and if you know your daughter is healthy in all the ways you have mentioned I wouldn’t worry at all.

You’re the parent. You know your child. Have confidence in your own ability to look after her wellbeing. She’ll probably thin out a little as she grows taller. Just keep your own eye on her

@Hell0G00dbye What can I do?

Answer- Bin the letter and understand that BMI means nothing - especially in children. Never give it another thought and skip the weighing in year 6 too.

@Doggirl

The thing about having a HCP who is clearly overweight/ out of condition, can actually be the opposite problem--that they lose sight of what 'normal' is supposed to be.

I saw a consultant once, where I recapped that I'd been fit and active but then gradually lost stamina: I'd had to give up running then most cycling, until by the appointment I was having to rest between flights of stairs.
He was completely "meh" about this. Rightly or wrongly, I couldn't help link his low expectation of what an apparently healthy 40-something should be able to do, to the fact that he physically had to unwedge himself from the armrests of his chair when he got up to examine me.

My father was diagnosed with a heart condition not because he was struggling but because his cardiologist felt strongly that a man who had been able to run 10+km with barely a puff and now suddenly couldn't, was a problem. He had passed all initial tests with flying colours (probably because he was super fit and healthy) but cardiologist decided to do further examinations.... Probably saved him from a ridiculously and unexpectedly early death or significant deficits or similar as a result of a heart attack!

So completely agree with you.

@Lia198

Following on from my comment, this is my daughter VERY overweight, not just overweight!

I see a child that is stocky

And what I saw time and time again is a “stocky” child at this age, become an overweight child by 12

It goes back to the point that the NHS is just trying to get in there early and preempt a problem later down the line.

Makes total sense to me

They weren’t telling me that she was going to be very overweight in the future though, they were saying she was very overweight at that age at that size? She is 8 now and still the same build, which I still don’t believe is very overweight.

Ignore the letter
I know ill get similar with dd. Shes tall and average build but weights loads.
Fwiw shes 4 and wears age 7 as anything smaller is far too short.

Lia198 i agree with them. Your child has a wide waist and that and other factors at your DC age is used to suggest obesity. Your DC should have grown out of the baby belly but your DD hasnt. It is an indicator for future weight problems.