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 got one of those letters re my youngest son. I spent approx 7 seconds perplexing, 10 seconds walking said letter to the recycling bin and have wasted not even one more second thinking about it since. You should do the same.

My DD is very overweight too. You don't see it on her. Like yours, she is solid and certainly heavy but you wouldn't pick her out as the fat kid. Of course, part of this is because kids have all got bigger (the reference population for the centiles is from 1992 I believe). Perhaps 40 years ago she would have stood out. She generally fits the right size for her age but certainly she will outgrow waist before height.

The thing is, especially for girls, is that it is a constant tightrope between not making food an issue and trying to address the weight. We limit treats, usually home made food, try to control portion size and encourage her to fill up on less calorific food like veg rather than carbs, ecnourage exercise. She does swimming twice a week, martial arts three times a week, PE at school and we try to get her running around during weekends and other times. We had to try diffrent sports until we finally (thankfully!) found the marital arts that she really enjots.

The thing is that I see that
a) she likes food more than her friends. She isn't picky thankfully but she does polish off her plate and doesn't seem to have a natural off switch that her siblings have and that her friends have. She could easily eat an adult meal and then ask for dessert. She just never really seems full and this makes it hard for her to naturally control her meals
b) she's a bit of a couch potato. She's a kid who'll naturally prefer to sit and read, play lego, do a jigsaw etc. She's not a kid who is full of beans (physically, it's not that she's sitting on screens all day - she's always busy doing something, just not running around). Other kids her age (and her siblings at her age) just seemed to naturally be more physically active

So I feel we're fighting these two natural tendencies that are just part of who she is. In a less obescogenic environment it wouldn't matter so much but these days it does make a difference. We're doing our best with her but at the same time don't want to make her miserable or for food/activity to be an obsession. She'll never by skinny but hopefully we can instill in her as many healthy habits as possible to stand her in good stead in adulthood. Although maybe we're failing as she's still overweight, I don't know.

By the way, we've had visits to the GP and there's no real advice other than what we're already doing. It's really hard.

[quote Bostonbullsmumma]@Papayamya I get so defensive as why should my child be humiliated in to being given a letter in front of his mates saying he's overweight. No support was offered to me after either. What was the point in the letter? It's impossible to make a GP appointment and his HV, since we moved, never returned my calls. If he was overweight I'd have sucked it up and done something about it. Please do tell me what the benefit of the letter is? [/quote]
I agree it shouldn't have been given in front of the rest of the class, but the point is that it makes you aware and hopefully assess what he's eating and activity levels- why would you need to see a GP? Self responsibility for your child isn't a bad thing, lots of people (seemingly yourself included) are oblivious to the fact their child is overweight so it's good it's highlighted.

I agree with the majority, throw the letter in the bin and give it no more thought. Bodies are all different shapes and sizes and different body shapes can be healthy too . I think the system they use to determine this is extremely outdated. Don’t give it any more head space.

Ignore it, and don’t share it with her. If you’re happy that her diet and exercise are OK then she is what she is. My daughter had the same and was a bit heavy as a child but when she hit puberty that has all disappeared. I’m sure these interventions are very well meaning but are also often unwarranted. Simple measurements so not give the whole picture.

@Namesrus

My DS was the opposite very tall and thin from birth, got referred to a nutritionist and investigated by the GP. We were told to increase the fat content of what he ate, encourage snacks etc basically the opposite of healthy eating. It didn’t work he still managed his sports and activities but never bulked out. As a young adult he’s still tall and thin, can drop lbs in weight if he’s unwell it’s just the way he is. He really doesn’t get his metabolism from either me or his dad.

Yes, I had this with my first. They wanted me to be adding butter to her cereal as an infant, giving as many mashed bananas and avacadoes as possible, stop breastfeeding her to get more solid fatty food in.

She looked indistinguishable from baby photos of me, or of my dad, to the point that apart from photo quality it would be easy to mix them up.

When I pointed this out to the pediatrician after months of trying to get her to eat more (she already ate plenty and just didn't want more) the silly bugger told me that she'd end up with deficits, and also that I was keeping her in the high chair for too long which was bad for her.

After that I washed my hands of the whole thing and also ignored it when the others all had the same issue. Interestingly my eldest now could possibly be said to have put on a bit too much weight and the others are all beanpoles and make the doctors happy.

My SIL and BIL are both overweight. They had the letter when their DD was in reception. They have dismissed this the same as most people on this thread and they are removing her from the program in year 6. She is now 9. She is very visibly overweight or "big boned" as they call it. Research suggests that overweight children will become overweight adults which is masked by puberty.
My SIL really hates her weight and struggles to keep it down. At this rate they are setting DN up for the same battle and they just don't see it.

BMI isn't useless. But it's crude and a statistical and not a diagnostic measure. It should be indicative that there MIGHT be problem not definitive that there is one. But a high BMI centile shouldn't just be ignored as it is very likely (statistically) that the individual IS overweight or obese. Not definitive but a high probability. Why people get so angry and annoyed about the BMI I don't quite get. Just accept it for what it is, it's not a judgement, it's just a (crude) metric.

Would school tell you what she’s had a lunch for a few weeks given you’ve had the letter. It may be she’s having seconds daily or choosing bread in the ‘salad’ bar.
The issue with the throw it in the bin is the stats are awful and have risen unsurprisingly in covid. The yr 6 stars in some areas are more overweight than not so the does she look
Ok compared to peers doesn’t work.
No one will tell you outright. If you watch do you notice any habits dd has that peers don’t eg is she always eating at parties, does she have a snack after activities when others don’t.
The upping veg for all of you is a great idea.

This is why I didn’t give consent for my son to take part in this school Weighing BS

@NdefH81

And the Dozens saying “just ignore” are being a little reckless with their health advice I think

Realistically, what other option is there?

Her mum knows what she eats, knows that the portions are fine and the food is healthy, and also that the child is active, that she isn't eating empty calories or snacking much.

She's hardly going to put a child that age on a diet or give her an exercise regime, that would be totally inappropriate.

I know bones aren't heavier etc but there is different builds
My friend is a petite size 6. If I stripped all the fat off my body, I will still have a bigger frame because I'm 5ft 10 and my shoulders are twice the width! My uncle is a heavyweight boxer and my grandad was a wrestler. I was never going to be a ballerina build
Even age 14/15 and lean, I was a size 12 because my shoulders have never fitted in a size 10 in my life

@PositiveLife

Chuck it in the bin and forget about it.

My dd was on the 4th centile consistently. She got one of those letters saying she was obese. You could see all her fucking bones, she was so skinny. If anything, she was underweight.

Best advice here - Chuck it in the bin.

Continue the healthy lifestyle.

MangyInseam

Have a read of Teapacks post. Really insightful. It's about instilling good habits and being aware of individual circumstances.

Best info my children are grown up now centile never heard of it my kids ate healthy with the mantra..eat what you want that I've cooked, none of this eat it all up ..no after school clubs as I worked full time so after school time was my time where we would go out walking playing football they have carried on healthy eating and both weigh look fine..There only complaint was why did I let them have fizzy pop occasionally

I threw it straight in the bin, didn't help that I'd refused permission but some how he was weighed anyway.

He's like his older brothers who as adults are very tall, well built and perfectly fine bmi

@WhatNoReally

I know most people on here are saying ignore the letter, but in DD's class there were 2 children (1 girl 1 boy) who got that letter. The parents were outraged and everyone supported the in the same way as on this thread (big boned/will grow into it). Both of those children are now very significantly and very visible overweight. It's an early warning sign for you that shouldn't be blithely dismissed.

I can understand it being an early warning but in this case I don't think it applies. The parents are a healthy weight and monitoring the child's diet and exercise. That's enough.

Assuming your DH is a doctor with some knowledge of this stuff, what does he think?

There is no doubt in my mind that many parents are in denial about their children's weight. Having said that, there's a limit to what you can do when your child is this young and you have to be realistic.

DS was overweight. We knew it. Not crazily so, but clearly overweight. I discussed with the doctor. Her point was that at that age, restricting food is not advised. Exercise, healthy, varied diet is more important.

A few years later, we did have to take a more proactive approach because by then he was more overweight. He was also old enough to understand this. Part of fixing the problem was me and DH, as his parents, taking a long hard look at our OWN behaviour and what WE were doing.

We had to acknowledge that that he WAS having more treats and food that was high in sugar and/or fat than was good for him.

But we also had to acknowledge that as a tall child who genuinely has bigger bones than others, he needed more/different exercise than other children. I came to realise that he wasn't always incentivised to keep moving when he was outside and that he was more of a burst of activity type of kid. But that wasn't going to help him with the weight.

We also looked at his "healthy" food. And had to realise that traditional kids food wasn't good for him. If DD eats something like shepherds pie its a good dish for her - protein, carbs, veg (on side and hidden). But for DS, who loves food, he will eat a big plate of whatever is served to him. if that's shepherds pie, it might be very nutritious but a b ig plate is too many calories. As a good eater, we could switch to serving him the kind of meals many younger children wouldn't eat - a piece of salmon with rice and piles of steamed veg or baked chicken with salad and new potatoes etc - allowing him to have a large portion but without the same number of calories.

None of these things would have happened if we'd continued to be defensive : "but he eats normal healthy food" or "but he does lots of activities and is out and about all the time."

@Teapacks

BMI isn't useless. But it's crude and a statistical and not a diagnostic measure. It should be indicative that there MIGHT be problem not definitive that there is one. But a high BMI centile shouldn't just be ignored as it is very likely (statistically) that the individual IS overweight or obese. Not definitive but a high probability. Why people get so angry and annoyed about the BMI I don't quite get. Just accept it for what it is, it's not a judgement, it's just a (crude) metric.

I think people get annoyed when HCPs take the BMI as gospel, rather than as a crude metric, and ignore the various other indicators of health that are also important to consider.

@DomesticatedZombie
Yes, but the letter the schools sends out is just BMI and, iirc (left the UK so got the letter only with my older DC) just says that your child is on x centile and this is the x category and that you might want to consider taking action if it's not in the normal weight category.

It's such an a valuable public health resource to see changes in children's weight. It would be a real shame if it were scrapped because parents get upset about being told their child is in the overweight category.

Personally, I know my DD is overweight. I know her weight approximately, I know her height, i see her build. I don't need a letter to tell me that. But I have no problem if it will help contribute to the population stats on children's weight.

@Hornetfarmer

*MangyInseam*

Have a read of Teapacks post. Really insightful. It's about instilling good habits and being aware of individual circumstances.

But the things said in that post simply don't apply to the OP's DD, who does a lot of sport/activity as well as non-formal exercise like a lot of walking (so is definitely not a couch potato); and there's no indication that she doesn't have a natural off switch or that she eats adult portions.

I think people get annoyed when HCPs take the BMI as gospel, rather than as a crude metric, and ignore the various other indicators of health that are also important to consider. @DomesticatedZombie yes this.

After DS lost all his weight, he had his year 6 weigh in. Officially, his BMI is too high. 10 seconds investigation on the NHS website and I discovered they ADMIT that for children who are unusually tall or short, applying age as part of the BMI measurement can give readings that are not accurate. In DS' case, if I stick his exact measurements into the NHS calculator but change his birthday so that he is 12 (I chose this age based on the fact that he wears age 12 clothes, all of which fit him perfectly in both width and length - age 13 tend to be a bit baggy but are also wearable) .... his BMI is considered absolutely fine.

It's a tool, not a bloody diagnostic certainty and it annoys me that so few people see that.

I’m intrigued that everyone thinks they all even out/ shoot up / whatever. That’s obviously not true is it? There are loads of fat teens and adults. I’m a fat adult myself.

Why people get so angry and annoyed about the BMI I don't quite get. Some of us it's because we know how out of date the measure is - as in it is 100 years old and has had very little/no updating, depsite the obvious changes in population measures.

www.medicalnewstoday.com/articles/255712#is-it-too-simple

And don't suggest fat calipers, cos I have a tale of horror about that. The measure was 'invented' by a gorup of men who went round Texas morgues and pinched the inches of dead Texan men. That formed the fat caliper measure. So forget all about user error and think about how adipose tissues separates from skin after 12 - 24 hours of death; Texan men? Men? When was it recalibrated for a modern society, maybe even for women? Answers on a postcard please...

God how I miss that era of my life - lecturing on health measures and how to laugh at them!

Maybe, Teapacks, but look at the letter in the context of the OPs post:

...a big issue with the HV team...

... HV just weighed and said she’s still overweight and to watch portions

... being made to go monthly to the HV for weight checks and their disapproving looks when she continued along her centile.

I've had similar disapproving, stern talks from the HV (admonishing me for breastfeeding, etc) although in the opposite direction as my DD was always light and small. I think many others have had the same. Fine to use BMI to flag potential issues; not fine to use it as a stick to beat people with.