to ask is my teenage DS actually obese or not?

[darkhedges]

My almost 14 year old DS was always fairly slim and not above the 50th centile for weight as a baby/ toddler/ primary age child. He had his puberty growth spurt relatively young and is now tall but also a high weight. To look at he is “stocky” in build and has a definite belly and bit of a double chin but not standing out as very overweight. On the growth chart he is 99th centile for height for his age and also 99th centile for weight. As these are at the same level, does this point to obesity or not? Any views would be welcome.

Pretty sure 99th for weight is obese, but what does it say on the NHS BMI Calculator for kids?

https://www.nhs.uk/health-assessment-tools/calculate-your-body-mass-index/calculate-bmi-for-children-teenagers/

A double chin and belly would scream overweight to me . Does he have a healthy diet and lots of exercise? Are the rest of the family slim or overweight?

He wouldn’t be classed as over weight

we are under dieticians and they are happy it centiles match
if he
was on 99th for weight but 50th for height they wouldn’t be happy - over weight

or 99th for height and 50 for weight which is where my DD is - unhappy ( underweight )

I'd be more concerned that there's a belly and a double chin. But it might be he's preparing for additional growth. How tall is he?

Is he active? Does he eat healthily? At this age, that feels more important to me.

Thanks. According to BMI calculator for child he is overweight but sale scores for an adult he is not! The rest of us are a healthy weight. We really try with healthy choices etc but at the age he is I can’t monitor and control his intake at all times so it’s difficult.

For reference he’s 5 foot 10 and about 11 stone 9lbs

My confusion is that he is heavy for his age but also tall for his age so do they in some sense balance each other out?

99th for weight and 99th for height? That doesn’t say overweight to me. He may have a different shape but I don’t think he’s ‘obese’.

And when you’re looking at BMI, google its history. It was never supposed to be a medical tool as such - and the health sector is starting to question its relevance in the way that it’s being used,

I thought if he is 99 for height then 99 for weight is right for his height?

Only partially. When DS was 95th percentile for height and 99% for weight, he was nonetheless, clearly overweight. But a year later, he was on the same percentiles but wasn't overweight any more which was obvious just from looking at him.

I actually used the NHS BMI calculator with correct height and weight, but changed his age and it was fascinating - at the age he was, they were all red alert, MASSIVELY OVERWEIGHT. But at this height and weight for a 12 year old, (he was 10 at the time), all perfect, no problem. So those measures aren't terribly useful basically. And in the small print, the NHS does acknowledge that their measures aren't helpful for particularly tall or short children.

What size trousers is he wearing - ie, if it fits on his waist, does it fit in the leg? Again, when DS was genuinely overweight, we could go up a few sizes to get things that fit his waist but then they would be too long. When he lost the weight, if we went up a few sizes, it all fit perfectly - waist and length. He's almost 13 now and wearing size 15 clothes, but they're fine for him and just looking at him you can see he's got no extra weight. He is 5ft7 and weighs about 63 kg (I need to weigh him again to check that as we haven't done it for a few months).

What about food and exercise? My nephew gets quite chunky before another growth spurt but SIL doesn't worry about it as this has been happening his whole life and he's very active - lots of sport - and generally eats well. And sure enough, after a few months he's suddenly taller and very slim again.

Overfeeding results in faster growth, so fat children are often taller than their peers till they reach their adult height.

So if he's on the 99th centile for weight, yes, he's overweight. Surely that's obvious though, if he's got a wobbly tummy? Children should be slim with visible ribs if they're a healthy weight.

I can't imagine your DS being overweight as he's on the same percentile for both height and weight. Don't let him believe anything else! The whole.concpet of BMI is flawed, anyway, not least for children.

As a side note - I was told I was heavy as I was over the 50th percentile as a child. What they failed to notice was that I was also on the 90th percentile for height. But being told about my weight caused me a lot of issues - when in fact I was quite underweight. It messed with my head for years.

Trust your instinct.

He’s in the biggest m&s school trousers for age 16/17 years and they fit around the waist and for length. He basically looks like a 16/17 year old size wise and we have to regularly clarify that he’s 13. With the wobbly tummy and bit of a double chin he could do with losing a few pounds regardless. I guess I’m just concerned to know if he’s actually considered obese or not. Very interesting points about the use of BMI as a measurement.

OP he has a wobbly tummy, a double chin and is in clothing for children 3 years older than him. You don't need a metric or a centile, he is overweight.

I wouldn't worry about classification of obese etc. He's sort of in proportion, so that's something. But he looks a bit overweight so it's worth dong something about that but it doesn't have to be a huge deal. Is he getting enough exercise? If not, how can you improve this? A few ideas could be joining a new sports club, insisting he does another extra curricular at school, walking/cycling to school, joining a gym (at this age, they all love a bit of gym action) etc.

Then look at food - teenage boys seem to have endless appetites so it's important that if he's struggling a little with his weight, he's not eating too much sugar and even, up to a point, carbs (they need carbs).

You don't want to be restricting food, but think about balance - eg, if my DS would happily eat pasta every night. The problem with that is that it tends to be large portions, and very carb heavy. And while he's fit and healthy, he can just eat too much. So we aim to have lots of meals where it's easier to balance it out. eg this week we're having two vegetarian curry style meals both of which will have lots and lots of veggies and sauce, then served with rice. We're also having salmon and DS will have a large portion, with a vegetable and noodle stir fry alongside. He can and does have large portions of all of these, including carbs, but overall, the carbs are at most 1/2 of the meal, often less.

No child should have a double chin.

He's overweight. Never mind numbers, just use your eyes.

I would ignore percentiles and BMI for now because they don't matter given you can clearly see he is overweight.

Also it's true kids who are overweight can grow taller faster.

What sports does he do? I would look at meals and meal portions.

Sorry but with a double chin and wobbly belly he is overweight either way and not as healthy as he could be. I’d step away from the numbers and look objectively and then subtly support him to make healthier eating choices and be more active.
and yes as others have said overweight children also tend to be tall children then they stop growing and get more overweight so it’s difficult to comment on the centiles matching

Is he still growing in height, OP?

Likely he still has a lot of growing to do and particularly as he wasn't overweight until now, he just needs to put weight on in proportion to his height and likely we will grow upwards and not outwards for a bit and even off. Just encourage him to do plenty of exercise and not have too many snacks.

DD2 is 15, 5'10 and 70kg (11 stone) and is in a healthy weight range so he's not that far off particularly if he has a growth spurt coming. She is slim - size 8 to 10 clothes - and goes to the gym 3x a week.

It can be the case, but DD2 was 10cm longer than DD1 when she was born and 1lb 2oz heavier, and has always been 99th centile for height. She was never not going to be tall.

You could take him to the GP and ask? That would make more sense than asking randomly on the internet.

I understand that it's tricky to calculate properly when they are growing because they have growth spurts. And BMI doesn't differentiate well between muscle and fat.

I also agree vv difficult to control a teenager's diet.

Is he reasonably active, and are you concerned about his diet?

Eating a lot in general is very normal for teenage boys - but if it's all relatively normal stuff like your family dinners topped up with loads of toast, cereal, noodles and pizza (they all seem to eat like they are carb-loading) then it's likely not an issue compared to if there are concerning patterns like obsession with sweet stuff, or seeming to be unable to stop himself.

It doesn't sound huge. My 18 year old is 5ft 11 and around 57 kilogram. He is very slim however and finds it impossible to gain weight. For somebody with a naturally stocky build your son's weight sounds okay. He shouldn't have a double chin or large belly though, that's not healthy.

Kids are supposed to have a lower BMI than adults.
I've a feeling under about BMI20 is typical for a young teen. So being overweight on a kids chart, but normal on an adults chart is totally expected for some kids.

Belly and double chin would suggest he either is about to shoot up again, or is putting on weight a little too fast. Worth keeping an eye on.

The wobbly tummy and double chin, sure. But the clothing that's a size up - I think you're being a bit myopic here - that's not a sign of an overweight child. DS wears age 15 (in things like Nike trackies etc which admittedly, might be a slightly odd size as his school trousers are size 13/14). He's not quite 13. He is not even a tiny bit overweight - he's slimmer than almost all of his friends (and taller, obviously). He could wear trousers a size down if he wanted to - they'd be a bit snugger, but would still fit, but they'd be too short. I know this because I had to sneak his old school trousers out and toss them as he kept wearing them even though they ended above his ankles.

No his clothes size doesn’t mean his over weight my DD wears age 12 she is 10 and is underweight by medical definition and been under the dietician for years
she like your son is on the 99th centiles for height - but 50th for weight they want her centiles to match at 99th.