Two Year old “overweight”

[oopsididitagain66]

My son had his two year review last week, at which his weight and height was recorded. The nurse went on to tell me that after working out his BMI which was “very high” so he was overweight and suggested I see a nutritionist. He is a healthy happy boy, maybe a bit on the chunky side but absolutely nothing unusual in my eyes. I assume by pointing us towards a nutritionist it was to help him lose weight. I politely declined as he has a very healthy, varied diet at home and eats well.

Is this the norm?

My DS was born on the 98th percentile and stayed there all through childhood. We were told at his weight check in Reception he was overweight, he wasn't, we had a hospital check around the same time and I brought it up with them, they plotted him on the percentile graph (rather than using BMI designed for adults) and he was still bang on the 98th percentile.

He's about to turn 14 and is 5 foot 9 and slim physique, BMI for kids is a bloody nonsense! If you know he eats a healthy balanced diet then take no notice!

I don’t think they do use BMI for children - they use their weight to height ratio, with 95 - 105% being deemed ‘healthy’.

Is he 'in proportion'? My girls were always heavy for age. My 10 year old wears age 12-13 clothes because anything less is too short for her.

Looking at his clothes (non stretchy ones) to get them the right size to go around his body comfortably, are they then too long in arms/legs? Can you see each rib clearly?

I think you are missing a really key point here. His diet may be healthy and nutritious, but if you are giving him too much he is going to be overweight. Too much of a good thing can also be bad for his health.

I’m not really sure why you wrote this post if you are happy with what he is eating and you don’t think you need to do anything about it, go and live your life and don’t worry about it.

The fact you’ve written the post, suggests to me you know he is bigger than he should be, in which case, take them up on the offer to see a nutritionist.

I think YABU to refuse the referral. I would see what they say first, they might have some useful advice or context. He's 2 so he won't be damaged psychologically by having the appointment, even if they come out with a load of outdated fatphobic nonsense.

In terms of the poster saying it changes suddenly at age 2, it's mainly because height is difficult to measure in younger children because officially it's done lying down.

This document which is also probably in your red book explains how BMI is calculated. It is a rough measure and children who are naturally tall because their parents are tall can sometimes get a misleading reading on this, but OTOH in younger children, where they are overweight it often leads to them being taller as well, which can mask a dietary issue if parents assume that their child is on a high weight centile because they are tall.

https://www.rcpch.ac.uk/sites/default/files/2025-11/Boys_0-4_years_growth_chart.pdf

It's tricky to tease out but I would take the question to the dietician - is it possible that my child is heavy because he is tall, or is it more likely he is tall because he is heavy, what makes them think this, essentially don't be afraid to ask questions, they are there to help support you and your child's health, not make judgements and criticise you.

Children vary so much in their portion size and appetite so it can be really difficult to know what is a reasonable diet IME.

I disagree. BMI is a poor measurement for adults because it doesn’t take into account muscle mass. Before I had my first child I was a ‘healthy BMI’ but I had no muscle, definitely the definition of ‘skinny fat’. I started going to the gym when my son was 1, lost the fat and built muscle. When I checked my BMI again 1 year later I was classed as overweight - which I wasn’t, I just had significantly more muscle.

With a two year old there are very few mitigating factors that could make BMI and in accurate measure for weight. No 2 year old is bulking up in the gym. If the BMI says he is overweight, then he’s overweight. 2 year olds shouldn’t be ‘chunky’. A 6 month old baby, yes, but a 2 year old, no.

You say you are confident his diet is healthy etc and that you don’t feel it is appropriate to seek nutrition support at this time, but then also describe him as “a bit on the chunky side” (parents often downplay the reality) and say you know he is overweight.

Healthy and appropriate diets don’t lead to overweight two year olds and I imagine your Health Visitor was trying to be diplomatic.

Overweight toddlers lead to overweight pre-schoolers. Things can very easily snowball and it’s shocking how overweight some young school children can be (we have all seen it at the school gates).

I would absolutely take the HV’s advice and nip this in the bud as early as you can. It will be much easier to make early modifications to your child’s diet and lifestyle now than further down the line.

Children lose a lot of body fat when they are toddlers. Just like everything else, that process will happen at different rates for different children. If you are feeding him a healthy diet then his height will catch up to his weight in time. The HV doesn't know what you are feeding him so a referral to the nutritionalist is a sensible suggestion. You could take it or not take it but I wouldn't worry either way.

I assume he’s short if this is a problem? As most medical professionals wouldn’t refer if the parents are tall enough to justify it, I’d assume you are both below the 95% centile in height? If you guys are average to short you need to stop kidding yourselves that you are going to have a tall child or that his diet is healthy and start getting real advice.

A high slop (processed carbs like grain) diet might seem healthy but it’s fats, proteins, veg and wholegrains that give satiety. You also need to honestly review your child’s activity. At 2 I’d expect them to be running around and moving all or most of the day — if they can’t do that due to their weight you have a problem.

I would go for the nutritionist. You have nothing to lose and potentially a lot to gain. It is possible that you are doing everything right and your DS is about to have a massive growth spurt. It is also possible that you are giving him the right diet but too much or it is possible that you think you are giving him the right diet but actually it needs some slight adjustments.

I would suggest looking at pictures of yourself and your DH at 2. I worried so much about DD1 at this age and my MIL assured me that “this is just the way children in our family are”. I didn’t believe her but she was quite right, exactly as predicted she just sort of stretched out at 6.

Please don't decline the support. It can be difficult for non-experts to know what a healthy weight looks like. I was overweight as a child and into adulthood. My parents buried their heads in the sand and never gave me support to lose weight - they were overweight themselves so I suspect they just didn't see my "chubbiness" as an issue. It affected by confidence massively. Nip it in the bud as soon as you can.

In our area they don't measure height at all at reviews (unless you are concerned) as it's so hard to do it accurately on babies and toddlers. If the height is wrong it will throw off the BMI figure. They just do weight centiles and if they go up (or down) across 2 centile lines on the chart you get referred.

Just be aware that a real registered professional is a Registered Dietician. Anyone can call themselves a nutritionist as it’s not a protected title.

Conversely my DS was always skinny / he was usually 95 centimetres for height and maybe 50 for weight? He pretty much followed this trajectory all his childhood and now as a young adult he’s just started to put a bit of belly weight on (uni weight!). He’s still generally slim though and the little pot belly will probably go away after he leaves uni (in 2 months!).
So what I’m saying is get the help now as it’s more likely your son will follow his trajectory (obviously if he’s 95 percentile for both then he’s just built in that way). It’s when there a mismatch it’s an issue.

No, it isn't normal for a HV to say that in that situation.

Normally they check that they're tracking the same centile. It is change they usually look for, and flag-up change greater than up or down by 2+ centiles.

They know some children have to be on the 95th centile and some on the 9th, otherwise it wouldn't be a centile.

So if your son has always been 95th centile, then I'm surprised they suggested an intervention. He's just continuing on his growth curve, which is what they usually check for.

I was literally going to write a post along these lines. Don't discount genetics and look at both sides of the family.

My family's babies always pile on the pounds even when they're EBF. Their weight is quite literally off the charts and they have so many rolls. Give them a few years and they drop some of the weight but look a bit chubby until around 10 when the weight drops off and they shoot up and become slim. Nobody in my family is overweight as an adult and nobody has to massively watch their diet. Weirdly I notice the opposite with lots of other children who eat whatever they like and are stick thin until they hit their teens, especially late teens, and the weight piles on despite the fact that they're often not eating loads more than their peers. I think a lot of this stuff is genetically programmed.

Perhaps changing from full fat milk (it that's what you're using) to semi skimmed? The advice on this has changed recently.

Hi Op, sorry I’m back again ! If he’s following a consistent growth curve I dont think you have anything to be worried about , BMI isint always a great indicator for adults or children . You sound like a great Mum, you know what you are feeding your boy . It’s ludicrous anyone suggesting to you to take your child to a nutritionst. At 2 my youngest girl was built like a brick house, but solid muscle from climbing , god I was envious of the muscle in her arms but she looked seriously chunky , now she’s a tall 5 year old waif who sees eating like it’s a competition she puts away so much .

What percentile is his height? My DD was 95+ percentile at birth and as a toddler, but she is also the same kind of percentile for height and now as a 7 year old is a gangly, slim energetic very tall girl with large feet and long limbs, and I've always had to buy clothes about two sizes bigger for her because of her height. She was a little roly poly toddler but I see now that she needed all that stored energy for all the growing that she had to do. Your son may be due a growth spurt.

I think it is worth paying attention to if there is a mismatch between height / weight or if he is increasing through percentiles rather than staying relatively consistent.

I think if a HCP refers your child for a form of health care, then it's your duty to your child to take them to the appointment. This is your child's body and health not yours, so I don't think you should override medical advice on his behalf. If you attend and its not helpful it's not the end of the world.

I don't think that a chunky 2 year old with a healthy diet needs a change just yet. I was an absolute fatty as a baby and toddler. I loved (and still love) food and my mum was incredibly strict with my diet in terms of not having processed stuff or too much sugar (she still gave me carbs). I naturally thinned out as I got older and was then the skinny teenager even though I still ate loads. My dad was the same.
If someone was feeding their child rubbish then I would underatand the concern but if not, why not wait and see if things change in the next year and then take action if not?

My Gds was a very fat baby, and still ‘well covered’ at 2, but at 9 now, although eating loads, he’s extremely active and skinny as a rake. As soon as he was really running around the fat soon melted away.

Unless the family in general is overweight, and your ds is eating a lot of junk, I’d ignore the woman. Just 2 is still a baby as far as I’m concerned.

Look up how BMI is outdated and should not be used anymore...

What size clothes is he in @oopsididitagain66 and what’s a typical daily meal plan