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?

I don’t believe BMI is supposed to be used for children? Certainly not of this age.

If he’s been consistently on this percentile since he was little I wouldn’t be worried. Especially if he eats a good varied diet with appropriate portion sizes.

All three of my children are high percentiles for both height and weight. Their dad is very tall and solidly built despite me being short so not that surprising. They’ve consistently been on those percentiles for most of their lives.

Nobody including any medical professionals/drs/HVs have ever raised it as a concern. I get a lot of comments about how tall they are but nobody has ever once suggested any of them are overweight. I mostly find it an issue that people assume they are older than they are and expect them to be more grown up (would get snotty comments about them
being in the pram still when they were just two for example). That and the fact that all their clothes/shoes are more expensive than most children their age as they’re in bigger sizes and I have to pay for them to go into places with height restrictions when they’re barely old enough to go on anything or people don’t believe me if I say they’re under the age for needing a ticket.

My eldest in particular was on the 98th percentile for weight and stayed there until about age 2. He then stayed pretty much the same weight for a whole year and grew much taller. Since then he’s been on the 91st percentile for weight. He’s almost 6 now and still on high percentiles. Nobody would say he looked overweight now but he was certainly a very chunky two year old! I did decline him having his height and weight measured when he started reception though. I know his measurements, don’t need a snotty letter about it or to upset him.

I find they go through phases of filling out, then having a big growth spurt in height and then repeating.

People often have quite outdated approaches to child weight. Kids used to naturally get a lot skinnier as they got older, so that 8 year olds were skin and bones. But our food environment is quite different now and fat toddlers seem more likely to become fat kids rather than the fat melting off. Personally I would take the help and see if you can avoid storing up problems for later life.

Sometimes/often little children get chunky then they grow taller and balance out. Maybe he's about to take a stretch

Rule of thumb when mine were young is cam you see their ribs should be visible under the skin. If not then they are carrying too much fat.

My 2 were the same and have levelled out perfectly. They are now very tall!
Not all children are the same and if he is eating a normal healthy diet and there are no concerns there I wouldn't be worried.
I think people worry so much about following the rigid lines of a BMI without taking into account different body types/shapes.

My kids tend to get a little chunkier for a couple of months, then have a growth sport and be skinny and tall again. Might it be worth monitoring more closely for the next few months to see how it goes. Just stand him on the scale and measure his height, then you can plug the numbers into the NHS BMI calculator.

My son was a very chunky toddler but also walked or balanced biked for miles every day. By age 4 he was stick thin. Then chunked out at puberty again and now has had a growth spurt and is stuck slim again. If he eats well and exercises I wouldn’t worry.

OP you can tell chat GPT exactly what your kid is eating each day and ask if it is meeting the recommended nutritional requirements. Be as specific about quantities as you can.

this will give you much more accurate information than the chat with the nhs dietician (I have done both).

BMI doesn't tend to work on certain ppl, I'm very short and when I lost weight and got down to a 10 my BMI said I was still overweight, also it will not be accurate on children and ppl who have a lot of bulk from weightlifting, I'd quite frankly tell them where they can stick the BMI.

Not everyone who is deemed overweight on BMI is overweight, the op can use their eyes you know

My son was a chunky healthy eating 2 year old, I got tendinitis because of how heavy he was. He shed the weight as he got older. My youngest and middle were born big babies.

Of course you don’t see anything wrong ‘in your eyes’ you’re the one feeding him.

children absolutely can be overweight and this attitude is why we have a terrible epidemic of obese children with multiple health issues and shitty lives ahead of them.

it’s not always junk food being the issue, it’s huge portion sizes and lack of knowledge of nutritional value.

Please consider portion size then. My diet is also healthy and nutritious but I eat too much of it. As a result I am overweight!
Healthy food can be calorific and any food will lead to weight gain if overeaten.

This is more or less what I was going to say. Age 2 is also typically when they start using the pushchair less and start walking more, their coordination increases, their motor skills become more refined, and they become way more active which is when they really start to lean out.

HV at my eldest's 2yr check told me she was concerned about DC being on 95th centile. I pointed out DC had always been on that line even when a newborn, didn't eat junk or massive portions, and was very active (something which she also commented on when she asked "do they ever sit still!?"). It worried me so I saw my GP. GP laughed and said DC was fine, that HVs create more worry than they resolve, and that they'd only be concerned if DC's reception age weight and height check came back as over/underweight. Reception height and weight check came back as normal, DC now taller than me and not at all "chunky."

DC2 was the polar opposite and on 5th centile which also caused questions at the 2yr check. HV asked me to keep a food diary as was concerned DC wasn't eating enough. Was stunned a week later at how much DC was putting away and gave me some patronising advice about "too much of a good thing" and to let DC have some treats because they "have centiles to spare." DC is also now taller than me, calls me "bruh" as is "bruh, I'm starving", and is still a human hoover who never seems to put on weight.

DC3, 50th centile for height and weight despite eating nothing. At age 2 was living on Babybels, plain chicken breast, bananas, and uncooked yellow peppers. They wouldn't refer me to a dietician because they were "all healthy foods" and DC was "a healthy weight." Later diagnosed with ASD and ARFID.

DC4 was another one who was 95th centile from birth. HV quizzed me about DC's food to see where I could cut down. She agreed you can't really cut down on half a dry Weetabix at breakfast, one scrambled egg at lunch, and chicken and cucumber at dinner. She looked at me like I was lying when I said DC didn't like sweets and that their favourite snack was a bowl of garden peas, preferably still frozen. DC also later diagnosed with ASD and ARFID.

I think it’s probably pointless since even if she refers you which it doesn’t sound like she did you’ll be highly unlikely to get in front of an nhs nutritionist anytime soon.

both my children were referred to a group service which had some good ideas.

Ultimately the only thing that helped is when they were old enough to limit their food intake to less than that of an average child out of choice to be thin. They never really had a fair chance of being normal weight any other way.

Op, they are just doing their job and reading figures and weights.

It is not personal. Talking to a nutritionist could never be negative. You might learn something positive
It would be arrogant to refuse the referral.

I wouldn't be that fussed tbh. My dd was built like a tank at 2 years old. She was a lazy wee thing and it took her an age to be persuaded out of the pushchair. Once she started walking everywhere she was grand and at 16 now she struggles to find clothes small enough to fit her sometimes.

You say he's always been at the top end for weight, what about height? Is that a) consistent and b) on the higher end as well? Because if the answer to either of those is no, I'd be concerned.

Franky, I had two children at similar BMI at 2 and yes, both continued to be overweight - one notably so. It HAS evened out as they've entered puberty and got more active but it has also taken a bit of effort, particularly in the case of DS who just loved food (still does) and simply ate too much considering how much exercise he did. He still eats an astoniishing amount of food, he's just also now almost 6ft, and is doing sport and activity every single day so it's not an issue and he's very slim AND toned.

My top tip is to look at portion size but also ratio of food. At that age, a lot of children are eating lots of food like spaghetti bolognaise, cottage pie, fish pie etc - easy to eat, popular food that's often nutrient dense. But it's also often calorie dense and for chidlren who are really good eaters, actually, they don't need that. A huge part of getting DS' weight down between 9-11 was by shifting to a lot more food like simple proteins with large portions of vegetables/salads and "normal" portions of carbs. Even now, if he has pasta, he's eating a LOT but I make a huge effort to ensure that the sauces we have with pasta are a) chunky so a high proportion of the plate and b) lots and lots of vegetables.

This doesn't mean the OP shouldn't be fussed though.

Given the childhood obesity rates, not every child is like your daughter.

So it's a bit of a blind gamble to take.

It’s easy to see your own child through rose tinted glasses. They’re perfect to us! However it’s better to nip this in the bud and I’d take the advice of a nutritionist could be a snack adjustment or portion sizes.

The OP is confident that his diet is healthy, nutritious, and low in ultra-processed foods though so it doesn't seem like that much of gamble. Sure if she was feeding him sausage rolls and a bottle of coke for breakfast and wondering why he is chunky but the OP clearly knows about nutrition, he has always been in the same centile for weight, it hardly seems like cause for panic stations to me.

But it's not happening to you.

And to be honest if the OP wasn't worried, they wouldn't have started the thread.

She should probably see the nutritionist, if only to put her own mind at rest as to why her child is overweight.

I think it depends what the weight is. My 2 year old was 75th percentile for weight and 25th for height, but she was so active most of it was growing muscle!! And she looked in proportion for the HV wasn't concerned, she's now 4, still shorter than average, still "solid" as a build but very healthy

grabs bingo card 🙄

You’re absolutely not being unreasonable. Imagine giving two year complexes about their weight! For goodness sake. Literally nobody talks more shit than Health visitors. Ignore them