To ignore BMI as an indicator of a child being overweight?

[HappyHolidays22]

My DD is 4, 5 in 2 months time. She’s tall for her age and looks older than she is because of this. (Just for context, her dad is 6 ft 5 and I am the shortest female in the family at 5 ft 6… so she doesn’t come from small stock!)

Today we had a letter from some NHS service to say that they have done some measurements in school (with our permission) and that she is overweight. Her height is just over 118cm and weight slightly over 26kg. According to the BMI calculator this puts her over then 90th percentile and therefore overweight…

but my problem is that she looks totally in proportion for her height! Never in a million years would I have thought to say she was overweight…

we eat healthily and encourage DD to eat a range of foods (with varying levels of success as I think is normal for a 4 year old).

my question is - AIBU to ignore this BMI calculator/info from the NHS if I believe my daughter is fine? Or should I be doing something to trim her weight down? (Of course, I’d never ever tell DD this as don’t want her to ever have a complex!)

Her height and weight are the same gentile. So she should be fine. My son is like this and variably not overweight (lean muscly tummy, easy to buy clothes for as slim build).

I would say ignore the comments from people just saying that’s heavy based on their own child’s/nieces weights.

How is it different to you child being 50th centile for height and weight if they are 98th for both?

Being “too tall” is a general prediction of obesity, though - because the child is getting too many calories too young, thus promoting growth.

Look at portion sizes. Increase exercise (dancing at home, walking instead of driving to school, an extracurricular club).

Just consider it an early warning.

(My DD was 16kg at that age... I remember weighing her to see if she was safe to move to a seatbelt. )

Because taller children are supposed to be a bit skinnier to account for it. They’re not supposed to have the same proportions as an adult.

@HappyHolidays22 I would cut out the dessert every night. We don't ever have dessert here unless it's a special occasion.

I would also only give "healthy" snacks at home, so hummus and carrot sticks, cherry tomatoes and cucumber. Chocolate once a week. No yoghurt unless it's plain Greek yoghurt etc

Cereal for breakfast...I'd only give plain cereals so porridge oats or muesli with no sugar and fruit, so maybe look at how much sugar is in what she usually has.

Being on the 98th for both weight and height isn’t a get-out clause. It’s a warning sign.

My DD is very tall. Her BMI is normal though. Height is taken into account with BMI, that's the point.

Your DD's diet sounds like a total carb-fest. Does she like protein and fats, vegetables and fruits? They are more satiating and less likely to lead to overeating.

And what about exercise? I think it has a greater effect on children but that's anecdotal.

Centile!

The comment saying being overweight makes them tall when you have stated the dads height! As if that wouldn’t be the reason.

To be honest I would cut snacks completely 🤷🏼‍♀️ unless just an apple per day or similar. We never snacked as kids (not as a structured, ‘oh look it’s 2pm time to get out the bread sticks type thing anyway) and you rarely saw fat children. Just focus on 3 meals a day of correctly sized portions and maybe cut the dessert a bit.

Shes heavier than I'd like if she were my daughter, and her diet isn't great. Way too many carbs. But if you're happy and she's happy then i guess it's ok

I would watch the fruit as it is a lot of sugar even though pushed as endlessly healthy, it's not.

BMI is a literal ratio of her height to her weight. That means it’s already taken into account that she’s tall and still determined that she’s overweight. I know you don’t want to hear it but she’s overweight and should lose weight. The parents of overweight children almost never think their child is overweight - even fewer parents of overweight children realise that their child is overweight before it becomes a huge problem.

The child’s BMI calculations take into account that children bulk before a growth spurt, that they’re often constipated, that they have other reasons why they’d retained water etc so only those at the very, very, very top get notified that their child is overweight. I’m sorry OP, I know it’s not what you want to hear.

Gosh. I feel sick with guilt.

I’ll try to take it as a positive that it’s been highlighted now and I can make small changes as suggested.

Being happy doesn’t negate the effects of obesity?!

My son is autistic and gets measured at the hospital a lot. He is 110cm and 19kg. It is hard to tell so don't beat yourself up. The hospital are just doing their job. If you think she needs some small tweaks best to implement them now rather than wait till she is older.

Have you talked to your GP about it, OP? I have the opposite issue (underweight) but have been reassured by tests, etc, that all is well. Maybe a general check up would be a good idea?

Yes, it's a good thing you have been thinking about it. You can get on with making positive changes in the right direction. Best to nip it in the bud. Good luck.

The reason they weigh and send those letters is so you can act, no point feeling guilty, but at least now you know so you can do something about it. 💐

By comparison, my 6YO is 126cm and 20KG, which puts her on the 3rd centile - she’s always tracked around the 5th since birth, had CMPA and still can’t have dairy.

I’m 5ft 2/55KG/8st 6lbs(ish), my ex is 6ft 6/11st(ish). Short and slim, very tall and very slim.

So no, in your shoes, I wouldn’t ignore it.

My sister got this letter years ago, was totally in denial, got very upset... then calmed down and realised my nieces diet was all beige foods and high sugar fruit and snacks. More veg, less snacks and an increase in variety fixed it quickly.

Sounds like it won't take much to get her back on track.

Wrong!

BMI takes into account weight AND height. Which essentially means even compared to other very tall children, she is overweight.

My DD followed the approximate 90%s for height and weight and her BMI was normal. Also a very tall father.

4stone at almost 5! My 11 year olds are 5 stone and 145cm tall and the other is 4st 10 and 140cm (she’s petite but the other has a little belly and eats too many sweets if I’m honest.

I think you need to be realistic and consider the choices around what she’s eating and how much.

She is a stone heavier than my 7 year old boy...
He is slim but that still seems a significant difference.

Use it as a rough guide although don't rely on it.

It's a half decent indicator but everyone is different. For example - I had pancreatic cancer 5 years ago and was absolutely tiny at 5ft 7 and still read as overweight which I absolutely was not. My nurse at the time was begging me to eat more and bulking me out with ensure - it's not always right.

I think by looking at someone you can tell if they are overweight or not, it's largely common sense and no two builds are the same.

Guilt is useless!

All this does is alerts you to some parenting needs. No diets whatever you do. More exercise, more protein and fats, fewer carbs and just keep an eye. Gently does it!