Letter received from NHS about my "clinicially obese" child....

[CantThinkofFunnyName]

I'm rather flummoxed. I have today received a letter from NHS Change 4 Life setting out details of the measurement programme they have been conducting and how my 10 yr old DS is considered "very overweight/clinically obese". There follows a bunch of suggetions about exercise, eating healthily etc.

My first reaction was complete and utter disbelief at the weight they said he was and then I weighed DS and he is that weight. BUT there is not an inch of fat on him! Each week he plays football, rugby, tennis, karate and cycles 2 miles every day. He is a fitness fanatic. He eats heathily with the odd treat/snack, but does tend to be constantly hungry.

He is 4ft 11 inch and 7 st 10lbs which puts him on the 99th centile, qualifying him to be "clinically obese".

I really don't know anything much about this, but I do know my DS and simply cannot believe this. Athletic and muscly (even at 10) yes - but fat? It's almost laughable.

Anyone else had similar situations and what did you do?

BMI for children alters with age rather than being fixed at rather arbitary, values for underweight, ok, overweight, obese etc as it is for adults. So instead of saying a specific value of BMI=obese a percentile value is used.

In general pre-pubertal school age children won't have significant muscle bulk though that might not be the case for an individual child.

Ideally, imo, they should be measuring body fat % at the same time as doing BMI or doing some other measurement of fat stores such as mid-arm circumference etc.

I would ignore the letter but I wouldn't complain TBH

Morningpaper - thanks for that, you're probably right. Will "file it"

Cantthink, I'm interested to know what you want to complain about?

x posts

Yes quite!
I'm with mp, don't call them, just bin it and when they call tell them that they are being ridiculous.

LaDiDaDi - I probably won't complain, but the letter received has made me worry unnecessarily and is wrong. My DS cannot possibly be classed as clinically obese as the letter states and also that "the Trust will need to follow up on his obesity to discuss the results with me and work with the family to encourage him to take part in exercise and a more healthy eating programme."

It is really the tone and nature of the letter that is the problem. As has been rightly highlighted in this thread, each child is individual and I would rather that these aspects are looked at, accounted for at the time of measurement - or afterwards, but before sending such a worded letter.

It's a bog standard computer generated letter. The school health team will have done the measurements at school as part of the NCMP in Year 6 and inputted the results, and a standard letter will have been sent because he is technically obese, having a BMI on the 99th centile. Unfortunately height/weight BMI, whilst being a useful starting point for further investigation, is in isolation not a complete tool.

This DoH programme makes little allowance for natural variation and relies on the school nurses contacting the parents to further enquire as to the child's health. The school nurse is unlikely to have even seen your son, she will have just been given a pile of letters to follow up I imagine.

If you are contacted by the nurse I am sure if you explain what you have written here she will have no concerns. Don't blame the school health department for the wording of the letters, they are drafted and amended by the PCT. In our PCT despite being told that the wording was outrageously blunt and could be misinterpreted they still proceeded with the orginal format.

(Can you tell I'm not a fan of the NCMP programme? )

"the problem with these things is that health visitors etc don't understand statistics. they want everyone to be on the 50th centile when of course the whole point of these charts is that there is a wide range."

That is not the case with these letters. There is huge range that is considered normal. It's about 3 stone for my daughter's height and I think the child's BMI has to be on the 93rd centile before he or she is considered overweight and something like the 98th for obese.

MP- they use BMI centiles with children because it is more accurate than the height/weight charts- not sure why exactly but that's what the dietician told me when we had to take dd1. DD1 is the opposite- tiny and I was worried because her weight was on the 0.2nd centile. Her BMI is 17 which is apparently just above the 0.2centile for 3yo so she is not 'underweight'

Surely you can look at most children and commmon sense will tell you that they are basically a healthy weight whatever end of the spectrum they all. Or conversely, you can tell if I child is actually 'clinically obese' by looking at them. Or am I wrong?

I always opt out of this programme, am so glad I did now. A 10 year old boy in DDs class was crying in the class a couple of years back as he thought he would 'be fat' when it was his turn to be weighed. My DD came home with the letter and got straight on the scales!!!

what is NON clinicallly obese I always wonder.

he is SEVEN STONE?> at the age of 10

that is huge

He is very handsome its a load of crap where real people aren't making a decision but a table of stats is!

He certainly doesn't look obese (unless there is a bit of a tummy there unseen?).

I'm amazed by the variations in weight though. My 10 y-o is very nearly that height and very muscular and weighs only 5 stone.

My 14 y-o, very very muscular bcs post-puberty is 5 foot 5 and only 2 lb more than your 10 y-o.

Sorry, but he does look a bit chunky. Sorry. He might be muscly but it is hard to see with the photos. Most 10 yr olds are not mature enough to be properly muscly.

My Ds1 (nearly 9 yrs) is 4ft9in but weighs just over 5 stone.

One good indication of whether your child is overweight is the clothes you are buying for him. If you have to buy a size or 2 up to fit round the waist then it does indicate a problem.

NHS Healthy Weight Calculator

No way from the photos is your lovely son clinically obese.

eejits.

am slightly at the couple of posters saying that your ds looks 'chunky'

I (and several others) don't think he looks at all chunky. He looks like a tall boy with muscular arms and legs! His face is not the least bit chubby in the holiday pic with his sis.

I think children should actually look thin though and we're used to seeing the average child looking bigger than is "ideal"

I think it's hard to judge on those photos as it's not a close up. He does not look obese. He looks "solid" to me I suppose I would monitor his height and weight he could well be about to have a height growth spurt which would then drop his BMI centile down.

I do think they should be looking at the fat measurement thingy!

That first sentence is certainly true cargirl. I am always amazed by all the flab and roly-poly tummies on boys at the swimming pool. Lots of mums seem to expect this as normal. One friend of mine used to anxiously force food on her normal-weight younger son becaue he wasn't flabby like his brother.

InterruptingKid - no, he's not 7 stone at age 10, he's 7st 10 - even heavier! My first thought was that it must be a mistake as I thought it sounded huge too. But no, he really is that weight and Deadworm - no, no flabby tummy lurking underneath! But I agree, there is a huge variation in weight.

My DS has always been "solid" since birth. When he started school in Reception, I had to buy shirts several sizes too big everywhere else for him to accommodate his collar size. I still have that problem. He takes an age 14 collar - but it hangs on his arms, chest, belly etc.

With regards to comments about what size clothes he takes, I buy approx 2 ages up for length, not waist. With DD for example, she is in her correct age clothes for height, but I can only buy clothes with adjustable waists as she would take about 2 sizes down on the waist!

FWIW - he takes a size 8 shoe and his biological father is 6'4. Methinks there is a lot more growing to do!

He may be like my dh and gain height rapidly and stop growing at 14, my dh though was overweight at that age.

I'm only an inch or so taller than your son and I'm about half a stone heavier and I need to lose a few pounds in weight.

I wonder if he's going through puberty early or it's just his large frame?

My eldest dd has a much bigger frame than me, nos 2 and 4 have petite ones like me but at least they are going to be very tall with it!

can you opt out of these things?

i think i would send a letter telling them i no longer require their help or advice.

Don't give it a thought Cantthinkoffunnyname. I have looked at your DS's photo too and he looks totally in proportion height and weight wise.

My own DS is tall and heavy for his age but again, is completely in proportion. He was a scrap of a thing at birth but then grew like a weed and was always on the 90th centile for height and weight.

He is very solid and heavy set like his father and a lot of people on that side of his family are too. He is what he is ad it's down to his genes. He's also healthy and active and eats a healthy diet but actually eats a lot less than some friends and family's kids of the same age.

Some children are like skinned rabbits too - they eat and eat but just don't gain weight. My DS has a one very skinny friend who is a very picky eater and will only entertain eating junk. His diet is poor but because he is skinny and stays skinny his mother doesn't get any grief about it.

Your DS is healthy and very active by the sounds of it and has a very helathy diet and lifestyle too.

Don't worry about it at all. As someone else pointed out, some of Britain's finest atheletes would be clinically obese on the basis of these calculations.

Size 8 shoes

Yes, don't give the letter a second thought. It is daft. Sidge's post is really instructive.