13yr old's pediatrician just told her she is overweight and I am pissed

[Anonymous]

Because something like this needs to be handled sensitively if you don’t want to shatter a 13 year old’s self esteem, I would hope pediatricians would have a conversation with the parent first. OP is upset because she didn’t know this was coming and it felt to her like the pediatrician just blurted it out. Before telling a 13 year old girl that she’s overweight, shouldn’t the pediatrician ask the parent whether the daughter generally has a positive or neutral body image or is very critical of her own appearance? Is she a perfectionist? Has she gotten comments on her weight? As a parent, have you already had a conversation about her weight?

It’s okay for the doctor to disclose the BMI to the child and mention the typical BMI range for girls her age, while explaining that if your BMI is kind of high, you want it to be from higher muscle mass than average, and not from fat. Then she should praise the girl for being so physically active and building muscle. You don’t have to hit her over the head with the message. She’ll figure it out herself without feeling like anyone is being critical of her.

My dd’s best friend saw a specialist when she was 11 for some unrelated issue, and the doctor told her she was getting fat. The doctor actually used the word “fat.” This was a slightly pudgy girl who hadn’t had her big puberty growth spurt yet. She immediately began really limiting what she would eat and soon became very skinny (she’s a swimmer). Then Covid hit and she developed a full blown eating disorder that required treatment. She was never self conscious about her weight until the doctor called her fat. I’m not comparing what OP’s pediatrician said to calling a girl fat — obviously OP’s doctor did a better job — but I just think that doctors should always be sensitive when breaking it to a patient for the first time that they’re overweight, and if the patient fits the demographic most likely to develop an eating disorder, it’s especially crucial for the doctor to know whether the subject is already an emotional land mine.

[Anonymous]

A pediatrician called my DS overweight at a doctor's appointment once. He was maybe 9 at the time. He's 11 now.

It was a crazy thing to say. He's not overweight and has never been overweight. Not even a little. She was looking at the BMI. I asked her to stop looking down and actually look at HIM. He's a swimmer and has muscle and no fat.

She amended that the BMI isn't always accurate. Shrug.

[Anonymous]

I am Team OP (and Team OP's daughter).

She sounds solid, not heavy, and she's participating in sports that build muscle and reward stronger body types. I would be angry with the doctor and I would let him know.

[Anonymous]

Anonymous wrote:Because something like this needs to be handled sensitively if you don’t want to shatter a 13 year old’s self esteem, I would hope pediatricians would have a conversation with the parent first. OP is upset because she didn’t know this was coming and it felt to her like the pediatrician just blurted it out. Before telling a 13 year old girl that she’s overweight, shouldn’t the pediatrician ask the parent whether the daughter generally has a positive or neutral body image or is very critical of her own appearance? Is she a perfectionist? Has she gotten comments on her weight? As a parent, have you already had a conversation about her weight?

It’s okay for the doctor to disclose the BMI to the child and mention the typical BMI range for girls her age, while explaining that if your BMI is kind of high, you want it to be from higher muscle mass than average, and not from fat. Then she should praise the girl for being so physically active and building muscle. You don’t have to hit her over the head with the message. She’ll figure it out herself without feeling like anyone is being critical of her.

My dd’s best friend saw a specialist when she was 11 for some unrelated issue, and the doctor told her she was getting fat. The doctor actually used the word “fat.” This was a slightly pudgy girl who hadn’t had her big puberty growth spurt yet. She immediately began really limiting what she would eat and soon became very skinny (she’s a swimmer). Then Covid hit and she developed a full blown eating disorder that required treatment. She was never self conscious about her weight until the doctor called her fat. I’m not comparing what OP’s pediatrician said to calling a girl fat — obviously OP’s doctor did a better job — but I just think that doctors should always be sensitive when breaking it to a patient for the first time that they’re overweight, and if the patient fits the demographic most likely to develop an eating disorder, it’s especially crucial for the doctor to know whether the subject is already an emotional land mine.

Sure, in a perfect world, but no pediatrician has that much time. You expect her to take the parent into her office and discuss before talking to the child? That's asking too much. I'm glad our pediatrician was proactive by checking BMI and height at every visit and talking about eating healthy

[Anonymous]

Anonymous wrote:OP I am with you.

I personally would move her now to a gyn and new physician.

All bodies are not the same BMI is ridiculous.

Plus 1,000!!!
I am sorry

[Anonymous]

She is overweight.

How many sports (BTW - vollyball is just mainly standing - no cardio) a person does. It's diet, body shape/composition etc.
Sports will not overcome a bad diet. Even in teens.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Because something like this needs to be handled sensitively if you don’t want to shatter a 13 year old’s self esteem, I would hope pediatricians would have a conversation with the parent first. OP is upset because she didn’t know this was coming and it felt to her like the pediatrician just blurted it out. Before telling a 13 year old girl that she’s overweight, shouldn’t the pediatrician ask the parent whether the daughter generally has a positive or neutral body image or is very critical of her own appearance? Is she a perfectionist? Has she gotten comments on her weight? As a parent, have you already had a conversation about her weight?

It’s okay for the doctor to disclose the BMI to the child and mention the typical BMI range for girls her age, while explaining that if your BMI is kind of high, you want it to be from higher muscle mass than average, and not from fat. Then she should praise the girl for being so physically active and building muscle. You don’t have to hit her over the head with the message. She’ll figure it out herself without feeling like anyone is being critical of her.

My dd’s best friend saw a specialist when she was 11 for some unrelated issue, and the doctor told her she was getting fat. The doctor actually used the word “fat.” This was a slightly pudgy girl who hadn’t had her big puberty growth spurt yet. She immediately began really limiting what she would eat and soon became very skinny (she’s a swimmer). Then Covid hit and she developed a full blown eating disorder that required treatment. She was never self conscious about her weight until the doctor called her fat. I’m not comparing what OP’s pediatrician said to calling a girl fat — obviously OP’s doctor did a better job — but I just think that doctors should always be sensitive when breaking it to a patient for the first time that they’re overweight, and if the patient fits the demographic most likely to develop an eating disorder, it’s especially crucial for the doctor to know whether the subject is already an emotional land mine.

Sure, in a perfect world, but no pediatrician has that much time. You expect her to take the parent into her office and discuss before talking to the child? That's asking too much. I'm glad our pediatrician was proactive by checking BMI and height at every visit and talking about eating healthy

At bare minimum, it should be the standard of care for tween and teen girls before *the first time* there’s a conversation with the child about their being overweight, simply because, statistically, they’re the most likely to develop eating disorders. How many times a day do you think doctors are broaching the topic for the first time with a patient?

[Anonymous]

My 13 year old is slightly overweight and I’m GLAD her ped talks to her about it.

You’re letting pride and anger cloud your judgement here, OP.

[Anonymous]

My 14yr. old son is 5'.10", 135lbs.

I'm 5'4". 135 lbs.

He's fit and slim, I wear size 6 but could lose a few pounds to look my best. I cannot imagine being 150lbs and not worrying. I would listen to the doctors!

[Anonymous]

BMI should not be used. They need better tools. If your daughter has a lot of muscle that can make her BMI higher. Instead what the doctor should care about is the whole picture. If your daughter eats healthy-lots of fruits and vegetables, lean protein, healthy carbs and gets great exercise (which she does) then I would not harp on BMI. If anything they should assess muscle mass and body fat (can't special scales do that) and make sure bloodwork looks good and glucose.

I would be more concerned about a teen with a normal BMI who eats a lot of processed food then a teen with a BMI out of "normal range" who eats healthy and exercises.

I think there is a rosk of setting off an eating disorder if they don't do a more complete assessment. The last thing you want is a teen who eats healthy and exercises to start restricting, drinking energy drinks and getting injuries from overdoing the exercise.

[Anonymous]

Anonymous wrote:BMI should not be used. They need better tools. If your daughter has a lot of muscle that can make her BMI higher. Instead what the doctor should care about is the whole picture. If your daughter eats healthy-lots of fruits and vegetables, lean protein, healthy carbs and gets great exercise (which she does) then I would not harp on BMI. If anything they should assess muscle mass and body fat (can't special scales do that) and make sure bloodwork looks good and glucose.

I would be more concerned about a teen with a normal BMI who eats a lot of processed food then a teen with a BMI out of "normal range" who eats healthy and exercises.

I think there is a rosk of setting off an eating disorder if they don't do a more complete assessment. The last thing you want is a teen who eats healthy and exercises to start restricting, drinking energy drinks and getting injuries from overdoing the exercise.

You don't have to look at BMI to see that a 14 year old who weighs 150 lbs is overweight. No matter how athletic she is.

[Anonymous]

IF the pediatrician is using BMI in this manner, it's only a general guideline, and not always right. How it was explained to me by my DD's pediatrician, is that they keep an eye on the height/weight charts. A kid who as been tracking at 25th percentile on the chart for weight, suddenly moving up to the 50th percentile, without a concomitant move in the height chart also, is cause for concern. Just looking at the numbers, a parent might think 'Why is the pediatrician concerned when my child's weight is in the 50th percentile for their age?', but it's less about the absolute numbers, and more about the change in numbers.

This happened to us a few years ago, when DD was 10/11 (Covid year). Although he never said anything about fat/obese, DD understood that what he meant was that she had gained more weight than she should have, and it's something we needed to keep an eye on. She increased her activity level (swimming for an hour a day), and it has not been brought up since. Now, at 13, she looks back at her pictures from then, and asks me why I never told her that she was fat (she was going through puberty, and I knew that her height and weight would even out).

[Anonymous]

Anonymous wrote:At my daughter's well visit and during that time she talked to her about physical activity etc...

My daughter does cross fit in winter, volleyball in Fall, and travel softball year round. She definitely has an athletic body. She wears a size 6 in jeans and a small or medium in shirts/pants. She is 5.25 height and was 151lbs with her clothes and sneakers on.

This pediatrician talked to her about being in the overweight category in the BMI and I almost lost my $hit. My jaw dropped. She looks nothing overweight. She has muscular legs and arms (she is a softball pitcher) and no belly gut. She isn't a twig but man, I was thrown they would talk like this to a girl teen. When we left, I told my daughter to not listen to her and she is strong and beautiful and muscle weights more than fat and not to worry at all. But I know this made her start overthinking. I could see it.

Is this normal? Really thinking of moving doctors.

I mean, Cal Ripken Jr. was obese according to BMI. 🤷‍♀️

http://blog.wannabuddy.com/2012/07/the-tyranny-of-bmi.html

[Anonymous]

Anonymous wrote:At my daughter's well visit and during that time she talked to her about physical activity etc...

My daughter does cross fit in winter, volleyball in Fall, and travel softball year round. She definitely has an athletic body. She wears a size 6 in jeans and a small or medium in shirts/pants. She is 5.25 height and was 151lbs with her clothes and sneakers on.

This pediatrician talked to her about being in the overweight category in the BMI and I almost lost my $hit. My jaw dropped. She looks nothing overweight. She has muscular legs and arms (she is a softball pitcher) and no belly gut. She isn't a twig but man, I was thrown they would talk like this to a girl teen. When we left, I told my daughter to not listen to her and she is strong and beautiful and muscle weights more than fat and not to worry at all. But I know this made her start overthinking. I could see it.

Is this normal? Really thinking of moving doctors.

OP this was me as a HS athlete and your daughter hasn't even gone through real puberty yet. She hasn't reached her adult height either. I was 5'1-5'2 until 17 and then grew another 2 inches to 5'4'' between 17-19.

. It set me up for a lifelong issue and body hating and disordered eating and body image. I was <22% body fat at the EXACT SAME WEIGHT AND HEIGHT that you discuss here. I work bikinis before body positivity movement. I had no cellulite. I could not pinch fat from my stomach.
Your doctor is an idiot.

Also please stop saying muscle weighs more than fat. it doesnt- it is more dense that fat. 5lbs of muscle takes up significantly less space compared to 5lb of fat. That is why someone can weigh more but be the same size.
BMI does not account for athletes- it doesn't.

[Anonymous]

"Overweight" is not a judgment on your child. It's a clearly defined medical diagnosis. That definition is based on BMI.

You can be "overweight" because you are a highly muscular athlete, or because you are carrying extra fat, or even for other reasons. But "overweight" does not necessarily mean unhealthy. If you treat it that way, you are part of the problem.

- American Academy of Pediatrics Issues Its First Comprehensive Guideline on Evaluating, Treating Children and Adolescents With Obesity
- https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-issues-its-first-comprehensive-guideline-on-evaluating-treating-children-and-adolescents-with-obesity