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

Anonymous
Dealing with anorexia in my 17 year old DD that has required residential treatment and lots and lots of ongoing therapy.

It was prompted initially by something like this.

For some kids, it may not cause any harm. But for the ones it harms - it's absolutely disastrous. and really hard to come back from. It's thrown our whole family into a state of crisis for 2 years and counting. It affects every aspect of our life negatively.

No one who would look at her now would consider her anorexic because she's been weight restored, and weight restored means she has to maintain her weight a little on the heavier side in order to let her body make up for all the lost growth. Not only does she get invalidated for even being anorexic and having every single meal be a tough battle ("but you don't LOOK anorexic") but she also would be considered overweight by so many of the posters here. It's an f-ing nightmare to battle mentally for her.

BMI has never been a good measure for any member of our family - like some other PPs have stated - we've always been more "dense" than others - our clothing size/measurements don't match up to the number on the scale the way it seems to for other people. Fine - judge away - you all simply live in a different world than we do.

OP - I would absolutely not go to this DR again, let them know why, and prep the next one that if weight is going to be brought up it needs to be done way more skillfully.
Anonymous
Anonymous wrote:BMI should not be used. They need better tools.


“The guidelines emphasize "treating the whole child," rather than fixating on a number on a scale, Dr. Sheethal Reddy, a clinical psychologist who specializes in obesity medicine at the Emory Bariatric Center, told Live Science. "The goal here is not to get kids skinny — it's not to have them fit into a certain size pair of pants," said Reddy, who until recently worked with children and teens at a pediatric obesity clinic.

In practice, that means taking a child's and their family's medical history, vital signs and labs, nutrition and physical activity habits, mental health and social circumstances into account, rather than checking only their body mass index (BMI) — an estimate of body fat calculated using weight and height.

That said, BMI still factors into a child's evaluation, although the measure has been widely criticized as an imprecise measure of fat and poor indicator of overall health. More-precise methods of measuring body fat are more cost- and time-intensive, and thus not regularly used in clinics or in research.

"Even though it's flawed, it's still a useful tool," Reddy said. "I sort of think of BMI as kind of the yellow traffic light" — a signal to slow down and see what else is going on with a child's health.

"The higher the percentile, the more likely it is that a child is carrying excess adiposity," meaning fat, said Dr. Sarah Hampl, chair of the AAP's Clinical Practice Guideline Subcommittee on Obesity and a lead author of the guidelines. "Overweight" is defined as a BMI at or above the 85th percentile and below the 95th percentile for children of the same age and sex, and "obesity" is defined as a BMI at or above the 95th percentile. These categories are reflected in the Centers for Disease Control and Prevention's new extended BMI growth charts for kids and teens.

"And yet it's still only one of several measures we look at in terms of determining the child's health," and whether or not their weight is negatively affecting them, Hampl said.“

-LifeScience
Anonymous
Overweight is not a judgment poster has it right. Your daughter, like every girl and woman, is going to face a lifetime of comments and scrutiny on her body, regardless of the number on the scale. I might have wanted to smack the doctor too, but one of the best going-forward steps is to teach your body to evaluate medical data points (of which weight is one) as neutrally and objectively as she can, rather than becoming defensive, emotional, or interpreting it as any type of judgment at all. It's a data point, nothing more and nothing less. Don't give it any more "weight" than it needs.
Anonymous
Anonymous wrote:
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.


NP. My 14 year old is probably around 150 lbs but she’s 5’11”. Not overweight.

I haven’t read this whole thread, but I topped out around 165 lbs in my teen years (5’9”) and will never, ever forget a male x-ray technician telling me that I looked too heavy to be a runner when I was getting a scan for stress fractures. Those comments will stay with you for the rest of your life. I’m in my mid-40s now, a longtime runner and 130 lbs, and I still think about that a-hole every now and then.
Anonymous
Anonymous wrote:The doctor wouldn't be doing their job if she ignored that your child is over weight. Being 5.25 height and 151 lbs is significant for a 13 year old girl. Trying to find a doctor that spares YOUR feelings is not going to help your daughter.


65.25 inches

Keep up you twit
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:"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



Well BMI is not for athletes or those with real amount of muscle and the judgement that comes from hearing overweight as a teenage girl are life-altering. So stop using flawed metrics and then making judgements and treatment. Refer for a DEXA if you are really that concerned.


BMI is for athletes. It just doesn't mean what you think it means.


Okay well when one person has a BMI of 25 and is 5'5 at 150 with 120 lbs of muscle (20% BF active, etc) bvs 90lbs of muscle (40% bf) there is a difference. And yet that number (BMI) is somehow used as reasoning for X,Y, Z.


A 13 year old is different than a person who is in their 20s or 40s. A 13 year old's weight will likely only go up. OP's DD is already disadvantaged.
Anonymous
Anonymous wrote:Dealing with anorexia in my 17 year old DD that has required residential treatment and lots and lots of ongoing therapy.

It was prompted initially by something like this.

For some kids, it may not cause any harm. But for the ones it harms - it's absolutely disastrous. and really hard to come back from. It's thrown our whole family into a state of crisis for 2 years and counting. It affects every aspect of our life negatively.

No one who would look at her now would consider her anorexic because she's been weight restored, and weight restored means she has to maintain her weight a little on the heavier side in order to let her body make up for all the lost growth. Not only does she get invalidated for even being anorexic and having every single meal be a tough battle ("but you don't LOOK anorexic") but she also would be considered overweight by so many of the posters here. It's an f-ing nightmare to battle mentally for her.

BMI has never been a good measure for any member of our family - like some other PPs have stated - we've always been more "dense" than others - our clothing size/measurements don't match up to the number on the scale the way it seems to for other people. Fine - judge away - you all simply live in a different world than we do.

OP - I would absolutely not go to this DR again, let them know why, and prep the next one that if weight is going to be brought up it needs to be done way more skillfully.


+100. This also sparked my DD's bulimia. We do not allow her to be weighed at the doc anymore but I agree, it's harmful.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:"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



Well BMI is not for athletes or those with real amount of muscle and the judgement that comes from hearing overweight as a teenage girl are life-altering. So stop using flawed metrics and then making judgements and treatment. Refer for a DEXA if you are really that concerned.


BMI is for athletes. It just doesn't mean what you think it means.


Okay well when one person has a BMI of 25 and is 5'5 at 150 with 120 lbs of muscle (20% BF active, etc) bvs 90lbs of muscle (40% bf) there is a difference. And yet that number (BMI) is somehow used as reasoning for X,Y, Z.


A 13 year old is different than a person who is in their 20s or 40s. A 13 year old's weight will likely only go up. OP's DD is already disadvantaged.


So will her height
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.


yes it's normal. based on height and weight she is overweight.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:"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



Well BMI is not for athletes or those with real amount of muscle and the judgement that comes from hearing overweight as a teenage girl are life-altering. So stop using flawed metrics and then making judgements and treatment. Refer for a DEXA if you are really that concerned.


BMI is for athletes. It just doesn't mean what you think it means.


Okay well when one person has a BMI of 25 and is 5'5 at 150 with 120 lbs of muscle (20% BF active, etc) bvs 90lbs of muscle (40% bf) there is a difference. And yet that number (BMI) is somehow used as reasoning for X,Y, Z.


A 13 year old is different than a person who is in their 20s or 40s. A 13 year old's weight will likely only go up. OP's DD is already disadvantaged.


So will her height


Anything is possible - but she's probably at or near her adult height already.
Anonymous
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:
Anonymous wrote:"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



Well BMI is not for athletes or those with real amount of muscle and the judgement that comes from hearing overweight as a teenage girl are life-altering. So stop using flawed metrics and then making judgements and treatment. Refer for a DEXA if you are really that concerned.


BMI is for athletes. It just doesn't mean what you think it means.


Okay well when one person has a BMI of 25 and is 5'5 at 150 with 120 lbs of muscle (20% BF active, etc) bvs 90lbs of muscle (40% bf) there is a difference. And yet that number (BMI) is somehow used as reasoning for X,Y, Z.


A 13 year old is different than a person who is in their 20s or 40s. A 13 year old's weight will likely only go up. OP's DD is already disadvantaged.


So will her height

Not if she's already started her period.
Anonymous
Would you prefer your doctor not inform you and your daughter about health issues? She’s overweight and it’s better to address it now. You’re not doing her any favors by ignoring this.
Anonymous
Anonymous wrote:
Anonymous wrote:Dealing with anorexia in my 17 year old DD that has required residential treatment and lots and lots of ongoing therapy.

It was prompted initially by something like this.

For some kids, it may not cause any harm. But for the ones it harms - it's absolutely disastrous. and really hard to come back from. It's thrown our whole family into a state of crisis for 2 years and counting. It affects every aspect of our life negatively.

No one who would look at her now would consider her anorexic because she's been weight restored, and weight restored means she has to maintain her weight a little on the heavier side in order to let her body make up for all the lost growth. Not only does she get invalidated for even being anorexic and having every single meal be a tough battle ("but you don't LOOK anorexic") but she also would be considered overweight by so many of the posters here. It's an f-ing nightmare to battle mentally for her.

BMI has never been a good measure for any member of our family - like some other PPs have stated - we've always been more "dense" than others - our clothing size/measurements don't match up to the number on the scale the way it seems to for other people. Fine - judge away - you all simply live in a different world than we do.

OP - I would absolutely not go to this DR again, let them know why, and prep the next one that if weight is going to be brought up it needs to be done way more skillfully.


+100. This also sparked my DD's bulimia. We do not allow her to be weighed at the doc anymore but I agree, it's harmful.


your crazy. It's a fact that she's overweight. Take the rest in your hands and teach them about eating correctly.
Anonymous
Anonymous wrote:
Anonymous wrote:"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



Well BMI is not for athletes or those with real amount of muscle and the judgement that comes from hearing overweight as a teenage girl are life-altering. So stop using flawed metrics and then making judgements and treatment. Refer for a DEXA if you are really that concerned.


Even Olympic athletes with overweight BMIs (not obese, but specifically overweight) have been shown to track differently in health outcomes. This is for Japan, but there are other studies as well.

Mortality of Japanese Olympic athletes in 1964 Tokyo Olympic Games
https://pubmed.ncbi.nlm.nih.gov/33520254/

Japanese athletes in the 1964 Tokyo Olympic Games lived longer than the Japanese population. BMI≥25 kg/m2 was associated with higher mortality, but smoking history and handgrip strength were not associated with mortality.


That doesn't mean these athletes with a BMI >25 were not healthier than the general population. They were. It also doesn't mean they shouldn't have been doing the training they were doing, or that they were bad people, or that "ew, yuck, their bodies are gross," or that they made poor food choices, or that they were not active, or any of the other things you might mean by the word "overweight." That word just means you fall into a certain category of BMI range, and it may or may not be associated with different outcomes.

It's a useful general screen to see if it might be helpful to spend more attention in this area. That attention might be a pediatrician saying, "you know, I can tell you are really strong and healthy. I'm glad you are so active playing sports you enjoy. You might notice that your body type puts you into what is called the 'overweight' category, but I am not worried about that because [XYZ]." Or something like that.

If you don't think a lot of teenagers know what a BMI is and how to calculate it, you have not been paying attention to teenagers. For some, bringing this up and talking about it is a way of heading off disorders, not causing them. Like everything else with kids, it has to be done with sensitivity and thoughtful caring.
Anonymous
Anonymous wrote:She is overweight, sorry. If she doesn't address this now, she will have life long issues.

If you mean 5'2 1/2 (5.25 is an odd measurement) then she's in the overweight category for BMI. I can tell you're defensive by bringing up her clothes/shoes. Thats a pound or 2.


At last annual visit, clothes, shoes and coat added 8 lbs. I weighed myself on a very reliable scale just before the visit…and the added weight put me into the overweight BMI.
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