Anonymous wrote:

A note from Satter re: use of BMI for individuals...

"In reading the research, you may have noticed that childhood overweight/obese designations have changed. Now, children whose BMI exceeds the 95th percentile are labeled obese rather than overweight, and those whose BMI exceeds the 85th percentile labeled overweight rather than at risk of overweight. This slippage grew out of a January, 2007 Committee Statement and recommendation and was made official by a recent National Health Statistics report. To its credit, NHS authors temporize about the legitimacy of such designations. Less than half of ''obese'' children (those with BMI ? 95) have a high percentage of body fat. Moreover, the consensus in the literature is that it is difficult to come up with any definition of child overweight or obesity.

The problem arises from the manner in which those terms - and definitions - are used. However the BMI levels are labeled, they are statistical cutoff points established for the purpose of population-wide evaluation. As such, they are not appropriate for diagnosis of individual children. Despite the shortcomings of the definition, that is exactly the way they are used. Little wonder that parents are unwilling to accept and act on a weight-related diagnosis for their child.

To remind you, the Satter Feeding Dynamics Model (fdSatter) says that the issue with weight not high weight per se, but weight acceleration: Abnormal upward weight divergence for the individual child. Such divergence gives a clue to distortions in feeding."

http://ellynsatterinstitute.org/fmf/fmf57.php
http://ellynsatterinstitute.org/htf/theoverweightchild.php

+1 on the bolded points about BMI. BMI is not a diagnostic tool. It is a tool for measuring populations.

Anonymous wrote:You do know they have a conditional chart that gives weight distribution conditional on height? They pull it out if there is a reason to be more precise. It isn't rocket science to tell if a 12 year old needs to lose 15-20.

If a 12 yr old has an actual weight problem (meaning an actual acceleration in weight not a kid who is just larger than average or going through the normal pre-puberty weight gain), the goal should be weight stabilization while s/he grows in height and returns to his/her normal growth curve. Going on a diet to lose 15-20 lbs is not an appropriate prescription for a kid.

You do know they have a conditional chart that gives weight distribution conditional on height? They pull it out if there is a reason to be more precise. It isn't rocket science to tell if a 12 year old needs to lose 15-20.

Anonymous wrote:

ThatSmileyFaceGuy wrote:That calculator is silly. For height it averages the mother and father together. My 9 yo is already 4'11" and 115. Yes he can stand to lose a few pounds and will during wrestling season. But to base his adult height at 5'10" (the average between my 6'4" and the mother 5'4" ) when he is already almost 5 foot at 9 is just ludicrous.

115 for 4'11" is a very heavy kid, no question about it. Not sure which calculator you used, but CDC's calculator says BMI is 23.2 for a boy which falls into the obese category.

104 at that height would be in the overweight category, so about 10% less than where he is now.

Try it here:

http://nccd.cdc.gov/dnpabmi/Calculator.aspx

But BMI is not the be-all, end-all assessment of appropriate weight. I know for myself that my healthiest weight, the weight I've been able to achieve and maintain for a long time with a healthy diet and regular, reasonable exercise puts me in the "overweight" category by BMI. I have been in the "healthy weight" category but to get there I have to pursue very unhealthy or completely unrealistic habits -- extreme dieting, 1 hr+ of daily exercise, high stress/very active job. When the calculator said I was "healthy" I sure didn't feel healthy and when DH saw a picture of me at that stage of life he thought I looked "gaunt". So, I'm happy now to be "overweight" with excellent stats for blood pressure, heart rate, cholesterol levels, etc.

The true measure of whether or not you are at a healthy weight is your eating and exercise habits, deeper measures of health (blood chemistry, BP, etc.), and weight stability. Unstable weight from yo-yo dieting is much worse for your body than maintaining a higher weight with healthy habits. My dr. says my weight is fine because of my other health factors even if some chart says I'm overweight. Overweight is a problem because of the other health issues that go along with it. If those factors are not there and you do not have a high % of body fat then being larger than average is not an issue but fighting your basic genetic makeup is a recipe for misery.

A note from Satter re: use of BMI for individuals...

"In reading the research, you may have noticed that childhood overweight/obese designations have changed. Now, children whose BMI exceeds the 95th percentile are labeled obese rather than overweight, and those whose BMI exceeds the 85th percentile labeled overweight rather than at risk of overweight. This slippage grew out of a January, 2007 Committee Statement and recommendation and was made official by a recent National Health Statistics report. To its credit, NHS authors temporize about the legitimacy of such designations. Less than half of ''obese'' children (those with BMI ? 95) have a high percentage of body fat. Moreover, the consensus in the literature is that it is difficult to come up with any definition of child overweight or obesity.

The problem arises from the manner in which those terms - and definitions - are used. However the BMI levels are labeled, they are statistical cutoff points established for the purpose of population-wide evaluation. As such, they are not appropriate for diagnosis of individual children. Despite the shortcomings of the definition, that is exactly the way they are used. Little wonder that parents are unwilling to accept and act on a weight-related diagnosis for their child.

To remind you, the Satter Feeding Dynamics Model (fdSatter) says that the issue with weight not high weight per se, but weight acceleration: Abnormal upward weight divergence for the individual child. Such divergence gives a clue to distortions in feeding."

http://ellynsatterinstitute.org/fmf/fmf57.php
http://ellynsatterinstitute.org/htf/theoverweightchild.php

Anonymous wrote:

Anonymous wrote:
Everyone should read Ellyn Sattler to try and improve on this front. Everyone.

Any book suggestions for the kids? Or is the Sattler book kids friendly?

Ellyn Satter (not Sattler). Read it yourself and apply as needed. I don't know why you'd want your kids reading about nutrition -- is this coming from you or from them. If it's from you, HUSH. Just . . . hush up.

ThatSmileyFaceGuy wrote:That calculator is silly. For height it averages the mother and father together. My 9 yo is already 4'11" and 115. Yes he can stand to lose a few pounds and will during wrestling season. But to base his adult height at 5'10" (the average between my 6'4" and the mother 5'4" ) when he is already almost 5 foot at 9 is just ludicrous.

115 for 4'11" is a very heavy kid, no question about it. Not sure which calculator you used, but CDC's calculator says BMI is 23.2 for a boy which falls into the obese category.

104 at that height would be in the overweight category, so about 10% less than where he is now.

Try it here:

http://nccd.cdc.gov/dnpabmi/Calculator.aspx

Anonymous wrote:

Anonymous wrote:

+1

I was a late grower & , until I hit a growth spurt at 13-14, was always in the 3rd percentile for weight.I was also, however, in the 3rd percentile for height so I was never too skinny, just really short,yet this chart would have labelled me as dangerously underweight! Meanwhile, had I weighed what the average girl my age weighed, given how much shorter I was than the average girl my age, I would have been overweight, yet this chart would have labelled my weight as being in the healthy range.This makes zero sense!

I'm currently 5'4". Should I weigh the same as a healthy woman my age who is 5'11" or one who is 4'10"? Of course not! Then why should a boy who is several inches taller than most of his peers weigh the same as they do? He shouldn't!

He shouldn't weigh the same as a kid several inches shorter. But he also shouldn't weigh 100 lbs. What do you think a normal 4'8" 10-year-old weighs?