Just been told your kid's BMI is too high? Here's why it doesn't matter

My bestie messaged me, outraged about a parent she knew who was told their "kid is too fat" at their B4 school check.

Since then I've seen many posts from aggrieved parents, in various groups, with similar experiences.

So I thought I'd say something on here about it.

The government makes health targets for our population. These targets are over arching health goals, that DHB's, GP's and other health agencies become responsible and accountable for fixing.

For example, faster cancer treatments and higher vaccination rates are two current government health targets.

Raising Healthy kids is another. And part of that program is the B4 School check.

Kids can be many sizes and be healthy. This is an example of a kid in the bottom percentiles and a kid in the top.

The B4 School check is a great, easily accessible and free way our kids can have a general health check. They can pick up learning difficulties, kids having trouble with speech or hearing etc

The B4 School check picked up that my kid needed glasses. I was then able to access funding for glasses and voila! Problem solved!

So the B4 check is a great resource.

But....

It's not perfect and the way they are told to approach parents of children who are in the 91 to 99% for weight is very problematic.

1. BMI in kids is terrible. It's even more terrible than BMI for adults. The only time BMI is useful is when your dietitian or pediatrician are following a growth pattern because it can show changes in weight to height, quite easily, which can be missed using growth charts alone. But for that you need many measurements and it's the pattern of those measurements on the graph that's helpful. Not the BMI itself.

2. We know that kids can grow normally anywhere from the 1st to the 100th % on their growth charts. What is important is the pattern. We want kids to grow predictably for them. Again we need a bunch of measures. One dot on that graph is not helpful and tells us nothing.

3. It is harmful telling kids they are too fat! *insert rant here - but I'm finger typing on my phone and it's hard! So PM me and I'll hook you up with blogs and previous rants on this subject*

4. It's not helpful for the parents either! Plunket nurses and GP's who do this assessment can't take a food and nutrition history and educate parents on appropriate feeding techniques. There's also next to no funding for dietitians in this space. So parents have no access to the resources they need to be able to make safe changes (if any are even needed)

5. Weight is not a great measure of health. There's such a thing as size diversity, genetics and kids are meant to grow. That number on the scale is given way to much importance.

6. We know that as a population we've gotten bigger (over generations). This is not an individual problem. When talking about our health and nutrition, we must consider the cost of food, poverty, the high living costs, low wages, people's access to healthy foods, food availability, how active or sedentary our jobs are, our access to safe spaces to exercise, what forms of transport we use etc etc! These things are not something that can be solved by finger pointing parents who's kids are on the 91st to the 99th % and tell them to fix it!🤯🤬

So

When going to the B4 school check, GP, dietitian or whoever's tell them you do not want to discuss your child's weight in front of them.

If they insist ask why. Ask for the evidence that weight and discussing weight is helpful, especially children. Ask them what resources they have that will help you improve nutrition. Ask about their nutrition training.