Who has a skinny kid with an above-average BMI?

[SKL]

I might be crazy. Must be. Because when I look at my kid when she's dressing, she looks skinny to me. Gaunt, even. She's 6.5 and size 3 shorts just started to be snug on her. She still wears the same undies I bought her when she was potty training at age 1.5. Yet the last 2 times she went to the doc, her BMI was supposedly above average and they gave me literature on managing her diet and exercise.

 

She's very strong and active, so I guess some of it is muscle. She's also short, if that matters.

 

I wonder if I should be trying to get her to eat more . . . or less . . . or maybe I'm just crazy.

 

Anyone else?

[Crimson Wife]

Here is a good article from Baylor College of Medicine discussing problems with using BMI to determine obesity in kids. I would ask your doctor about measuring bodyfat percentage to see whether that is within the normal range.

[Arcadia]

You might want to re-calculate her BMI again just in case the doctor's office accidentally used the adult formula.

 

CDC BMI Percentile Calculator for Child and Teen

CDC information page on BMI for children and teens

[SKL]

You might want to re-calculate her BMI again just in case the doctor's office accidentally used the adult formula.

 

CDC BMI Percentile Calculator for Child and Teen

CDC information page on BMI for children and teens

 

I did recalculate it using internet BMI calculators, and they said the same.

[Ottakee]

My son is a lot older but he is 25 and 5'4" and about 150-160 pounds. He borders on the BMI scale between overweight and obese------but needs a belt for 30 inch waist pants. he is solid muscle and NO fat.

[SKL]

Here is a good article from Baylor College of Medicine discussing problems with using BMI to determine obesity in kids. I would ask your doctor about measuring bodyfat percentage to see whether that is within the normal range.

 

 

Hm, my daughter is biologically Asian (indigenous Central American to be specific). I wonder if that makes any difference.

[zimom]

OP, I just used the BMI calculator Arcadia posted. My youngest daughter is 9 y.o., according to the chart she is overweight. She would not be described as 'skinny', those that know her also know she is not 'fat'. She is solid muscle, broad shoulders and chest. She also is Asian, BTW. Swims 5-6 days a week, participates in triathlons and more. There are more to these calculators obviously. I think you have to look at the whole picture.

[MicheleinMN]

 

Hm, my daughter is biologically Asian (indigenous Central American to be specific). I wonder if that makes any difference.

 

 

Yes, it does make a difference. And my most fit child has a BMI that says he's overweight. He's not. It's wrong. It does not take into account if you are shorter with a larger muscle mass.

 

Rant over.

[HelenNotOfTroy]

My son has a high BMI. He has always had a high weight for his height due to the way he is built and his current height to weight ratio would be considered normal or underweight if he were older.

[Arcadia]

 

Hm, my daughter is biologically Asian (indigenous Central American to be specific). I wonder if that makes any difference.

 

 

 

http://depts.washington.edu/bonebio/bonAbout/race.html

http://www.ncbi.nlm.nih.gov/pubmed/10375058

it does make a difference.

[BrookValley.]

I think the BMI is a bunch of crap. I understand the need for arbitrary measurements, but seriously...it can't possibly measure all aspects of a person's weight and conclusively determine if one is healthy or not. I may be bitter because I was told I was near morbidly obese and should only gain 11 pounds with this pregnancy...never mind that I easily ran 5-6 miles several times per week and could wrestle an elephant to the ground with my thighs alone. Sorry, but I'm not obese. I'm a monster with a lot of muscle! So I can only imagine how inaccurate the BMI must be for children. Sounds like your kiddo is healthy. Actually, from the little you've described, I'd be inclined to say she needs more calories--especially from fat!

[J-rap]

When I first read your post I thought you meant she was 6 feet 5 inches tall!

[SKL]

When I first read your post I thought you meant she was 6 feet 5 inches tall!

 

Wow! LOL. Last I checked she was the height of an average 5.0yo girl. She's been growing lately!

[Crafty Mathy Mom]

My youngest is slightly overweight according to the charts. Doctor looked at the results and said they were stupid but had to be reported.

[Mommy22alyns]

I looked up my 7 year old's BMI and it says he is very underweight. The doctor said he is fine, he is growing and gaining weight from visit to visit. He jumps and runs, and shows no signs of any sort of problem. So what the heck.

 

 

Rebecca's comes out as underweight too. She's solid muscle and stronger than the rest of us put together!

[misty.warden]

Our ped specifically told me he doesn't use BMI because he doesn't think it's accurate for kids.

 

 

BMI isn't accurate for anyone, it doesn't take into account body composition. If a doctor insinuated to me that a 6 year old wearing a size 3 in children's clothes needed a diet I'd tell him the number of a good optometrist.

[Jennifer in MI]

My 16 yo!!! He is overweight according to the chart. He's 6'2" and 195. He's pure muscle. He rows and works out with his team twice a day. He has a six pack! When I entered his measurements, I was told to contact his doctor!! :)

[ocelotmom]

 

BMI isn't accurate for anyone, it doesn't take into account body composition. If a doctor insinuated to me that a 6 year old wearing a size 3 in children's clothes needed a diet I'd tell him the number of a good optometrist.

That was my thought, too. I'd be looking for a new doctor if I felt my doctor was looking at the numbers and not the person.

 

(I'll give the OP's doctor the benefit of the doubt and assume the literature was given by the MA or whoever did the weighing and measuring prior to actually being seen.)

[Murmer]

My 5 year old is considered overweight...she is 95% for height but 96% for weight....she is all muscle without an ounce of fat. Thankfully haven't received the diet info but have received the exclamation mark after every appoint listed next to her weight. I think it is ridiculous the way they pigeon whole children so young.

[jhschool]

My son had a high BMI when he was 10.

The stupid doctor gave a lecture that it was too high, blah blah blah.

But the stupid doctor had said NOTHING the whole time he had been

checking everything else out...because DC was not fat *at*all*.

He was wide but there was no fat on his body.

After the guy plotted the weight and height (both off the charts), the

guy said the BMI was too high.

But I showed the guy: look, DC has no fat on his body. He still shook his head at

me and said his piece about the big tragedy of our time is the nutrition

tragedy.

 

Well, we don't have that doctor any more. The current one doesn't annoy us.

 

Now DC's BMI is 21.3 which is in the "Normal." But we didn't change diet

or exercise (DC's diet is pretty good and so is his exercise). He's just always,

thank God, been healthy.

 

I wouldn't put too much importance on the BMI for a healthy child who has a good

diet and plenty of exercise.

 

(It reminds me of my first pediatrician who saw my exclusively 4 month old b'fed baby (off the

charts in length and weight) and said "a baby this big should not be b'feeding every

4 hours," when she found out I nursed on demand. I just stared at her. What did she

expect? I wasn't going to feed the baby so that it would shrink? That I would let it go

hungry because it was genetically big? DH is very tall, so is FIL, so it's not like

the baby got big by overfeeding. It wasn't fat--it was a big baby.

Anyway, just follow your instincts. Genetics play a big role too. If you or your DH are

tall and big-boned, your kids will be tall and big-boned. )

 

(This also reminds me: One of my friends, who is about

4ft 6 in, whose husband is about the same height, had a tiny cute healthy toddler, who of

course was way under the charts in length and weight. The pediatrician told her to feed

it doughnuts so it would gain quicker.)

 

We can't all be the same proportions. Forget the BMI.

[Unicorn.]

My youngest is slightly overweight according to the charts. Doctor looked at the results and said they were stupid but had to be reported.

 

Reported to whom?

 

As for BMI- it's all a load of hooey! That is all.

[ZeeMommy]

We can't all be the same proportions. Forget the BMI.

 

"BMI is particularly inaccurate for people who are fit or athletic, as the higher muscle mass tends to put them in the overweight category by BMI, even though their body fat percentages frequently fall in the 10–15% category, which is below that of a more sedentary person of average build who has a healthy BMI number. Body composition for athletes is often better calculated using measures of body fat, as determined by such techniques as skinfold measurements or underwater weighing and the limitations of manual measurement have also led to new, alternative methods to measure obesity, such as the body volume index. However, recent studies of American football linemen who undergo intensive weight training to increase their muscle mass show that they frequently suffer many of the same problems as people ordinarily considered obese, notably sleep apnea.^[30][31]

BMI also does not account for body frame size; a person may have a small frame and be carrying more fat than optimal, but their BMI reflects that they are normal. Conversely, a large framed individual may be quite healthy with a fairly low body fat percentage, but be classified as overweight by BMI. Accurate frame size calculators use several measurements (wrist circumference, elbow width, neck circumference and others) to determine what category an individual falls into for a given height. The standard is to use frame size in conjunction with ideal height/weight charts and add roughly 10% for a large frame or subtract roughly 10% for a smaller frame.^{[citation needed]}

For example, a chart may say the ideal weight for a man 5'10" (178 cm) is 165 pounds (75 kg). But if that man has a slender build (small frame), he may be overweight at 165 pounds (75 kg) and should reduce by 10%, to roughly 150 pounds (68 kg). In the reverse, the man with a larger frame and more solid build can be quite healthy at 180 pounds (82 kg). If one teeters on the edge of small/medium or medium/large, a dose of common sense should be used in calculating their ideal weight. However, falling into your ideal weight range for height and build is still not as accurate in determining health risk factors as waist/height ratio and actual body fat percentage." http://en.wikipedia....Body_mass_index

 

Or this website for accurate measurement of body fat: http://www.builtlean...-fat-percentage

 

Hope this helps! :)

[gardenmom5]

they must be doing it to everyone. even when I took dudeling to the child dev center at the medical school for his asd eval, they gave me information on lowering his fat intake - and bluntly told me he was getting too much in his diet. the last time I saw my DO ped, he said the same thing. they were concerned about his bmi

 

gee, skinny jeans need a belt so they don't fall down, or else wear them so they are too short to cover his legs. yeah. sounds like a "fat" kid to me. (not.) It's not the first thing they said that made me roll my eyes at them.

 

he now predominantly sees a ND (and multiple times a year for regular appointments) - and after starting therapy with her, he's gained inches and pounds to where he is now wearing normal sizes. she also tracks his height and weight, she's never told me he's "fat" or to "cut fats". (unlike the every western med guy)

[SKL]

they must be doing it to everyone. even when I took dudeling to the child dev center at the medical school for his asd eval, they gave me information on lowering his fat intake - and bluntly told me he was getting too much in his diet. the last time I saw my DO ped, he said the same thing. they were concerned about his bmi

 

gee, skinny jeans need a belt so they don't fall down, or else wear them so they are too short to cover his legs. yeah. sounds like a "fat" kid to me. (not.) It's not the first thing they said that made me roll my eyes at them.

 

he now predominantly sees a ND (and multiple times a year for regular appointments) - and after starting therapy with her, he's gained inches and pounds to where he is now wearing normal sizes. she also tracks his height and weight, she's never told me he's "fat" or to "cut fats". (unlike the every western med guy)

 

 

I have a cousin who is autistic. As a kid he was solid muscle. Weighed a ton, but he was skinny. You would think someone who studied human biology / physiology for 10+ years would be able to tell whether a kid is fat or muscular. :/

[Arcadia]

My 5 year old is considered overweight...she is 95% for height but 96% for weight....she is all muscle without an ounce of fat. Thankfully haven't received the diet info but have received the exclamation mark after every appoint listed next to her weight. I think it is ridiculous the way they pigeon hole children so young.

 

 

That is weird. My older is also high on the percentile for height and weight. The pediatrician divided the weight percentile by the height percentile and consider it as within normal range.

 

Your daughter's weight over height is 96%/95% which is almost 1. That is not worrying.

[SKL]

To clarify, the docs aren't in my face about her BMI. The fat kid recommendations are included in the post-visit printouts that I assume are automatically generated based on a few bits of data entered.

 

She doesn't look skinny when she's dressed. She has a big rib cage which makes her look almost stocky in a t-shirt. But when you look under the t-shirt, the part under the rib cage is concave.

 

I was noticing her compared to the other girls in her gymnastics class tonight. Her chest is really big around compared to the other slim girls'. Hmm.

[TranquilMind]

I might be crazy. Must be. Because when I look at my kid when she's dressing, she looks skinny to me. Gaunt, even. She's 6.5 and size 3 shorts just started to be snug on her. She still wears the same undies I bought her when she was potty training at age 1.5. Yet the last 2 times she went to the doc, her BMI was supposedly above average and they gave me literature on managing her diet and exercise.

 

She's very strong and active, so I guess some of it is muscle. She's also short, if that matters.

 

I wonder if I should be trying to get her to eat more . . . or less . . . or maybe I'm just crazy.

 

Anyone else?

 

How is this even possible - skinny with above average BMI, unless she is a rod of steel, muscularly?

 

I don't understand. What is her height and weight, unless you'd rather not share? Maybe she is just short for her current size? That will correct itself.

[TranquilMind]

they must be doing it to everyone. even when I took dudeling to the child dev center at the medical school for his asd eval, they gave me information on lowering his fat intake - and bluntly told me he was getting too much in his diet. the last time I saw my DO ped, he said the same thing. they were concerned about his bmi

 

gee, skinny jeans need a belt so they don't fall down, or else wear them so they are too short to cover his legs. yeah. sounds like a "fat" kid to me. (not.) It's not the first thing they said that made me roll my eyes at them.

 

he now predominantly sees a ND (and multiple times a year for regular appointments) - and after starting therapy with her, he's gained inches and pounds to where he is now wearing normal sizes. she also tracks his height and weight, she's never told me he's "fat" or to "cut fats". (unlike the every western med guy)

 

Wow, this must be the new thing they are harassing parents about. It has never happened to me, but my kids are teens now and very thin. My son used to be bulkier though before puberty, but they never said anything at all. He was always 99% for height and at one point maybe 75 for weight.

[TranquilMind]

My 16 yo!!! He is overweight according to the chart. He's 6'2" and 195. He's pure muscle. He rows and works out with his team twice a day. He has a six pack! When I entered his measurements, I was told to contact his doctor!! :)

 

That's ridiculous.

 

Every football player out there must be "overweight", including virtually all the pros.

[TranquilMind]

My youngest is slightly overweight according to the charts. Doctor looked at the results and said they were stupid but had to be reported.

 

Reported??

 

Reported to whom?? Your doctor reports weight of your kid to someone?

 

Yikes. I must live under a rock.

[TranquilMind]

 

I did recalculate it using internet BMI calculators, and they said the same.

 

Oh my goodness.

 

My daughter is healthy as a horse, and never gets sick. She's had an antibiotic maybe twice in her life and is in her mid teens.

 

The calculator says that she is in the 1st percentile for weight and "underweight and should be seen!"

 

Nope. She's the same as she has been her entire life, built like a fashion model with a large bust. Hardly desperately underweight. Lol

 

But my other kid, who is built like a rail is at the 49th percentile.

 

Whatever. They are both the same, just male and female.

[Element]

It has been my experience that BMI charts are pretty much useless for growing children.

 

[TXMomof4]

 

 

That's ridiculous.

 

Every football player out there must be "overweight", including virtually all the pros.

 

 

Yup - those little runningbacks who are 5'8" with 200 lbs of muscle would be fat by bmi standards. Dh is in the army and part of is ptntest is height/weight measurements. When he was lifting weights (on top of daily P90X and Insanity workouts) he had to be taped because his BMI was too high. Never mind that he's never NOT maxed out the pt test. Because, ya know, strong soldiers aren't a good thing. He's dropped serious weight lifting so he's not as bulky. Makes me more than a little angry for him.

[LisaKinVA]

I have 5 children who all eat pretty much the same foods. They are all built differently. My oldest has a BMI that is considered overweight. I'm struggling to find jeans that will fit. Because 16's are flirting with being too short, but require a cinched belt to remain up...and if he tries to cinch a size 18, the belt sits at his waist and his pants balloon out below it (very unflattering at the front). ZERO fat stores on this child. My 11yo dd is "normal." My 9yo boy is considered overweight-flirting with obese. He's a brick. Finally grew out of his size 8's He's average height, but weight is higher. DD6 is closer to underweight (she just passed the 5th percentile -- woo-hoo). DD4 is "normal" -- although she's just petite all over.

 

I'm thankful for my pediatrician and our CNP, both looked at the BMI indicator THEN looked at my kiddos and laughingly told me not to worry about it. My kids were not at any risk of *anything.* BMI is a worthless measurement.

[klmama]

OP, BMI works for some people, but it doesn't take into consideration that muscle weighs more than fat. When my very athletic dd was that age her weight percentile was much higher than her height. The doctor rechecked the measurements twice because they didn't match up with the very skinny dc he saw. Finally, he just said he didn't know where she was hiding it.

[Mom-ninja.]

Well, my ds is very thin (although we've gotten him to gain 10 lbs in 3 months!) and his doctor went off height vs weight vs other development. My ds really did have a weight problem because he hadn't gained weight in over a year and then lost weight. He wasn't even on the chart for % he was so underweight.

 

A good doctor will look at the whole child. My child was clearly sick and something was wrong. I, as his mother, knew this and took him in.

 

Go with your mommy instinct. If your dd seems healthy to you then ignore the BMI/weight charts.

[Crafty Mathy Mom]

Reported to whom?

 

As for BMI- it's all a load of hooey! That is all.

 

 

Recorded. Dang autocorrect. Sorry about that.

 

The height and weight are entered into a spread sheet and the BMI popped up indicating that she was technically overweight. Doc didn't give us the Manage Your Child's Weight pamphlet.

[ByGrace3]

well, that BMI calculator says my dd who is a level 4 gymnast and works out 9 hours a week is borderline overweight/obese. nope. rock solid yes.

[Unicorn.]

Recorded. Dang autocorrect. Sorry about that.

 

The height and weight are entered into a spread sheet and the BMI popped up indicating that she was technically overweight. Doc didn't give us the Manage Your Child's Weight pamphlet.

 

 

Oh, ok. Whew! I started having paranoid thoughts about govt. officials coming after us/our kids for BMI violations! Guess I don't need to buy that private island just yet. :D

[alisonconn0326]

my 3 y 10m old daughter is 38 inches tall and also weighs 38 lbs. to me she looks thin slender like myself. she wears a 3/4, her belly is flat. no fat on her body...yet the dr says the scale is showing that girl is over weight. I'm confused. 

[frogger]

On 2/27/2013 at 8:52 PM, Element said:

It has been my experience that BMI charts are pretty much useless for growing children.

 

They are useless for anyone who has the slightest muscle mass also.

[Carrie12345]

I HATE BMI. It’s problematic in both directions in our family.

DS#1 was flagged as too low as a kid. I was somewhat similarly slim and tall pre-puberty.  Sadly for him, his post puberty shape followed the same curve as mine and his bio dad’s.

Dh and I have 2 kids who have been pretty average on the charts. We also have 2 who are/were “too low”. Dh’s body fat percentage has been ridiculously low for 43 years, so it makes complete sense.  I’ve had peds look at me doubtfully when I’ve chalked it up to that (they never see dh,) but our most recent one completely believed me when I shared genetic history at my 13yo toothpick’s most recent check up, thank goodness. The 17yo is still a size 0/2, but now she’s in the “normal” range.

For me, I’ve had a high BMI since my late teens. Right now, it is legitimate fat, but I’ve traded that for serious muscle several times over the years. I still get an overweight BMI. I did hit the “magic number” once. I felt like garbage and looked sick.  It’s not for me!

[plansrme]

My Chinese daughter has been overweight on every BMI calculator that's been run on her since she was about 5. She is now 20, a D1 college swimmer, 5'3", probably 145, and could break you in two. She's always been muscular (well, once she got past the malnutrition from her 15 months in the orphanage). She had a body scan done once, when she was about 13, that actually showed her as having too little body fat. She has put on some fat since then, but I distinctly remember laughing at the note on the scan result that she might be at risk for anorexia and telling her we needed to stop for doughnuts on the way home. Anyway, I wish they wouldn't do BMI calculations on kids, especially athletes. It's stupid. Some kids just naturally have more muscle. 

[ktgrok]

BMI has a known issue for anyone who is athletic with a lot of muscle OR larger or smaller frame (bone mass) than normal. It's a known limitation and in the fine print of most/all BMI calculators. So, it's useful IF you are of average frame size, average bone density, and average muscle mass. Which, to be fair, is most people. It's useful for them. 

It is NOT meant to be used for those who don't fit those parameters. And any doctor should know that - as those saying their doctor said to ignore it did. Not because BMI is always wrong, but because it really works best for adults of average build/muscle mass. 

And for kids, you have to add in not just all the normal caveats for adults, but that kids are growing so fast and some kids shoot up and then add weight and some kids gain weight and then shoot up, and if you measure them before they balance out again it will be totally wonky. 

As you said, she wears a smaller sized pants than most kids her age. She is fine. But there IS an issue with overfat children in our country, and most parents do NOT see it so I'm glad that doctors are helping point it out - as long as they are using their own eyes and not just BMI calculators. 

[RootAnn]

Zombie thread from 2013!!!!

[TravelingChris]

35 minutes ago, RootAnn said:

Zombie thread from 2013!!!!

Yeah, I started reading it from the beginning and was confused because SKL's girls are so much older now.  Still didn't check date until I saw TranquilMind's post and I hadn't seen any posts from her in many years.  

But as to BMI,  I don't think they were doing that when my kids were younger but my kids were born long and skinny.  No one mentioned anything with ds at birth or soon after but after dd1 was born, I was being told to not give orange juice but grape juice, and other things to fatten the two of them up.  Because they were on the very low end of the weight scale.  By the time DD2 was born, my lowest weight child, I decided there was zero reason to try to fatten anyone up.  

BMI is just a guess- what it means has everything to do what percentages of bone, fat,. muscle and water there is.  Just this past Fall, I gained a lot of weight quickly- it was my lymphatic system malfunctioning and retaining water- and when I went on Lasix, I lost eight pounds just as quickly.  

You know your own kids and if clothes that fit their height are falling off them, they do not have a weight problem- or at least not a overweight problem.

[Drama Llama]

BMI doesn't work for my youngest who is just a big kid but is all muscle.  He's built like an offensive lineman.  

It didn't really work for my kid with major malnutrition either.  His BMI was low, but not as alarmingly low as one would expect because the malnutrition also stunted his growth. 

What does tell the story for both kids is the shape of curve on the growth chart.  My healthy kid's curve is super smooth.  His weight at 10 is exactly where you'd expect it be looking at his weight at 6 or at 2.   My malnourished kid's curve is like a picture the story of his life, it changes directions and goes up and down depending on all sorts of factors, like the level of inflammation in his body, the dosage of steroids he was on, whether he was getting fed regularly, etc . . . It's the curve of a kid in crisis.

 

[ieta_cassiopeia]

On 2/28/2013 at 4:06 AM, Unicorn. said:

 

Reported to whom?

 

As for BMI- it's all a load of hooey! That is all.

Most likely, statistics collection. For at least three decades, the USA, like the UK and many other countries, has official statistics for overweight (BMI 25+) and obese (BMI 30+) children (as well as overweight/obese adults, though their statistics are skewed because doctors see a larger proportion of people at unhealthy weights - in either direction - than healthy weights). Morbidly obese people's weights (BMI 40+) began to be collected somewhat later. The general idea is to get a broad view of weight trends for entire populations.

Obviously such a simple measure cannot take into account everyone's lifestyle, especially given that muscle (usually a good thing) weighs more than fat (often a bad thing in the context of someone who is obese). I think BMI is configured with the assumption that people have the average Western sedentary lifestyle because that's most likely to be accurate. However, large swathes of people don't live a sedentary lifestyle; doctors would be wise to make adjustments based on activity before bringing out the nutrition/exercise advice.