• Thu, Jan 23 - 4:00 pm ET

Do These Little Boys Look Obese To You? Their BMIs Say They Are

bmi-for-kids

Jolene, the blogger behind Yummy Inspirations was pretty pissed off when she took her three-and-a-half year old son to the doctor and was told her healthy child was obese based on his BMI.

Jolene writes:

“I’ve always had a problem with the BMI Charts – I’m 5 foot 4 and my Husband is 5 foot 3 – we both have broad shoulders and are genuinely big boned – and since bone is dense and contributes to your weight we have ALWAYS been in the overweight/obese category. In fact if either of us were in the healthy weight category we would likely be gaunt and worryingly sick.”

She says that she was told both of her sons were overweight at their three year appointments, something she says is based strictly on the formula and doesn’t take into consideration their family history, their diet, and other variables:

“Both their weight is average or a tiny bit above average for their age BUT because of their shorter stature they are both considered to be OBESE on those ridiculous BMI Charts.”

Man, if I were Jolene I would be pissed off, too. I imagine her sons’ doctor was just trying to do his or her job, but Jolene says she she was “lectured about watching my kids weight – and told to limit their sugar, milk and increase the exercise they do.” Eeesh.

Of course, it’s not enough to say “Look at these kids! Do they look fat? NO?! Then they’re not fat!” (Like how I trolled you in the post title, though? MUHAHAHA). There’s more to body composition than just the way we appear or what we eat, even though Jolene says her sons are fed tons of fresh fruit and vegetables and meals made from scratch.

What this is really about is the BMI formula and how it sucks. I’ve written about this for Blisstree concerning a similar situation, except with a school; Some research has shown that that BMI is a flawed method for determining who is overweight or underweight. While it can still be a valuable tool in some contexts, I feel like pediatricians should maybe be a bit more sensitive and judicious when informing parents that their children are obese. I’m not saying toss BMI out altogether, but maybe speak to a parent about a child’s lifestyle and diet, and genetic history before lecturing them.

Photo: Yummy Inspirations

What We're Reading:
Share This Post:
  • Larry Drew SG

    Everybody is different.

    BMI Charts are stupid and for lazy health professionals that want to fill in your med chart without doing actual analysis.

    Hubby’s only 5’3″?

    • Boots

      Lazy is a bit harsh. BMI charts have their place in population comparisons & many health workers will adjust for build, pregnancy, athletes and children.

  • Kay_Sue

    My older son and I are always on the flipside of this; we consistently rank as too low on our BMIs. We’re finely-boned, and we don’t keep weight on. The difference, to me, is that my healthcare professional (who is amazeballs, and I typed that with a quasi-straight face) actually took the time to listen and understand our history and take that into account. No lectures for us, because she understood that BMI does not tell the whole story. It probably helps that she was my pediatrician in my late teen years, and has been his since birth.

    Anyway, long story short, I too think BMI is a flawed formula.

    • brebay

      Yup, my kids and I are all anorexic when we go to the doctor…then we roll our eyes and go for pizza.

  • shel

    BMI can be helpful, though I find it much more useful in the over 18 crowd… and it is far superior to the old height vs weight straight charts they used to use (You are this height- your weight should be this and only this!) but BMI still can’t account for a lot of differences in body composition.
    It is just a peace of information to used to put together the whole puzzle. Unfortunately, medical practices are getting bogged down with more and more paperwork and more things to ‘track’, so things like BMI are something we are forced to document in a very rigid manner that isn’t really helping anybody.
    A discussion about healthy eating and exercise is always appropriate, but it shouldn’t be a “you’re doing it wrong!” lecture.

    • I agree. BMI is a good base point and then you should look at *why* someone’s BMI fell where it did. Maybe that person is “overweight” because they have a larger muscle mass. Maybe that person is “underweight” because they have a small frame. I fluctuate between “normal” and “underweight” because I have such a small frame. I’d be pretty chubby at the upper end of “normal” but my sister (who is about the same height) looks fantastic at that weight because she has a normal sized body and not freakishly small hips and shoulders.

    • SunnyD847

      Those old charts used to have different “frame size” columns which BMI does not. I’d rather have that than one-size-fits-all BMI.

  • Nica

    My DH and I always chuckle about this and even more so now… He recently lost SEVENTY pounds – yes 7-0 by working with a nutritionist. At age 45, he’s in the best shape he’s been in since college. He is now 245 lbs on a 6’4″ frame. He looks fantastic and he feels fantastic. He’s health is excellent but his BMI comes in at 29.8, just shy of obese, which is utterly ridiculous. HIs nutritionist has counseled him that a) he’s lost enough weight and he should now maintain and b) ignore the BMI charts, they’re based on averages and if you are not average in anyway, it won’t be accurate for you. I would think it would be even LESS accurate for kids given the way that they grow in fits and starts.

  • Kelly

    I’m nearly obese on BMI charts and I have flat abs. It’s because I’m muscular. BMI charts are bullshit.

  • Andi

    I have similar issues with my very muscular and dense son who has earned me more than one misguided medical lecture from our ped.

    With kids the margin between a healthy weight and an overweight label is really slim.

    Example:When my son was 3 I got the “his BMW is too high” lecture. We went home and he had a massive poop. I had a good laugh and re weighed him, only to find him back in normal territory. Between that and growth spurts where kids bulk up before shooting up in height, I just don’t feel like BMW is a good tool for small choldren.

  • Andi

    Stupid auto correct.

    BMW=BMI

    • Alanna Jorgensen

      Mine tried to correct to BIN.

    • brebay

      I wouldn’t mind getting a BMW from my doctor…

  • Aimee Beff

    I would absolutely say BMI charts should be thrown out of doctors’ offices! The measurement was developed to be used as a comparison between populations – it’s meaningless at the individual level because it fails to account for any variation in body types. There are numbers doctors should concern themselves with (BP, pulse rate …) but BMI ain’t one of them!

  • Alanna Jorgensen

    I work out regularly and am a size 10 (goal is a size 6/8). Because I’m 5’3″ and have a lot of muscle (under my pudge) from running I am obese or just below on the BMI chart. Definitely needs a commonsense approach when interpreting this data.

    • brebay

      Please don’t set a size goal, sizes change by year and by brand, and are set to a 5′ 6″ frame anyway. I hope you’d set a muscle ratio goal or something like that. As hard as you’re working you shouldn’t be discouraged by something as arbitrary as sizes. I wear anything from a 2 to a 9 in jeans. Years ago I took to tearing the size tag out of my jeans as soon as I bought them, and I give them names instead, which I write inside in laundry pen. I love how I look in Stella, and if Darby is tight, I work out a little more, but I never see a stupid number in there. I don’t remember what any of the sizes are. Good luck with your workouts!

  • bozzgirl

    I effing hate BMI charts and I distrust any doctor or nutritionist who uses one.

    • Alanna Jorgensen

      Absolutely agreed. My daughter’s pediatrician uses a scale that measure her own growth pattern against itself. Much more individualized.

  • Pumplestilskin

    I have the opposite problem with my kids. They are considered underweight. The doctor knows that this is how my kids are. She’s seen them every appointment of their lives and they have always followed the same growth curve. I was super skinny as a kid and my husband is 6 ft and weighs 175, it’s called genetics. A new PA started in their office and she happened to see my son at his 9 year physical. He is in the 90th percentile for height and the 20th for weight, always has been. She proceeded to quiz him about getting enough food at home and looked at me and said, “Mama, he can eat whatever he wants”. Um, no lady, he cannot, the kid eats me out of house and home as it is. We had to have a sit down once and tell him that before going to his grandmas refrigerators he had to first say hi to them. He called them Grandma Pancake and Grandma Pudding because that is what they would make for him when he went to their houses. The boy eats. A few weeks later, same PA same results with his sister. She’s only in the 15th percentile for height but her weight isn’t even on the charts. She was 4 pounds 10 oz and 17in at birth, she was full term but she has always been a tiny little peanut and the PA asked her all kinds of questions. I called the Dr. later to complain. She said “oh yes, she came to me about it, I made her go back and read your kids charts, it’s ok now”. It really bothered me because people just don’t fit into these mold that they want us too. My kids eat, play sports, dance, do well in school, they’re obviously healthy, why should they gain weight?

  • Oywiththepoodlesalready

    My son is tiny…25% in height and weight and was told that just b/c his weight is a bit higher than his height his BMI is higher and we should prob keep an “eye on it” Bullshit. He’s 32 lbs and has to wear the slim jeans and is a healthy looking kid. And they wonder why kids have body issues.

  • Rachel Sea

    What do you call a doctor who graduates at the bottom of their class?

    Doctor.

    BMI is a statistical tool and it should never, ever be applied to individuals. Anyone who tries does not understand math, or health. Anyone whose doctor chides them for being an outlier should ask if their doctor has ever heard of the Bell curve, and then walk out.

  • Holly G

    I have a girlfriend with two graduate degrees – one in evolutionary biology and one in nutrition – to say the least, she’s no dummy. She informed me some years back that BMI was designed to be used and applied to populations, not individuals. She was pretty livid about the pervasive use of it with individuals these days. I’ve had trouble with BMI personally too – the only time my 4′ 11′ large-framed self was considered to have a healthy BMI was when I was deathly ill with HG during my twin pregnancy…yeah, fuck that, not going back there.

  • Joy

    BMI is a bunch of crap for anyone, let alone children. I’m a size four but short (5’3″) and with a more muscular build than the average woman, and that damn chart says I’m borderline overweight despite being in the “athlete” range for body fat percentage. Eff that noise. If the doctor had glanced at these kids it’s obvious they are not overweight at all and he should know to just not bring it up because the chart is ridiculous.

  • Kara

    I’m 13 weeks pregnant (YAY!!!) and at my first doctors appointment I was instructed by my midwife to only gain 15 pounds total during my pregnancy because I am so big to start with. (This is my 4th pregnancy) I am 5’6 and 211 pounds. So I understand I am overweight, technically obese (I think my bmi is 31 or something) but COME ON WOMAN! 15 pounds is just not going to happen. I’m just focusing on eating healthy and walking every day :) **Rant time** she even had me do the gestational diabetes test super early (I was 10 weeks) because of my weight! I have no history of gestational diabetes and the test was negative :)

    • Bethany Ramos

      Congrats :)

    • disqus_bmlOVOUWMw

      My mother had gestational diabetes and was underweight when she was pregnant. I hate when people assume that health problems always come to anyone larger and never to thin people. It sounds like you’re healthy and happy and that’s what matters.

    • AugustW

      Sheesh. 7 lbs of baby and 7 lbs of placenta….and that’s all! Not much room for fluid retention, blood volume increase, or just general pregnancy weight is there?

      I was 250 at 5 foot 1, so bigger than you, and they recommended 20-25 lbs as my healthy weight gain. I lost 20 lbs in first trimester from sickness, gained 21 after that so…I ended up 251 at the end. Lmao.

    • candlesoffate .

      i was never scolded by my doctor for weight gain. wish i had been. i’m 5 foot 1 and weighed 125. When i had him i weighed 205. I managed to lose 50 pounds only to gain it back working the night shift.

  • marimba_girl

    This happened to my kid last year at school. He participated (with my permission) in the free physical offered by his school. They sent a letter home stating that he was obese. He’s very tall and proportionate, currently 5’6″ and 110 pounds at 11 years old. (His dad is 6’6″ so I know where we’re headed.) We didn’t participate this year.

  • AugustW

    I was told at my daughters recent 3 year old appointment that she was “in danger” at the 95th percentile. I was told to increase her exercise because her diet is already fantastic.
    How do you increase a 3 year olds exercise? Her whole day is some variation of exercise, other than nap times!!!

  • MaebykittyRN

    BMI is flawed in that it does not take muscle mass and bone density into account. It is way more accurate to measure body fat percentage, but that takes a little more work than calculating a BMI, so I’m guessing that’s why it isn’t done. Yay healthcare…

  • MeLuRe

    My oldest was overweight according to bmi and my ped kept saying to buy lower and lower fat milk…not something my son drinks enough of to matter, calorically speaking (he drinks water 99% of the time). He was proclaimed healthy bmi at his last appt. All I wanted to say to his doc was: it must have been the switch to nonfat milk.

  • tSubh Dearg

    My Beau was at one point in his life bordering on dangerously underweight but when you looked at his height and weight on a BMI chart at the time it would have said he was borderline for being overweight. Not the kind of thing you need to see when you are suffering from an eating disorder.

  • ErinCochran

    I’m getting in trouble with BMI during my pregnancy. I’m very muscular and short and had a bit of a weight gain going into my pregnancy due to training for a half-marathon, which always bulks me the heck up. So I fall comfortably into the “overweight” category on a BMI chart. According to the new weight gaining guidelines, that means I should gain no more than 15-25 pounds during my pregnancy, and they’re STRONLY recommending that I gain no more than the lower end, 15 pounds. At my mid-point check-up, I had already gained 7, so I’m already getting some fun “watch what you eat” lectures. I’m already eating fewer calories than I was pre-pregnancy because I just don’t have the appetite! My diet consists of carrots and low-fat yogurt! I’m just livid that they’re so entrenched in the BMI process that they can’t look at me and register that I’m a muscular lady and that hell yes I need to gain more than 15 pounds to have a healthy baby, and that the risks of having a low-weight baby FAR outweigh the risks of having an over-weight baby (and I’m hardly on track to gain more than 25 pounds) and they should err on the side of caution that way. Grawr. I’m going to go eat a cookie now.

  • Aussiemum

    I’m 166 cm tall. I’ve had 4 kids and weigh 70 kgs. I’ve been 166 cm since I was 16. Before my last kidlet was born I weighed 80. Before I got knocked up with him I was 60 kilos and looked like a skeleton, with bones sticking out everywhere and catching every bug cruising for a new victim.. And I certainly was not happy with the way I looked. But my doctor congratulated me for being not to far off my BMI. Apperently I still was too fat. WTACTUALF?
    I’m now proudly a size 12 and I love the way I look. So does my husband. I actually look healthy and there’s no freaky elbows or knees.
    My cousin on the other hand if 150 cams tall and weighs less than 50 kgs. She told me she would love to be able to put on weight and stop being told to eat more and think of her health! She can jam more food in her face than my 16 yr old! It’s not her fault she can’t put on kgs and she should not be told by her doctor she is anorexic. She is as healthy as an ox and has the same constitution as one!
    You can’t judge people by a stupid scale where unless you weigh 50 kgs as a chic and 70 kgs as a male, you’re obese and about to keel over from all that fat running through your arteries.
    Wake up professional medical people, we are not short, nor do we all desire to be stick figures walking down the street.
    I don’t mind a bit of junk in the trunk but that does not make some one obese

  • TwentiSomething Mom

    I remember when I was pregnant I was told my BMI was too high and I couldn’t gain more than 18 pounds because I was technically overweight. I am 5’7 and was a size 6 when I first got pregnant. I often would say to my doctor: Do you SEE what I look like? Do you see the muscle mass I have because I work out? BMI is a crock and shouldn’t be taken seriously.

  • Katherine Handcock

    One of my friends had a baby who was born at a high birth weight, then didn’t gain weight quickly. She was constantly made to worry by nurses, doctors, etc. who would say that the baby wasn’t gaining fast enough according to the chart. She even at one point got told she should wake a baby who was already sleeping consistently through the night to INTRODUCE night feedings, to make the weight gain match what the chart said. Meanwhile, said baby was hitting all her milestones, laughing, smiling, active, and busy.

    The one time I weighed what the BMI chart said I “should” weigh, I was really sick and looked awful. Other people could be slender and have terrible lifestyles and be at risk — or, alternately, be really thin and be living a totally healthy life. As tempting as it is to reduce everything to numbers and/or external appearances, we’ve really got to start acknowledging that the human body is a complex machine.

  • SusannahJoy

    We had an issue with my doc only looking at charts too. In his case, he’s an infant and didn’t gain enough weight between his 3 and 6 month appts. We changed what we were feeding him, came back in 3 weeks, and found out that he’d gained a full pound! Woo! only, no. He still wasn’t where he was supposed to be on the chart, so the doc was still all freaked out. He’s completely healthy. He was totally happy and hitting all his developmental milestones. He wasn’t skinny. He wasn’t hungry. But because the chart said so, the doc wanted us to go to a feeding clinic. We said we would, didn’t, and by his next appt was exactly where he should be. It was infuriating.

  • Pingback: W.E.W. Volume 9 | BFD Blog