Say what?! You heard me. Your son is overweight.
Yup, that is what we were told at E’s 4 year well visit. The hubster and I looked at each other like the nurse and doctor {they both pointed it out} were insane. That kid doesn’t have an ounce of fat on him! The doctor kindly reminded us about making sure he’s eating more fruits and veggies and less sugar. Kind of a no brainer, right? We have definitely gotten a lot better about the veggies since I started Medifast. And fruit? The kid loves fruit. As for sugar, he’s allowed one Capri-Sun a day {ok maybe 2} and the rest is milk and water. I think we are doing pretty good.
After I calmed down a bit {who am I kidding, I am still a little peeved}, I turned to my favorite online peditrician, Dr. G. I love her practical and sound advice. Here’s what she had to say!
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Wow, this sounds like a really frustrating experience! You leave that appointment wondering whether your doctor is delusional or your son has a real health problem.
First let me say that checking BMI in kids this age is appropriate but that it can completely freak parents out. This doesn’t have to be the case, with good information. We start checking Body Mass Index (the measure of a child’s weight compared to height, age and gender) at age 2. Even for these preschoolers, this is one good indication of nutritional status, though certainly not the only one.
Your son is four years old. This age is the least forgiving on the curve, allowing the lowest possible weight of all ages before looking overweight, and that has to do with how kids grow. In the older preschool years kids
should be really active and should thin out, losing that toddler belly. Kids, especially boys, can look very fit and still be high on the curve.
A BMI in the overweight range at this age should spur some double-checking of nutritional plans for kids. Ask yourselves these questions:
1. Is he getting less than 8 oz of sweetened drinks per day? This includes juice, sports drinks, sweetened iced tea and sweetened milk (like chocolate or strawberry). He should not be drinking any soda.
2. Do you follow the American Academy of Pediatrics guidelines and make sure he has less than 2 hours of screen time per day? This includes TV, computer time, noodling around on your phone or iPad.
3. Does he get at least 60 minutes of vigorous play per day?
4. Does your son eat breakfast each day, and eat dinner with an adult?
5. Do you eat out (or take out) with him more than once a week?
6. Are you (and his other caregivers) intentional about sweets and junk food?
7. Do you avoid using food for comfort or reward?
8. Are you practicing reading food labels together?
If you are already following all these guidelines, check portion sizes! My Healthy Plate has a great poster to put in the kitchen to remind everyone to fill their plate with healthy amounts of each food group.
These are healthy guidelines for kids who are overweight or of normal weight. He certainly should not diet or LOSE weight. Kids who fall into the “obese” range of the BMI curve on more than one visit to the doctor may need additional support.
When you discuss this with or in front of your son, use words like “healthy” and “fit” instead of “fat” or “diet.” Shaping our children’s self-image is as important as helping them streamline their physical shape!
You can feel overwhelmed by all these suggestions so I always recommend making one change at a time. Remember, an active kid may “grow out” of being overweight on his own. However, you only have about the first 12 years of his life to help build all these healthy habits so this is a great time to do it!
***
Great advice, Dr. G! I knew I could count on you!
Dr. G (Deborah Gilboa, MD) has been empowering parents around the country to increase their knowledge and to utilize the parenting instincts they already have, but have been dampened by stress, doubt and guilt, so that they may raise their kids to be people they respect and admire. As a Board Certified Family Physician, mother of four, and a professional parenting speaker and writer she follows 4 basic principals when guiding parents from toddlerhood to young adulthood – Respect, Responsibility, Responsiveness and Resilience.Get in touch with Dr. G on Facebook, Twitter, and YouTube.
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Great tips! I can’t believe they told you E was overweight!!!??? I wonder what they will tell me at C’s 4 year appt! Thanks Dr. G for prepping me to not freak out!
Stephanie,
Don’t freak out at all! If you want a heads up, go to http://www.cdc.gov/healthyweight/assessing/bmi/index.html and calculate it!
Thank you!
Just got back from C’s 4 year visit… 90% and 17.5 BMI. I must say, I’m not that concerned because he is so active and he doesn’t have a chunky frame. He’s starting to become less picky (he ate grilled steak last week!!!) in what he eats.
This is an awesome post! We just had my son’s 4 year check up on Friday. He was in the 72 percentile for weight which shocked me because I was afraid he was underweight he’s so skinny. The choose my plate picture is great, I will share it. Also those 8 questions are tough!! My son doesn’t like juice so water and milk is great, less then 2 hours tv and the 60 minute play we can do all that but no way can I do less then one night a week of take-out or eating out!!! Thanks for sharing!
Sarah, don’t worry! If you can follow most of those guidelines, he’ll do great. The eating out thing is really if you don’t think at all about being healthy. One of the tricks to eating out in a healthy way with kids is to order the kids menu vegetable as an appetizer, and ask for the drink to come after the food.
Wonderful information! Over the years (my children range in age from 8-22) I have seen the change in how pediatricians discuss nutrition weight and health. It seemed odd at first but then I realized my doc had my kid talking about all the sports and things they enjoy. He would always add a tip or two that we didn’t know that was very helpful for gender, age and specific interest of my child. I will have to share this with my fav fitness doc http://www.drnick.com! He love sthis stuff!
Why thanks, Mary Ellen! I am really pleased to look at Dr. Nick’s website – love new resources!