Healthy, active boy labelled 'obese'

07:00 AEST Sat Feb 25 2012
By Emily O'Keefe, MSN

The health-conscious parents of a four-year-old Melbourne boy were stunned when they were told that he was considered obese despite eating a diet full of fruit and raw vegetables.

Kelly Palmer said her son Lydon was classified as obese by a health care nurse at the Sunshine Child and Maternal Health clinic during a routine check-up.

Lydon, who weighs 21.6kg and is 109cm tall, was given the diagnosis after he fell into the 95th percentile according to his body mass index (BMI).

"I was shocked. It was a bit like a slap in the face,” Mrs Palmer told ninemsn.

"We have a really healthy lifestyle. My husband is a personal trainer and amateur bodybuilder so all we usually eat at home is meat and steamed vegetables.

"Lydon loves eating fruit and raw vegetables. He even eats raw broccoli when we are at the supermarket."

Mrs Palmer said the health care nurse advised her to give Lydon low fat milk to drink and try to engage him in more physical activities.

"She was saying you might need to get him out a bit more. I was thinking you don't even know what I do with my son. You do walk away feeling really inadequate," she said.

Yesterday another Sunshine mother, Helen Karalexis, told Nine News her daughter Viktoria was labelled obese by a nurse at the same centre after her BMI was calculated.

Isis Primary Care, which runs the Child and Maternal Health clinics in the area on behalf of Brimbank City Council, is standing by the use of BMI by its nurses to determine if a child is in a healthy weight range.

"We are talking about an internationally standardised instrument that is used worldwide," Isis Director of Community Services Michael Girolami said.

He said talking to parents about their children's weight was a sensitive issue but it would be careless for nurses not to provide advice to parents about eating and exercise when necessary.

"The fact is that these children have registered on an internationally validated scale as being obese. I am a bit concerned that we could be throwing out the chance to provide information and support in favour of parents' reactions," he said.

Lydon's father Sean said his son's classification was ridiculous and had upset his wife.

"She was really cut up about it. She was thinking she was a bad mum and that she was feeding him the wrong foods," Mr Palmer said.

Mr Palmer, who is also classified as obese according to his BMI despite having only 12 percent body fat, said his son was very active and healthy.

"They need to look at another way of assessing people other than using BMI, it's a really out-dated method," he said.

Dietician Melanie McGrice said that it was important to remember that the index is a population guide and results can be skewed by increased muscle mass.

She said that while giving skim milk to children over two years old was sound advice it is important to look at each case individually.

User comments
Either the BMI range expected reasonable for children is different from adults (I don't know if this is true) or the nurse cannot calculate it correctly. As one of the previous commenters said - this kid's BMI is 18.2. A 'healthy adult' is in the range of 18-25, and that doesn't really account for muscle-bound athletes. Half of the All Blacks would be considered obese by this method too - how ridiculous is that?!
well, his BMI is well within normal limits if the above mentioned weight and heights are correct. Obesity is a growing problem in children in this country and it does need to be addressed, but I think a good look at a child and accurate assessment is what was needed in this case as well as an appropriate apology to parents as this child's BMI is 18.2, between the 10th and the 25th percentiles for age and no child can be called obese until his or her BMI is above the 95th percentile for age. It's a wrong conception that children are allowed to be overweight as they are growing. Obesity in children is associated with increased risk in type two diabetes even before reaching adulthood as well as increased risk of obesity throughout adulthood with all the associated risks of high blood pressure, heart disease, you name it, and it does need to be addressed in primary care appropriately.
I think the BMI is a stupid, outdated medical index. It is completely inaccurate. Kids who are eating healthily and getting a decent amount of exercise can't be labelled as obese. I think that no kid under the age of 8 should even be tested for obesity unless it is pretty obvious as they are still growing and there is going to be a little bit of extra fat here and there. But above all, they need a new way for testing obesity. The BMI won't work because they don't take into account that the person may be an athlete or have extra muscle, ethnicity, and a few others.
He looks like a normal healthy looking child to me. Rather than get so uptight, perhaps the mother could have believed in her 'mother instinct' and trusted herself that she is doing a fine job. By the way, eating food at the supermarket before it is paid for is classed as stealing.
the following is a small snippet copied directly from wikipedia BMI was explicitly cited by Keys as being appropriate for population studies, and inappropriate for individual diagnosis. Nevertheless, due to its simplicity, it came to be widely used for individual diagnosis, despite its inappropriateness also it was a concept developed between 1830 and 1850 i think we could come up with something a bit more accurate with our modern medicine
I can't believe they are still using BMI as an indicator of health.. it doesn't work! I remember reading a wonderful article where several of the all blacks took the test and were surprised to find that they were obese.. yeah right.. some of the fittest and healthiest people around.. obese.. I don't think so.. find a better way..
That nurse was just stupid. Muscle volume weighs more than fat. She had no idea what she was talking about. That kid doesn't even look remotely fat.
i am a mother of a 95 percentile child as well and i have the same story that hes overweight and that i need to feed him better and that he may need physio to strengthen his legs. When i was breastfeeding i was told that i was overfeeding him and that he needed to cut down on feeds
I thought BMI was NOT supposed to be used for children... Taking into account the fact that kids grow at different rates and often put on more weight before a growth-spurt. My younger brother was lots bigger than that kid, he was also fit and ate well, and as soon as he hit his teens he got tall and skinny- he wouldn't have gotten as tall as he is now if he didn't have the fat-reserves. As long as kids have a healthy diet and lifestyle, there shouldn't be a problem.
Reliance on the Body Mass Index (BMI) alone is a little foolish. A BMI is still a valid measurement, the best course of action would have been to ask more questions to determine if the measurement is relevent or not. Muscles are have a high density than fat so a fit and health althlete may be class as being obese. I think it may even be a bit dangerous to fit children into BMI's as they have massive stages of growing in height and often before this they put on a lot of weight to help this happen. Setting constraints based on the BMI on how much child eats could affect the natural growth of the child. Unfortunately I am also classed as being over weight by the BMI, but I'm not prepared to lose any muscle as I use them every day


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