Why are hundreds of healthy and happy children like these being branded OBESE by the NHSThey're happy and healthy – but to the fury of their parents, the NHS insists they're dangerously fat…
11:30 GMT, 10 May 2012
Extreme measures: At 2st 12lb, Logan, aged four, is a mere three pounds outside the recommended weight range but he was still told he's obese
To all outward appearances Logan Knowles is a healthy, active little boy. The football-mad four-year-old loves nothing more than kicking a ball about in the garden after school, and if he’s not practising his goal-scoring skills then he’s usually to be found tearing around on his bike.
So imagine his mother Stefanie’s shock — and outrage — when in January this year she received a letter from the NHS saying her son was ‘clinically obese’ and warning that he was at risk of heart disease, cancer and diabetes.
‘I was absolutely furious — there’s nothing of him,’ Stefanie says. ‘If anything, he is skinny for his age. He still wears clothing labelled for a three-year-old, although he is nearly five. There’s not an extra ounce of fat on his body — sometimes you can see his ribs.’
The letter arrived after Logan was weighed at school as part of the controversial National Child Measurement Programme, which started in 2005 and assesses the heights and weights of children in their first and last years of primary school.
As a result, hundreds of ordinary-looking children, like Logan, have received letters informing them they are overweight or obese, an often distressing experience for both child and parents.
Logan is 3ft 3in tall, and at 2st 12lb is a mere three pounds outside the recommended weight range for his peers. But at such a young age, that tiny difference makes an immense difference to his BMI, putting him on the 99th centile.
For adults, BMI is measured by dividing weight in kilograms by height in metres squared. But the calculation for children is different. It begins the same way, but the result is then compared with others of the same age and sex to calculate the child’s ‘centile’ — or position relative to others on a scale of one to 100.
Between 91 and 97 is classed as overweight, and any child who scores 98 and above is branded clinically obese.
No other factors are taken into account, not least because the letters informing parents of their child’s obesity are often generated by a computer which studies the data.
While no one is suggesting the Government shouldn’t take measures to tackle the childhood obesity crisis, there are many who view the system as misguided and flawed.
Under fire: Stefanie felt like she was being criticised as a parent when she received a letter saying her son was overweight
As Tam Fry, Trustee of the National Obesity Forum and Honorary Chairman of the Child Growth Foundation, explains: ‘These letters do not take into account the build of the child and its heritage. That is the major problem. A child can have a high BMI, but be absolutely normal if they come from a tall, well-built family.’
‘Sometimes a computer will inappropriately trigger a letter saying your child is overweight and will die, or some such nonsense. It’s unbelievably bad medicine and in many cases hugely insulting to parents who are probably extremely fit and making sure their child is brought up properly.’
Stefanie, 29, a part-time administrative assistant from Walsall in the West Midlands, certainly felt her parenting skills were under fire. She says she wasn’t even informed that Logan was being weighed at school, and the letter was the first she knew of it.
'As a parent, I know what’s best for my
child. It angers me beyond belief that these people don't realise the
detrimental effect they are having'
‘I phoned the woman from the NHS trust who had sent it to tell her how ridiculous it was and she started quizzing me on his diet and exercise,’ Stefanie says. ‘It felt like there was some kind of ulterior motive — as if she was questioning my parenting skills. Whatever happened to common sense Anyone who looks at Logan can see that he’s fine.’
Stefanie, who lives with her partner
Luke, 33, a flood technician, and also has two older daughters, aged 11
and ten, says labelling children when they are still growing is
‘Sydanie, my ten-year-old, was weighed at the same time and was at the other end of the spectrum. She came home saying she was the thinnest in her class and it seems that they were told their weights in front of everyone. Children shouldn’t be preoccupied with these things.’
Unfortunately, despite her best efforts to protect him, Logan became aware of the fact that he had been branded obese after his older sister revealed what had been in the letter. It had a profound effect on the boy.
‘For weeks afterwards, his eating became very laboured,’ Stefanie explains. ‘He just went into himself and didn’t eat as much as usual. He will normally try new things — which is actually very unusual in a young child — but he became much more cautious.
‘The woman who had sent the letter followed it up with an email about after-school activity clubs. Logan doesn’t need that — he’s for ever running around with his older sisters. I completely ignored the advice I was given by the NHS and thankfully Logan is back to normal and eating well again.
‘As a parent, I know what’s best for my child. It angers me beyond belief that these people don’t realise the detrimental effect they are having. BMI is a ridiculous marker for children — I don’t know why health officials can’t understand that.’
Libbie Boardman, too, started eschewing food after a similar weigh-in found her to be borderline obese.
Sporty: Libbie, age seven, weighs 5st 5lb and does gynmastics and table tennis so her mother, Louise, pictured with her left, was appalled when she was told she's obese
At seven, she is 4ft 2in tall and weighs 5st 5lb, putting her on the 97th centile. As Libbie, who comes from Greater Manchester, is a budding gymnast and table-tennis player who loves playground games with her friends, her mother, Louise, was appalled after she and her husband received the news in a letter in December last year.
‘We were very shocked to see that she was considered in that way,’ says Louise, a 34-year-old office manager. ‘She’s very active and gets a lot of fresh air playing outside with her friends. She also eats a healthy, balanced diet.’
Louise, who is married to Paul, 43, a window cleaner, and has another daughter, Sophie, 14, adds. ‘We took Libbie to the GP, who said that the numbers were right but that there was nothing to worry about because Libbie was perfectly healthy. But the whole thing meant we had to discuss with her what was going on — she’s very inquisitive and needs answers.’
Mr Boardman, 43, adds: ‘Afterwards, Libbie started saying things like she didn’t want any tea. I told her she was being silly. She never has junk food, just the odd treat now and again. She’s also very active — what I’d describe as the rough-and-tumble type.’
Not surprisingly, the Boardmans haven’t weighed Libbie since receiving the letter from the NHS. ‘One look at her tells you she’s healthy,’ Louise says. ‘I don’t want her to start focusing on her weight.
‘I was angry because they didn’t treat my child as an individual, but just as a set of numbers on a piece of paper.
‘It’s more than just the height and the weight; they should look at the build of the child. Libbie was a big baby — not fat, just big — and has stayed at the upper end of the scale ever since.
'We live in a world where there is such a
huge emphasis put on diet and weight. It's really damaging for little
girls and it now starts when they are toddlers'
‘I do think this will fuel anxiety over body image. It gets children thinking about the way they look at far too young an age. They should have the same kind of innocent upbringing we did.’
Child experts are already concerned about the negative effect anti-obesity messages can have on impressionable children.
Chris Calland, a former secondary school
teacher turned educational consultant, who recently set up a body-image
course for primary school-age children, says: ‘Some children have
absorbed the anti-obesity message to such an extent that they dread
‘I’ve spoken to parents who say their children have become obsessive after learning about obesity as an issue at school — and the research shows even young children identify being fat with being unintelligent, lazy and smelly — something, in other words, to avoid at any price.’
And many parents, like those of six-year-old Kian Johnson, argue the figures are little more than useless in any case, because when it’s followed up with health professionals they are told there is nothing to worry about.
Kian, from Colchester, Essex, was branded clinically obese after he was found to be on the 98th percentile last year. Aged five at the time of his assessment, he was 3ft 8in tall and weighed 3st 11lb.
His mother, Emma, 29, says: ‘It was such a shock. We were worried that we’d had done something wrong. You always try to do the best for your children, so it’s very upsetting to have something like that come through the letterbox.’
The letter, from their local healthcare provider, said that doctors would describe Kian as ‘clinically obese’, meaning he was more likely to get diabetes, or suffer from low self-confidence.
Shock: Kian Johnson, with his mum Emma, left, weighs 3st 11lb but was told he has an obesity problem
Emma says: ‘He’s a robust boy, who loves being active and playing in the garden. And he eats a really healthy, balanced diet. His favourite foods are strawberries and tomatoes.’
Stay-at home mum Emma, along with husband Paul, 43, a DJ, decided to visit their local Primary Care Trust in person to discuss Kian’s supposed obesity problem.
‘They told us not to worry,’ says Emma, ‘And that he was actually fine. If that’s the case, I don’t understand why they’d send us something like that in the first place They should apologise in writing.’
Wanting to protect their son from the findings, the Johnsons haven’t weighed Kian since last year, and there’s an argument that if the letters cause parents to disengage, then the process is failing again.
But there are some experts who feel that the current system is a valid and sensible one.
Paul Gately, professor of exercise and obesity at Leeds Metropolitan University, says: ‘From a scientific perspective, BMI is a good tool and one that is unlikely to identify children who are not overweight.
‘In fact, I would say it is more likely to underestimate children — it’s still relatively conservative.
‘We often hear examples of the English rugby team or sports people with high BMIs, and that’s true, but children are not professional athletes. It’s a way of hammering BMI when it’s actually completely out of context of the lives of the children that we talk about.
Nearly a quarter of children are
overweight or obese by the time they start primary school, NHS statistics suggest
‘It is absolutely critical that if a child or a parent or a doctor or a school is to take action, it must have hard data that gives an accurate picture. The National Child Measurement Programme is arguably the best population measurement system across the globe.’
However, even Professor Gately admits the system is not perfect and says improvements are needed — both in the way that parents are notified and also how a child is followed up.
‘We are far too sensitive about this as an issue,’ he adds. ‘There are lots of parents out there who see these letters as them being told they are a bad parent. But this is merely an objective measure — no different to a child’s maths result in a test — the tone of how it’s conveyed is critical. What is also critical is what then happens to these children.’
It’s perhaps the only issue upon which he and Tam Fry agree, as Tam says: ‘It’s disgraceful parents should be getting these letters about their child without anyone having seen the child to see if it is appropriate.
Active little girl: Esme, age two, weighs 2st and was told she was obsese when she was taken by her mum. Charlene, left, to a routine check up with her GP
‘They may well panic about their child’s weight, which might be quite inappropriate.
‘All of this could have been avoided
by the Department of Health thinking seriously about what the letter is
saying. It’s totally inappropriate.’
Esme Pearman’s experience illustrates
not only that labelling can start even before a child reaches school
age, but also the difference between receiving a letter and finding out
from a health professional.
Aged two, her mother Charlene recently
took her to their GP’s surgery for a routine health check, only to be
told that she, too, was clinically obese. She is 2ft 1in tall and weighs
Charlene, 27, from Chelmsford, Essex,
says: ‘The doctor weighed and measured her. She was on the seventh
centile for height but the seventy-fifth for weight, which made her
technically obese. I was really surprised because she is such an active
‘She’s also intolerant to dairy,
which eliminates a lot of processed foods — they would make her ill. She
has three meals a day and a couple of healthy snacks.’
In fact, since she could see the evidence before her eyes, Charlene’s health worker ultimately concluded that Esme was fine. ‘She said she looked so healthy that they weren’t worried about her despite the result,’ Charlene explains.
‘But why should I be told that she is technically obese This kind of labelling can definitely cause anxiety for parents.
‘I dread to think how I would have felt if I had received that information in a letter when no one had looked at Esme and seen that she is perfectly all right.’
Stay-at-home mother Charlene, who is married to IT engineer Robert and also has a three-year-old daughter, Stella, says: ‘We live in a world where there is such a huge emphasis put on diet and weight. It’s really damaging for little girls and it now starts when they are toddlers.
‘I struggle with my own body image and that’s not something I want to pass on to my children.’
There are many parents who would wholeheartedly agree with her sentiments.