If you saw my 8-year-old son, you'd think he was the picture of health. His clear skin, bright eyes and infectious smile make much more of an impression than the size of his limbs. But he's a skinny little thing. In fact, he's extremely underweight, according to his BMI calculation.
Based on his height (4 feet 5 inches) and weight (53 pounds), and taking into account his age (8), my son is classed as underweight. In fact, he’s in the first percentile for boys his age (meaning that compared to boys of the same age, none of them have a lower BMI than him.)
However, he’s also a picture of health, is rarely ill, has bags of energy and — most importantly — has a huge appetite. And I mean huge. Adult-sized portions, seconds... he basically eats me out of house and home.
My boy's BMI doesn’t bother me in the slightest, but it has been on my mind recently after reading so much about children's BMI in the news. My children have never been weighed at school, but perhaps if they had, I would have received a warning letter similar to that sent to other parents, such as Alex and Hannah Jackson, who received a letter from doctors stating that their 5-year-old daughter Harriet was overweight. Harriet’s height and weight had been measured in at her primary school in Norwich, England.
"These results suggest that your child is overweight for their age, sex and height," warned the letter. "If your child is overweight now they are more likely to be overweight as an adult. This can lead to health problems."
As Harriet’s dad pointed out, for some people a letter like this could be extremely distressing, leading them to question their ability as parents, which could then have a massive effect on the child. Labelling a little girl as "overweight" at 5 years old could lead to serious emotional issues with food that could carry on into adulthood.
BMI can also fail young people by missing diagnoses of eating disorders. One young woman, 21-year-old Chantelle Mason, was suffering from anorexia, weighing the same as an average 11-year-old girl and wearing clothes intended for children. But despite this, her BMI of 17.6 was within the "healthy" range, so doctors wouldn’t initially refer her to specialists for treatment. In the U.K., the threshold for being diagnosed with anorexia is 17.5, meaning that 0.1 was the difference between Mason getting the help she needed and being classified as healthy. It was only when her BMI dropped to 14 that she was referred to an eating disorder clinic.
BMI can be useful — but only as part of a much wider health assessment. More doctors and teachers need to see the bigger picture — and a pretty good start would be to read the essay written by Indiana eighth grader Tessa Embry in response to an assignment set by her physical education teacher. The 14-year-old had been classed as "obese" following an earlier in-class BMI calculation.
Instead of calculating her BMI as requested, Embry wrote an explanation on why BMI is "an outdated way of defining normal weight." In Embry’s case, she focused on the fact that BMI fails to take into account what portion of a person’s weight is fat and what is muscle. A softball player on two different teams who has always "been a 'bigger girl," Embry said she was "strong and powerful," adding, "My BMI is none of your concern because my body and BMI are perfect and beautiful just the way they are."
My child's case is the opposite of many stories that make the news, proving yet again how being overweight or obese is widely believed to be so much worse than being underweight. But even though my son's BMI is at the lower end of the scale, I can still relate to those parents whose kids have been labeled unhealthy based on BMI alone. I know this number doesn't tell the whole story about my son's health.
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