Have you ever felt like our lives are being defined by statistics, a balance of probabilities and numerous and restrictive graphs? I first became aware of the crushing effects of a graph as an adolescent. They defined my persuit of the perfect weight, and perfect me, through my twenties. Then, in my thirties, they contributed to my parenting insecurities. I know that a graph has it’s place, but does it have to be the only thing we look at when making decisions?
The Body Mass Index is the calculation applied to establish who is underweight, overweight, obese, morbidly obese, or just plain ‘normal’. A calculation that was devised in 1840 (I am not joking) it has defined how generations have viewed their health and wellbeing. The problem is that it is a calculation of height, age and weight. It does not include a measure of fat or muscle or the overall health of the subject. It just assumes everyone has an identical physical make up, which we all know is total nonsense. Applied as a blanket assessment of health, the results are only ever going to be two dimensional.
This is my problem with BMI and the use of a graph as a hard and fast rule rather than a guideline. Which is all it can be by it’s very nature. In my working life I apply statistically established rules to the people I work with, but before I reach my final decision I am expected to apply my professional judgement. If my judgement overrides the results of the statistics and I can justify my decision, then my judgement trumps the graph. In the Top Trumps of real life, sound judgement totally trumps the graph.
“Overweight children Will become overweight adults!”
Recently I went for a run with Top Monkey. Like his father he is broad shouldered and, unlike me, he is tall. His energy levels are sky high and, he can run like a rocket. He struggles to sit still for long and loves to be outside. A fussy eater, but his appetite is healthy. I do my best to get him to eat well. Just read The Big Food Fight if you don’t believe me.
Top Monkey ran a 2 mile circuit no problem. His running style consisted of hopping, skipping, jumping and sprinting. If he wanted a rest he ran off ahead a few meters then would wait for me to catch up. He never once slowed me down. Unless you count a few pauses for road safety purposes. It is therefore amazing that only a year and a half ago, after his first school health check, we recieved a letter from the school nurse informing us that he was overweight. Telling us that we should start considering how we could make him more active and improve his diet.
The letter included, in bold, the phrase “overweight children will become overweight adults”. I was shocked by the tone of the letter and it’s contents. Like a lioness whose cub had been targeted by a predator I was fierce in my response. I had suspected this would happen because he is big in build but when looked at more closely I saw that he actually appeared closer to obese on the BMI scale on the NHS website. I was furious that he had been pigeon holed based on an assessment of his height, age and weight and not by someone’s, eyes, brain and professional judgement. You can see his ribs when his top is off for crying out loud!
Is guilt the answer?
As for the advice, don’t get me started. ‘Encourage them off the sofa away from tv and games consoles.’ I wish they would sit still for longer than 30 minutes so that I can do all I need to do. ‘Get them outside and riding their bikes etc.’ They are better outside, inside it is only a matter of time before they want to batter each other. ‘Join clubs for regular exercise.’ It has cost us a fortune to keep them swimming, cycling and playing football.
I know that there are kids out there that need this support, whose parents struggle to know where to turn. However, is this the way to go about it? Guilt! Haven’t parents got enough of that already? Especially in cases like mine where parents are 100% fighting resistance to ensure they have healthy bodies and heathy minds. It may not be perfect but we are working hard.
Take TM, I breastfed him despite pressure to formula feed him on to the perfect position on the graph. Perfectly healthy otherwise, we were told to come and have him weighed weekly. Forced to chase the perfect points on the scale. One day after the formula feeding lecture was delivered for the umpteenth time, I snapped. “What is the problem? Am I damaging his brain or major organs? If I am, just say and I’ll go and buy formula today”. The unfortunate health visitor, finding herself in the firing line, managed to stammer something about him, possibly, getting cold! I promised to put an extra jumper on him, then left.
It’s all about language
Over the years I have fought TM to eat better walk when he wanted to ride in the pushchair or be carried. I endured weeks of swimming lessons where he would not stay in the water and we both cried, a lot. Football lessons, bike club and gymnastics, all in the per suit of a healthy lifestyle. All activities met with his unique brand of resistance and angry tantrums. So to be told, in very blunt terms, that everything I have fought for so far was pointless or just not good enough, was crushing. To me it was infuriating.
As I explained to the school nurse, who answered the telephone when I called to complain, it’s all about the language used. Why couldn’t the letter say, “your child is in this category based on his BMI, this does not mean that there is a problem”. “However, it can be an indicator that your child could be in an at risk category”. “Here is a list of other possible indicators”. “If you are concerned, please contact us for further advice or arrange a meeting with your school nurse”. FYI, she agreed. She also said that the only feed back they got was from the parents who didn’t really need the help.
Every child (and adult) is different
As a mother of three, who now categorises her own body image in terms of feeling comfortable in her own skin, my piece of hindsight advice is as follows. If you or your child doesn’t measure up to the graph, remember it is only a guideline. Every child (and adult) is different. If you or your baby feel and look healthy, you and they probably are. There is always room for improvement, but not hitting the graph doesn’t have to mean something sinister, like a lifetime of horrible health problems. Educate yourself as to what the graph might mean and apply a little bit of common sense. I mean, you maybe we’ll off one graph but hitting the target on another. You might be a bit overweight but don’t smoke or drink. It can all balance out along the way.
Finally, if a health professional ever uses language that makes you feel guilty or inadequate, tell them. You don’t need to be rude or confrontational, but you can let them know how they made you feel. Your speaking out might just help the person after you, who is more fragile, who could take the words more literally. Then the health professional might be more successful in conveying their advice as it is intended. Now wouldn’t that be nice?