Obese Kinder Child

Published

Sorry for all the questions today! I just had a teacher come to me to tell me how concerned she is for a little girl that is steadily putting on weight since last year (she was obese last year too). She was very confrontational, saying, "the little girl eats two breakfasts, one at home and one at school, and eats two lunches, the one the school provides and the one mom brings her! That's too much food!! We're ALL concerned, I know Mrs. XXXX (another teacher) brought this to your attention before!" First of all, this is the first time I've heard she eats her lunch from home as well as the one served at school, and the first time I've been told she eats two breakfast meals as well. Further, her mom is well aware that all the children are served free breakfast and lunch in school, and has never requested her daughter not be served.

While I know obesity is a health concern, I am a bit annoyed at the manner in which I was approached in regards to the little girl. It was almost accusatory, like, "why haven't you fixed this problem- this child is in grave danger"..

Yes, she has a weight problem. Her mother is also very heavy set. Her mom is also a very loving and attentive parent.

How would you proceed?

Specializes in School Nurse, past Med Surge.

Who is giving her the lunch she brings from home? If the teacher knows she eats school lunch, why is she letting her have the one from home? Just leave it in her backpack.

Up Vote Up Vote ×
Specializes in PMHNP-BC.

Oh gosh, the thread stuck a cord with me. I myself am in a very similar situation but not quite as extreme. My daughter only gets 1 breakfast and 1 lunch. But weight has always been an issue for both of us.

If you're concerned about her weight, what I've learned in my situation was to look at the child's growth chart... are they on the same projectile for weight? What all the multiple PCPs (I've seen multiple PCP for guidance on this issue) have told me is this:

-you can't put a young child on a diet. You can't even say the word diet around her. period.

-you should make a more sincere effort to choose healthier foods.

-make an effort to get exercise daily.

-monitor her to see if she follows her weight/height projectile. What we don't want are sudden deviances from their projectile (super high or super low).

Maybe speak to the mom, is there a possibility she doesn't know about the double breakfast and lunch? Is the girl possibly not telling the truth? My daughter would frequently lie about food. And she would display some of the many traits others wrote on this thread. And honestly, with total sincerity, I can't imagine where she developed these behaviors from. But what I can tell you is, I've noticed some of these behaviors in her as early as one year of age! It's almost crazy to believe that.

Her other siblings eat veggies all colors of the rainbow, avocados, hummus, and egg whites out of pleasure.

A few resources that I was directed to were: nutritionist, full blood work up done (to look for thyroid functioning etc.), and to see a psychologist.

This mother might find one of these resources helpful should you decided to speak with her about this issue. Personally they didn't lead much to anywhere in my situation.

You choose how far you want to get involved. One would assume their PCP has approached this topic? But calling CPS over this issue seems a bit ridiculous if you feel the child is well taken care of and loved. Might do more harm than good cause you scare the parent and the child with undo cause.

7
Up Vote Up Vote ×
Specializes in Med-surg, school nursing..
On 1/30/2019 at 1:32 PM, UrbanHealthRN said:

If you typically screen kids for height/weight/BMI, and have some sort of follow-up letter that you send home after these screenings, then I think that's all I would do, and make sure to include my phone number if mom wants to call and talk.

If the little girl is demonstrating inappropriate behaviors around mealtime, like stealing food from kids or shoving food into her mouth, then that could be addressed with mom. It could also be used as a gateway conversation to discuss her health.

I know we all want kids to be their healthiest and happiest, but honestly, I don't feel that I'm the appropriate healthcare provider to address weight issues with a parent. Compared to the kid's pedi, I'm a stranger who does not have a long-standing professional relationship with the parent.

Side note: we check each kid's height, weight, and BMI at the start of the year, and send home letters with that information + available resources if a parent would like help. One parent was so offended at her child being categorized as obese, she actually got the pedi to write a letter saying he's aware the kid is obese but it's fine.

We no longer put the actual BMI or "underweight, average, overweight, obese" on our letters home for this exact reason, it causes so much uproar. We just put how parents can calculate the BMI themselves.

Side note: We just had our employee health screens for insurance and I had two teachers come to me and tell me they were labeled obese, and these ladies in my opinion are anything but. They look super healthy and don't really have that much extra weight on them. They were upset and it upset me that even though I know (KNOW) they are living super healthy lifestyles-healthier than me- they now have that label floating around in their head.

1
Up Vote Up Vote ×
Specializes in School Nursing.
45 minutes ago, OyWithThePoodles said:

Side note: We just had our employee health screens for insurance and I had two teachers come to me and tell me they were labeled obese, and these ladies in my opinion are anything but. They look super healthy and don't really have that much extra weight on them. They were upset and it upset me that even though I know (KNOW) they are living super healthy lifestyles-healthier than me- they now have that label floating around in their head. 

-raises hand- That's me. I'm super muscular and most people looking at me guess on average 20lbs under my current weight. On the BMI scale I'm solidly in the "overweight" category.

Up Vote Up Vote ×
Specializes in ICU/community health/school nursing.
On 2/2/2019 at 10:47 AM, Thanksforthedonuts said:

Oh gosh, the thread stuck a cord with me. I myself am in a very similar situation but not quite as extreme. My daughter only gets 1 breakfast and 1 lunch. But weight has always been an issue for both of us.

If you're concerned about her weight, what I've learned in my situation was to look at the child's growth chart... are they on the same projectile for weight? What all the multiple PCPs (I've seen multiple PCP for guidance on this issue) have told me is this:

-you can't put a young child on a diet. You can't even say the word diet around her. period.

-you should make a more sincere effort to choose healthier foods.

-make an effort to get exercise daily.

-monitor her to see if she follows her weight/height projectile. What we don't want are sudden deviances from their projectile (super high or super low).

Maybe speak to the mom, is there a possibility she doesn't know about the double breakfast and lunch? Is the girl possibly not telling the truth? My daughter would frequently lie about food. And she would display some of the many traits others wrote on this thread. And honestly, with total sincerity, I can't imagine where she developed these behaviors from. But what I can tell you is, I've noticed some of these behaviors in her as early as one year of age! It's almost crazy to believe that.

Her other siblings eat veggies all colors of the rainbow, avocados, hummus, and egg whites out of pleasure.

A few resources that I was directed to were: nutritionist, full blood work up done (to look for thyroid functioning etc.), and to see a psychologist.

This mother might find one of these resources helpful should you decided to speak with her about this issue. Personally they didn't lead much to anywhere in my situation.

Donuts, this was (pardon the expression) food for thought for me. Thank you for this.

Up Vote Up Vote ×
Specializes in School Nurse.
34 minutes ago, LikeTheDeadSea said:

-raises hand- That's me. I'm super muscular and most people looking at me guess on average 20lbs under my current weight. On the BMI scale I'm solidly in the "overweight" category.

This is me also. I have worked out all my adult life, am muscular, eat healthy, and always have a high BMI. To me, BMI readings don't take into account the whole person and their lifestyle. I always use the example, that when BMI scales came out, Bo Jackson and Jackie Joyner Kersee (both top athletes) were classified as obese.

Up Vote Up Vote ×
+ Join the Discussion