My Child is Big Boned,Why Would He be Considered Overweight or Obese?

My child is “big boned” (i.e., muscle not fat). Why would he be considered overweight or obese?

That may indeed be the case if your child is very muscular and works out, but some of that muscle may actually be fat. As noted, the BMI does not measure body fat, and your child might benefit from a measurement of body fat. Several techniques are available to measure actual body fat compared with the BMI. These include skin-fold thickness, underwater weight, bioelectrical impedance, and others.

One common, easy, and noninvasive technique is the skin-fold measurement. In this technique, a special instrument is used to measure several sites (e.g., triceps, biceps, abdomen, thigh, and calf ) on the body. The skin is pinched into a double layer that includes fat (adipose) tissue but not muscle. The thickness is measured at each site. Because special calipers (that must be kept calibrated) and some training in their use are required for consistency, not all pediatricians will perform this test. They may refer you to a fitness or obesity specialist or clinic for measurement.

If, after this measurement, your son has a normal and acceptable level of body fat, there may be no issue with weight. If his BMI and body fat are elevated beyond healthy, however, then we cannot say that he is just “big boned.”

LeVon’s father:

LeVon is 12 years old and already weighs more than all of his friends. He’s very athletic and plays football at school. He’s young and still growing and wants to be an offensive guard on the high school football team when he’s old enough. He is serious and does well in his classes. I think he’ll do fine. He’s strong, big boned, and works out a lot.

LeVon is not too tall or fast, and that’s why he wants to be a guard. He’s a great eater, is not picky, and will eat any-thing we put in front of him. He loves fried food and barbecue, which is very popular here, but he also eats fruits and vegetables. The school nurse told us at the beginning of the year that she was a bit concerned about his weight. We said that he’s just big boned, but she said that she was concerned that he is too heavy for his age and height and that not all of his weight is muscle but also fat. That is true, as he does have a “spare tire” around his waist, but for a foot-ball guard position, that’s good. We’re not sure what to do because he is a great kid and is doing fine.