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Cathy Yeulet

The question

My 13 year old asks me if she's fat at least once a week. She's not fat or obese, but she's a little overweight. What should I be telling her?

The answer

If she asks you the same question on a weekly basis, it must bother her a lot. Don't dismiss her concerns.

As a starting point I would suggest is that you get her height and her weight done. Use those two values and calculate her BMI (Body Mass Index). There are online tools that can help you, but it is best to get it done in a doctor's office where they should have digital scales or a stadiometer (this is an instrument attached to a wall which is a more accurate way of determining height).

Once we have a BMI we can then see where she falls on a percentile growth chart for her age and gender. If she is indeed overweight, she will be between the 85th and 95th percentiles. (Higher than that is considered obese)

Even if her BMI is on the higher percentiles, but remains consistent (no steady increase), she should not be concerned. If her lipid profile, insulin, liver enzymes, urine tests and blood pressure are normal, and she is active for at least one hour per day, it will be reassuring. If her screen time is under two hours per day I would consider that to be ideal. If she eats 7-10 serving of fruits and vegetables daily, and consumes fish such as salmon or tuna twice a week, that also should encourage her not to obsess over her weight.

Set aside, intentional, un-interrupted time to meet with her: one-on-one. If possible, make sure both parents are present. Both parents must be on the same page. If you say she is overweight, but her dad says something different, it is not helpful.

Be sure to ask her if she has been teased or bullied at school. If none of the normal values reassure her, consider seeing a psychologist who can go over her interpretation of her body image.

Send pediatrician Peter Nieman your questions at pediatrician@globeandmail.com. He will answer select questions, which could appear in The Globe and Mail and/or on The Globe and Mail web site. Your name will not be published if your question is chosen.

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