Talking through BMI centiles with parents

Whilst it might seem best to to “play the issue down” or avoid the term “obese”, this can sometimes make things worse. Being told the facts about their child’s weight can be an important step to help families move forward.      

You will see in the videos below that it is possible to share difficult weight-related information in a sensitive manner. The following hints may help: 

a) Tone of voice and body language:  By adopting a non-judgemental tone and open body language, you will help parents/carers feel more at ease.    

b) How the information is presented:  Parents/carers need to be given time to digest the facts before any emotional response kicks in. One way this can be achieved is by first explaining BMI and how under/over-weight is identified in a clear, factual manner (before mentioning their individual child).  Once this is done and understood, you then explain where their child fits within this (e.g. by showing where they are on the BMI chart).  

c)  Presenting weight as a changeable component rather than a trait of the child: In video 2 below you will see the practitioner uses the word obese, but she does not specifically say the words “Chloe is obese”. Instead she talks the father through the BMI chart before showing him where Chloe is on the chart. The father is then able to work out for himself what Chloe’s weight status is. If you do feel the need to explain, it may be better to say “Chloe’s BMI is within the obese category” than “Chloe is obese”, since the first example separates Chloe’s weight from who she is as a person, rather than defining Chloe by her weight. This can be encouraging to help her father see weight as a manageable and changeable factor.        

d) Allowing time: You will see in the videos the practitioner talks through the information at a gentle pace and allows pauses throughout the consultation for the parent to digest the information. She also offers parents a chance to ask any questions and helps them feel ok to do so. Silence can feel uncomfortable, but it can also be helpful in allowing time to work through things. It is important to try and resist the temptation to fill any silences with “sugar-coated” information to help the parent feel better.    

e) Be empathic: Try and imagine how it feels for the parent/carer to receive this information. If they get upset or express surprise, let them know it is normal to feel this way. Acknowledge that it can be difficult for parents/carers to identify whether their child’s weight is healthy (which may help reduce any feelings of guilt they are experiencing). Give them space to work through their emotions and to ask any questions they may have.