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Hello, I'm your pediatrician. You'll be firing me today. And maybe suing me.

September 17, 2005 | Category: Mother to the First Power



Crappy week just took a nosedive. One of my favorite bloggers was in town, and I missed meeting him (argh!) because, you know, it was one thing and then another. And then it was Bear's 5-year checkup at the swanky, prestigious, downtown pediatricians' practice that we still use even though we moved out of the city 4 years ago.

Before I talk about what happened, I want to share my son with you. These are two pictures of him, taken in the last couple of months. One helping his dad, CD, push a lawnmower while wearing his special superhero helmet. Another pretending to be a jet plane in crazy game of tag with a bunch of friends at a park.
bearbiggi.jpg
Bearplane.jpg
This gorgeous redhead? Is Bear.

So the pediatrician does all the normal things at first: height, weight, blood pressure, and a solid inventory of parts. She scolds us because Bear can not recite his full name, address, and phone number on demand - most of which he knows but he was acting a little frozen.

Then she sat down and began talking about food choices. We explained that Bear was a picky eater and, in fact, we supplement his meals with a vitamin drink as was recommended to us a couple of years ago. (Bear chimed in with his favorite foods - carrots, apples with peanut butter, watermelon, pasta, meatballs, french fries, lingonberry jam (yes, he's Scandavian), pancakes and sausage, and grapes).

She sighed, and, ignoring Bear's list, pushed us about how we feed Bear. She wanted to know about the fats we give him, the sugars, and the starches. She gave me a fake smile and asked about the amount of butter we used on Bear's bagel - and Bear explained he hated butter and ate bagels plain.

We could all tell something was wrong, and grew tense.

Then she started talking about how Bear had gained more weight last year than he had grown in height. I looked at her, confused. She looked me up and down. And then she told me that we needed to stop making irresponsible choices for Bear. That annual BMI (Body Mass Indicators) tracking is now recommended by American Academy of Pediatrics. And that it was showing scientifically the undisputed fact that Bear's BMI number is (I just had to double-check) 16.7, which is 80% and thus Bear is obese.

CD and I gave each other a confused look, and then CD took Bear out of the room.

I babbled that I didn't understand. That Bear is extremely active, wears normal sizes, and that except for a little pudge on his tummy that goes away at each growth burst and big chipmunk cheeks (which are a genetic trait in my family) - he is, (in my completely objective opinion) ... perfect.

She gave me a stern look.

I tried to rise above the dread like a rock chafing my guts.

I explained that we had carefully avoided making food a battle ground, that we let him not only have input into his meals but also a responsibility in helping prepare them. That we severely limit convenience foods except on rare occasions. That we still use a small salad plate for him, so his portions are the right size. That he looks the same now, in proportions, as he has since he was 2 - and the same as most of the kids in his class.

I was babbling, and finally she interrupted me.

It was clear she felt that I had nothing valuable to say - I am overweight and I would, OBVIOUSLY, make my child overweight unless she stepped in and managed the situation. (And while we're making me the demonic pusher of fat, let's also ignore my tall, healthy husband and his influence completely).

The doctor then explained that she was prescribing a low-carb diet for Bear (for a 5 year old!) and wanted him back in her office in 3 months to make sure he had either stopped gaining or was losing weight.

On the way home, I wondered if I was just upset because I didn't like what the doctor had to say to the point that I might be rejecting a very important diagnosis. So in the car home, I called two family doctors and a noted child psychologist - all of whom know Bear.

They each consoled me that my son is in perfect health. That BMI's on children - especially as young as 5 years old - are flawed at best and that a respected panel had said so just a few months ago.

They pointed out that Bear is active, strong, healthy, has a stable body type, good eating habits, and emphatically re-iterated to me that he is NOT obese.

That there IS an alarming trend of overweight children in America who forge poor habits at a young age and then have to struggle with lifelong issues. But that Bear is FINE - in fact, the rosy picture that pediatricians should be striving for - no issues one way or another.

(Me? I was a perfectly active, healthy, and small kid. Got my bad habits the old-fashioned way. In college.)

I heard what they were saying, and it echoed what both CD and I feel in our gut. But it didn't stop me from crying, and hanging on to CD, and asking him if I'd been a bad mother for not pushing more steamed fish on Bear.

That pediatrician is SO fired. How could someone say these things? How? WHat gave her the right to be.... like that???? I mean, isn't my child supposed to be more individual than the current hysterical trend????

Excuse me, I am still so upset I want to scream.


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Comments


Oh God, I just had a flashback to my OB/GYN for my third baby -- he looked at my records and saw that I`d gained 50 pounds for each pregnancy (and lost it within a year each time). He told me I needed to eat ONLY MEAT AND VEGETABLES, no carbs or fruit! And he topped it off by saying, "Your husband will thank me for this."

I would have fired him, but we were in Japan and I needed a c-section, and this guy was good at epidurals, so I put up with him for 9 months.

Posted by: L. on September 24, 2005 12:32 PM


what robin said.

my brain is throwing sparks just THINKING about what i would have done. i definitely would have blogged the hell out of the story WITH the doctor's name. alternatively you could make a judysbook.com review of the stunning care you received. (this is not spam, it's a word-of-mouth website with which i have no affillation whatsoever where i found some docs, restaurants, stores, and so on to avoid/check out in my area - but it's nat'l). i would like to get a peek at that letter though.

sorry you had to even go through this. bravo to you for drawing the line.

Posted by: bitemycookie on September 24, 2005 10:46 AM


that is insane... I'm glad you fired her.

Posted by: cmhl on September 23, 2005 09:33 AM


As I kept reading I kept hoping I'd see that you were dropping the pediatrician. Good call. You certainly don't need someone like that.

Posted by: Chris on September 21, 2005 09:01 AM


When we took M in recently for what we thought to be strep throat, we were alerted that his weight was off the charts for his age. We were also alerted that he was too tall for his age as well. The child is 3.5 and weighs 43 lbs. (not an inch of fat on him) and is 43 inches tall. He wears a size 11 shoe and I just spent $200 on clothes for him because he went from a 3T to a size 5 (yes a boy's size 5) in the course of a month it seemed. The kid might as well have been starting pre-K this year.

My doctor did tell his he was overweight for his age, but due to his height and the height and body frame of his family members, he was not overweight.

My husband & I are both overweight, but our BMI is not as much as the "charts" say it is because we are (1) large frames, (2) tall, and (3) more muscular than the charts take into account.

I would be looking for a new doctor and filing a complaint with the State Licensing Board if I were you.

And don't feel too bad about the name and other milestones. We got scolded because M didn't know how to draw a stick person. Well honestly, my doctor just kept going until she found one thing he couldn't do.

Why can't we just let kids be kids, KWIM? Things were hard enough when we were growing up and now they expect them to be able to read and do math before they enter school. *shaking head*

Posted by: Christina on September 20, 2005 09:30 PM


According to BMI Arnold S. is obese. We should all be so obese.

Posted by: Locomotive Breath on September 20, 2005 04:02 PM


Ok...I guess this one touched a nerve with me because I want to add a bit more. I was, unlike Bear, at one point in my childhood, a bit overweight. My mom was back in school that year and we were all eating a few too many big macs. But I remember my mother's, and my doctor's, response to it. The tone was completely different than this doc. It was more like, hey, you're a beautiful kid, and you're healthy, but in order to stay healthy you need to eat a little differently. We'd like to see you lose x amount of pounds, but if you stay the way you are that's fine too, since you will be growing taller soon. This might be a good time to start taking walks and trying new excercise...and it might be fun! I remember being devastated by teasing from kids, but I felt encouraged and empowered by the adults around me. I lost 20 lbs and walked an average of 3 miles a day that summer. I remember a lot of things that doc told me...I remember being asked my favorite foods and being praised when tomatoes and carrots were at the top of the list.

My point? Even if she felt it was important to monitor Bear's weight gain because according to some scale he should be gaining at a different rate, there's a way to make people feel like they are all on the same team. You may have still walked away disagreeing with her assessment, but you wouldn't be worried about Bear's body image, and feeling angry and terrible.

By the way, just out of curiosity, what is her BMI?

Posted by: laura on September 20, 2005 12:02 AM


There are way too many great doctors out there to waste another minute with one that you don't feel a connection to. One that clearly isn't listening to what you say and what, even more importantly, your bright five year old is saying. If she had shut her mouth and used her ears for a few minutes, she would have realized her advice was totally inappropriate. Hang in there and enjoy that beautiful healthy child.

Posted by: E on September 19, 2005 10:39 PM


I tend to echo Robin's precise and accurate exclamation.

Do not fear about the "permanent record". Just get Bear's records from that doctor. You are entitled to them. Remove the five year checkup. There is nothing in there that matters, unless there was an actual indication of a problem. Give the remaining records to the new doctor.

Posted by: Jim on September 19, 2005 04:12 PM


Elizabeth, you KNOW he's fine. Look at him! My daughter grows the same way....out and then up. A low carb diet for a 5 year old?! Get real! The only problem I can see his the hair...that red hair is out of this world! Look at it, crackling and sparking off his head ! :)

Posted by: Tammy on September 19, 2005 03:54 PM


I think we have taken the BMI/obesity thing a bit too far. Yes, Americans are overweight, yes, we get too much sugar in our foods, etc. etc. but come, on! As my pediatrician says: "some kids are just bigger than others" (ahem, mine) and I believe this to be true in alot of cases.

I work with an an attorney who works out almost daily, has a bowl of green apples in his office all the time, is 6'2" and was deemed "obese" by the nurse when given a health care screening.

Yep, too far.

Posted by: Maria on September 19, 2005 01:45 PM


Elizabeth, what an awful pediatrician! She would have driven me to tears also, no matter how ridiculous I might know in my heart that she is. Bear is SOOOOO NOT OBESE! I have seen obese children, we all have, and that is not what they look like. He is perfect. Find yourself a new pediatrician, mention what happened and tell them to never again discuss weight in front of Bear again!

Lani's story scared me to death. Her poor daughter. That would have pushed me over the edge at 12!

Hugs to you and Bear!

Posted by: halloweenlover on September 19, 2005 12:56 PM


That is just wrong on so many levels. I'm sure you will handle it with true Elizabeth style. Give her hell.

Posted by: B on September 19, 2005 12:44 PM


Elizabeth, that's just crap. Go with what you know in your gut. Then take him to a new pediatrician and fire off a nasty missive to the old one - carbon copying the AAP.

Posted by: Stacy on September 19, 2005 12:30 PM


Okay, I think:

(a) that that swanky doctor wants a new mercedes and wants you to pay for part of it

(b) is obsessed with fat, and therefore thinks everyone else should be

(c) is nuts -- just because you become a doctor doesn't make you sane

(d) is all of the above!!

Trust your instincts as you have. They will serve Bear better than any doctor EVER WILL! Hugs to you.

Posted by: Eyes for Lies on September 19, 2005 09:54 AM


OMG... i would have ripped into that doctor like there was no tomorrow. A LOW CARB diet for a 5 year old? Was she smoking crack? And the BMI thing... yes .. it's all good that soooome doctors are on the look out for the welfare of our child but you are a damn good parent (hubby included) when it comes to raising Bear and helping him make good choices. She gets a small peak at him once a year and all of a sudden she's the expert on your flesh and blood.

As an smart parent you usually can tell when you should be alarmed about something with your kids. My oldest son has always hoovered at the top of the charts for height and weight and hangs around 60%BMI. My middle daughter is slightly pudgy in the belly and hips(runs in the family)and hoovers around 75% BMI because she's also short (again runs in the family, I'm only 4'11). My baby daugher is a peanut. In the 25%BMI. Under height and weight as a matter of fact. I HATE it when the doc's try to tell me what diets I should have my kids on. I refuse to beleive that depriving a child of essential carbs, fats, protiens, and occasional junk food is going to be better for them. Developmentally my kids are fine and like you said... I'm not going to make food a battle ground either. That's how people set there kids up for failure with food. By fighting about it.

I'm sorry... I am so angered on your behalf as well. That doctor should be reported (as others have said) She is going to injury some innocent child when some parent takes her word for gold and does as she prescribes.

I would have told her to take her low carb crap and shove it up her &%$#.

Good luck and keep doing what you and hubby have been doing with Bear. He looks like an awesome kido!!!!

Posted by: nina on September 19, 2005 08:05 AM


Anyone actually LOOKING at Bear can see he's not obese, that he is in fact fit and lean. She obviously wasn't looking (or listening. To you or Bear) If you follow her recommendations he will be underweight and possibly undernourished. Even if Bear did have a weight problem, she handled it in an indelicate and unhelpful way. Does she say the same thing about every kid to scare their parents into feeding them less? Does she think her tactics are actually helping reduce child obesity? Shall we follow up the child obesity epidemic with an anorexia/bulimia epidemic? What about the happy medium? Good for you for following up with other doctors, and for following your own better judgement.

Posted by: Laura on September 18, 2005 11:31 PM


You are right on. With parents like you, Bear's confidence will be just fine. That doctor is nuts. One look at Bear tells me he is not obese.

Posted by: Rhonda on September 18, 2005 12:28 PM


Your title said it all. Perfect! Check out the archives at http://www.bigfatblog.com/ for more support on this issue.

Sounds like this MD is an eating-disorder generator.

Posted by: Nancy Toby on September 18, 2005 09:01 AM


Elizabeth, just for clarification's sake: I don't think Bear is obese, I think the MD made a horrible error in judgement by discussing this in front of him, and I think you should fire her. My only point was that the MD was being a Scientist and reacting to Bear's weight gain vs height growth trend...which is something you may want to watch.

Posted by: Jill on September 17, 2005 11:48 PM


I wouldn't just fire her...I'd report her. There's something seriously fucked up here. Your son is so obviously NOT obese.

Posted by: kalisah on September 17, 2005 10:16 PM


Jill,

First of all, the numbers are flawed. But I won't get started on that, OK? Just to say that the accepted "Obesity Risk" percentage starts at 85% and Bear's is less than that.

(Thanks, Cheryl, for the links so I could find that out!)

Yes, too many children are at risk in this country for weight-related illnesses like diabetes. I am absolutely NOT sticking my head in the sand, OK?

But hysteria is NOT the answer. Neither is slapping a LABEL on my kid!!! The doctor put "Nutritional Concerns" as a diagnosis on his 5-year checkup. This is in his permanent records, and IT IS A LIE. He IS very healthy and EATS very healthy.

He makes great food choices. We shop together - often right from a farmstand. Fruits and vegetables and proteins are balanced with the starches. He does not drink soda or juice boxes or punch.

Children are recommended to gain 4-7 pounds and 1-4 inches a year, and Bear's growth was just about 7 pounds and 3 inches.

His body is beautifully shaped, and always has been. I sometimes wince when he and his dad tickle because after a growth spurt the limbs are thin and seem so fragile to me. And trust me when I say (as I said to her) if he has a little tummy this month, it will be gone in a growth spurt next month. It is how he has always developed.

Most importantly, when he looks in the mirror, he likes his body and all its parts. Bear likes to move, and is very active.

This pediatrician has only seen Bear twice, and what made us quit the entire practice was not only her alarmist behavior and failure to look up from her numbers and SEE Bear, it was also the UTTER disrespect with which she treated my son - who was sitting RIGHT THERE and listening.

And if this little scene with the idiot lady in the white coat plants a seed of bad body image in him or starts doubt in that great body image and bounding confidence that we have worked so hard to instill, then by all that is Holy - there is no measure to the hell I will bring to her life.

Children, kids, BELIEVE the grown-ups. They have no way to discount the information adults say. Whatever this doctor's intentions, she was WRONG in her actions. She failed her primary responsibility to Bear - by doing more harm than good.

Posted by: Elizabeth on September 17, 2005 04:52 PM


I don't have any children yet, so my opinion is probably "disposible." The number of children developing diabetes in America is staggering. It's due to our eating habits as well as our lack of physical fitness. Your MD was reacting to the Scientific Problem: Faster growth in weight over height and she was apparently alarmed. She, like many MDs, didn't use sensitivity or tact. So, my advice is to find a different doctor who you are comfortable with, but one that will continue to alert you to potential problems. As horrific acting as this MD may have been, perhaps it's worth making a few minor adjustments to slow down the weight increase until he sprouts up a bit more. And pleeze, no hate mail from anyone on this! The doctor was following the numbers and she's obviously concerned, albeit harsh.

Posted by: Jill on September 17, 2005 03:58 PM


OMG - I am angry on your behalf! That is ludicrous!!!

I have a 3 1/2 year old who is hovering on 50 pounds. She's big. She's also my fourth and the older ones were all so tiny, skinny, slight. This one... god, I love every inch of her and at the same time I'm scared. But I refuse to make food a battle ground and I refuse to put her on a 'diet' and I am darn glad my ped hasn't said anything other than how healthy and perfect she is.

Sorry, didn't mean to hijack this. Unbelievable. I'm incredulous.

Posted by: JustLinda on September 17, 2005 02:04 PM


P.S. I'm not sure it's possible to extrapolate Bear's future physique at this point. I was always the tallest kid in my class, until age 12, when I totally stopped growing. If you had seen me at age 5, you'd probably think I'd end up being tall, but I'm only 5'6". My husband was just the opposite. He was always average-to-short as a child, but now he's 6'2".

It sounds like you're doing a great job with the food choices. Try not to worry about it. :-)

Posted by: notdonnareed on September 17, 2005 01:10 PM


this is the most infuriating entry ever. that child is not overweight! i can relate because that happened to PD (my oldest) at her last check-up. the idiot doctor just told her point blank that she was overweight. i was livid. my daughter cried all the way home. she's had a weight complex ever since and she's only twelve.

are you going to lodge a complaint against this asshat?

Posted by: lani on September 17, 2005 01:10 PM


Alarmist doctors are only good for raising your blood pressure. The worst thing you can do is make Bear self-conscious about his appearance and his eating habits. She was really, really wrong to have that conversation in front of him. I think our society needs to become more accepting of different body types. Not everyone is going to be stick-straight and model-thin, no matter what they eat. As long as Bear is healthy and comfortable in his own skin, I'd let him be.

Posted by: notdonnareed on September 17, 2005 01:04 PM


Low carb for ANYONE is silly-for a five year old, I would consider it child abuse.

You are a better woman than me. I'd have told her what I thought in very plain terms before I left her office.

And not quietly either. ;-)

Posted by: konolia on September 17, 2005 12:52 PM


Just reading this made me mad! How dare she say those things to you. That's just awful and I'm so sorry that this had to come at a time when you were feeling down. In my totally non-expert opinion and simply based on the pictures you shared, Bear is NOT obese. I can't even believe she'd use that term. Appalling. That's great that you had other experts to talk to so that you aren't questioning your own sanity here.

Posted by: Jessica on September 17, 2005 11:43 AM


Get a new doctor. Now. And write a letter of complaint and file it with the state medical licensing board. Seriously. She's WAY out of line. And read this...http://www.nutri.info/

Posted by: Cheryl on September 17, 2005 10:11 AM


Ah, that sucks, I'm sorry. These "fads" make me really nervous. Like when women were only allowed to gain, like, 7 pounds during their whole pregnancy and encouraged to *smoke* to curb their appetite. We tend to put so much faith in what our doctors say, even when they are frighteningly wrong. If it feels wrong, what she said, I'd go with that feeling and change doctors.

Posted by: Hip Mama on September 17, 2005 09:32 AM


Oh FUCK her. You know how incredibly unprofessional it was for her to have that conversation in front of your son. And to be so condescending.

It's easy for me to say so, but I (hope) would have told her tersely and to the point exactly what I thought and that I was never coming back and looking into filing some type of complaint with the State or whomever if possible.

Posted by: Robin on September 17, 2005 01:08 AM