As Thanksgiving approaches and I'm trying to decide what I'm going to bake, I keep thinking about the "fat letters" that many schools are now sending home to the parents of children who've been found to have a high Body Mass Index (BMI). Thankfully, both of my children are at a healthy weight, but my skinny 8-year-old recently asked me if I think she's fat.
One mom in Florida got a lot of press recently when she complained about the fact that her healthy, active daughter got a fat letter after a mandatory health screening at school. (I hope the publicity made her daughter feel better about herself, not even more embarrassed.)
So I've been talking about this issue with some of the smart experts who work with Parents.
The childhood obesity epidemic in our country is very real, and overweight children face a lifetime of serious health problems. BMI doesn't directly measure body fat, but is considered by the American Academy of Pediatrics and the Centers for Disease Control to be the best tool to screen children for obesity. It takes a child's height, weight, and age into consideration when evaluating whether she is either underweight, healthy weight, overweight, or obese. Your pediatrician should be tracking your child's BMI starting at age 2.
But that doesn't mean that schools also need to weigh kids. "In our appearance-obsessed culture, children are acutely aware when their bodies don't match supposed ideals," says psychologist Eileen Kennedy-Moore, Ph.D., a Parents advisor. "Do we need to address obesity in children? Of course. But publically humiliating children with public weigh-ins and harsh institutional judgments is not going to help them make healthy choices. Even for children who are not overweight, public weigh-ins and knowing their weight will be judged can create anxiety and set the stage for or exacerbate eating disorders."
I have known children with eating disorders, and it is an incredibly painful and challenging situation for their parents. Kids are worried about having big tummies and jiggly thighs at younger and younger ages. That makes me very sad.
Another Parents advisor, David Ludwig, M.D., Ph.D., runs the childhood obesity program at Boston Children's Hospital. He pointed out to me that there are other reasons for BMI screening in schools. "If a school district develops a farm-to-school nutrition program, wouldn't it be interesting if data showed that it had an impact on students' body weight after a year?" Yes, I'm sure that information would help justify the money spent on the program. But at whose expense?
Of course, it's going to be hard to roll back the BMI screening programs that are law in about 20 states. It would be wonderful if all schools could incorporate nutrition education into the curriculum, and make enough time for phys ed and recess—so all kids have a better chance of being healthy and fit. Schools could also offer educational programs for parents about how to help prevent and treat childhood obesity.
I did like this piece of good news: Simply sticking to a strict bedtime can help kids stay at a healthy weight. A recent study found that kids who slept 1.5 hours longer each night for three weeks lost a half a pound.
As a parent, it's important to know if your child has a weight problem. You can calculate his BMI yourself. Parents' advisor Elisa Zied, RDN, has helpful advice in her blog, The Scoop on Food, about how to talk to your child about weight and health. As she told me, "Not every child will be slim, but kids can learn to eat and live in a way that helps them build the best body for them."
Do you think fat letters will help or hurt?
How to Eat Healthy: Raising Nutrition-Smart Kids