Category Archives: BMI Screenings

School BMI screenings may not be perfect but they are a useful tool in the fight against childhood obesity

FoodFacts.com has been keeping an eye on the recent information in the news regarding parental responses to the in-school BMI screenings that are currently occurring in 21 different states (Alabama, Arkansas, California, Florida, Georgia, Illinois, Kentucky, Maine, Massachusetts, Mississippi, Missouri, Nebraska, Nevada, New York, New Jersey, Ohio, Pennsylvania, South Carolina, Tennessee, Texas and West Virginia). Children are screened in school for their BMI and then parents whose kids are determined to be overweight or obese by their BMI measurement are sent letters with the specifics of those measurements. It certainly isn’t helping that the letters have been labeled “fat letters” by students and teachers.

Those opposing the practice are voicing a number of different concerns including bullying, self-esteem issues and eating disorders. It is felt that, especially for girls, this BMI-driven approach to combating obesity is sending the wrong message. Already bombarded by “perfect body” images in the media, young girls can now be told they are the wrong “number” and that could encourage a rise in eating disorders. There is a definite cultural attitude towards obesity that somehow associates the overweight with being less appealing and less likeable. Folks are reasonably concerned that a letter home regarding a child’s BMI can certainly be a cause for their child to experience bullying from other kids because they’ve been labeled “fat” by their school system.

But most concerning are the reports from outraged parents whose children aren’t overweight at all who are receiving these letters anyway. These children are typically athletes – kids whose muscle mass accounts for more of their weight than it would for non-athletes. In some cases, the children’s height was recorded incorrectly. And in some cases, it’s been a combination of the two. Bottom line, in these instances the BMI measurement wasn’t an accurate picture of the child’s health.

Recent data reveals that 31.9% of children and teens in the United States are overweight or obese. We can all agree that this percentage is far too high and that too many of our children are at risk for adult obesity. We can all agree that obese children are at greater risk for suffering from diabetes and high blood pressure and that the lifestyles of children can be drastically altered due to their weight. Doesn’t that sound like we need a way to measure and track those kids who are obese or at risk for being obese?

In 2005, the US Preventive Services Task Force found that BMI is the preferred measure for detecting overweight children. BMI measurements not only identify children at risk for adult obesity and weight-related problems, they can also be correlated with long-term outcomes.

The biggest criticism for identifying children at risk for obesity through BMI measurement is the misclassification of athletic children. Kids with a higher lean body mass may fall into higher BMI percentiles and therefore may be identified as overweight or even obese when they aren’t. This is true of the system – but it is only applicable to a relatively small population of kids. Proponents of the system, state that this is why BMI is used as a screening tool and not a diagnostic tool.

And while it isn’t difficult to see the association of BMI screenings and the subsequent letters sent home to parents and bullying, self-esteem issues and an increase in eating disorders, in the state of Arkansas studies have shown that the BMI screening system has not shown any negative consequences for those children involved. At the same time, those studies have found that since the screenings began more Arkansas parents have signed their children up for sports or exercise classes and that the quality of family diets has increased.

FoodFacts.com is well aware that there are a number of valid concerns being raised in relationship to in-school BMI screenings. On the other hand, we’re just as aware of the 31.9% of America’s children classified as obese who are at a higher risk of adult obesity, diabetes, high blood pressure, coronary artery disease and other preventable medical problems. If BMI screenings can give us a more accurate picture of the health of our children, help encourage lifestyle changes for those that need them and help lower weight associated health risks as a result, perhaps we need to hang in there through this process. While obviously not perfect, BMI screenings appear to be able to help the population. Perhaps the processes will be improved over time so as to ease the concerns expressed by parents and caregivers. As we seek ways to reverse the obesity crisis and assure that our children live longer, healthier lives we are called on to embrace the changes that will help us achieve our goals.

http://pediatricsde.aap.org/pediatrics/september_2013?pg=15#pg20