Long gone are the days where students only had to worry about getting their homework done.
Parents expressed concern over what some are calling “fat letters,” or Body Mass Index reports, and BMI testing in schools in light of a proposal on Beacon Hill to eliminate the practice, according to CBS Boston.
The letters, sent by the Mass. Department of Public Health, inform parents of their child’s BMI, a number that measures someone’s body shape based on weight and height. Schools across the state have tested students’ BMI since 2010, but the policy has come under criticism for being intrusive and potentially harmful to children’s self-esteem, CBS reported.
BMI is considered an alternative to directly measuring body fat, according to the Center for Disease Control. However, it is not an accurate way to determine whether someone is healthy or even overweight. It overlooks skinfold thickness, actual diet evaluations, physical activity, family history and other circumstances. It doesn’t even consider muscle mass.
A closer look reveals it is not just narrow, but outdated. The BMI was introduced in the early 19th century by Belgian mathematician Lambert Adolphe Jacques Quetelet. He devised the equation in hopes of defining the “normal man,” from the average arm to the age at which he marries, according to Slate magazine.
Eventually, it was adopted by the medical community as a way to show that “overweight” people died earlier than those with an ideal weight. Doctors started using standard information on height, weight and sex because they were easier to obtain than more direct assessments such as skinfold thickness and body fat evaluations. Today it is still considered a general indicator of whether someone is overweight.
The “fat letters” that parents have received from schools eclipse all the other factors — family history, diet evaluations, physical activity and all. Despite the good intentions behind the policy, the reports may only succeed in casting a spotlight on those who do not have the average or ideal body type. The letters only tell parents how far their kids fall from the average-BMI mark, as though health can be measured in a single calculation.
The DPH’s details about obese children being bullied only affirm how harmful they can be. If anything, they reveal that the policy implicitly promotes a one-size-fits-all mentality. At least, it angers parents like Tracy Watson, who told CBS Boston that the DPH called her son, Cameron Watson, obese in his “fat letter.” The son referred to the report as an “obese letter” and said the school thinks they will make kids stop eating too much or too little by sending these letters.
And at worst, these letters simply tell children they missed the mark and condition them into believing they are inferior or wrong by not having the ideal BMI. It’s the kind of mentality that can lead children to develop body dysmorphic disorders and even eating disorders down the line.
The schools’ involvement in addressing childhood obesity isn’t the problem, especially considering some families are not informed on the issue. The practice of sending reports to parents based on such a narrow calculation is. BMI is referenced everywhere, when discussing obesity. Michelle Obama spoke of concerns about her daughters’ BMI in 2010 during her national campaign against childhood obesity. Everyday people look to calculate their BMI to get a sense of how far they are from the body shape some say they should have. But it is too narrow and often inaccurate for determining whether someone, especially a child, is unhealthy.
Most schools can find alternative ways to address childhood obesity. A health class or nutrition lesson can inform children and their families about healthy eating habits and physical fitness. There, educators can make students aware of the signs of obesity and of the various factors that contribute to weight and body shape. More importantly, they can address individual concerns and make students understand that health is more about a number on a scale or a BMI report. Only then are students likely to reflect on their lifestyles and make constructive changes.
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An excellently written piece, but I think we all continue to lose sight of what body mass index is and is not, and just what its role is in determining health status.
First, there are a variety of mathematical equations discovered in the 19th century which still serve us well today. This point is moot. BMI has been studied extensively – in adults and in children, and is by far the best NON-INVASIVE, indirect way of identifying children with excess adiposity. In pediatrics, BMI is not a number as calculated in adults, it is reported as a percentile based on age and gender taking into account pubertal changes and bone mass development.
That being said, BMI is and NEVER WAS intended to be a DIAGNOSTIC tool – it is simply a SCREENING tool – to help identify children who MAY be overweight or obese. You are absolutely correct – it does not take into account muscle mass – Tom Brady would be considered obese if left just on this number as a tool. However, the vast majority of children whom need the most help in learning to lead healthier lifestyles and who have BMIs in the 95th or greater percentile are not playing professional NFL football – they are NOT living in homes with the education, resources and knowledge to understand what healthy nutrition, physical activity or obesity IS.
These letters are and never were meant to diagnose weight problems – they are meant to serve as an alert to parents who may have children who fall into these higher percentiles. They were meant to be sent with resources to nutritionists, weight management programs, physical education programs, and to discuss with doctors the overall child’s health status, not to be used as a percentile calculation in isolation.
The solution to childhood obesity is not weight loss, not bullying or continued use of terms like “fat letter” which further stigmatize children who receive them. It is exactly as you said – adequate nutrition, physical activity, and healthy lifestyles – all things which must begin and be implemented in the home, by families and parents. When done safely and correctly, BMI Screening notification is an additional way to reach out to families in a confidential manner to have discussions with healthcare providers and educators to look at the overall health of their child.