Pa. Screening Schoolchildren for Obesity
Sep 14 3:36 PM US/Eastern

By MARTHA RAFFAELE
Associated Press
HARRISBURG, Pa.

As they wait for their children's first report cards to come home this year, elementary-school parents across Pennsylvania also can expect to get a separate report on a key indicator of their children's health.

For the first time, the state Health Department is requiring school nurses to compute students' body-mass index _ or height-to-weight ratio _ during annual growth screenings of children in kindergarten through fourth grade.

Parents will get letters about the results that will encourage them to share the information with their family doctors. The letters will explain whether the BMI is above, below, or within the normal range for the child's age and gender.

"Schools have screened students for height and weight for about 50 years," Health Department spokesman Richard McGarvey said. "They're simply taking what they've already been screening for and calculating the BMI."

The measurement will be required for students up to eighth grade next year, and for all students in the 2007-08 school year.

Pennsylvania joins four other states that already collect BMI data during student growth screenings, according to the Centers for Disease Control and Prevention: Arkansas, California, Florida and Missouri.

About 35 percent of Pennsylvania's children are overweight or at risk of becoming overweight, according to a state Health Department study of more than 25,000 students' health records during the 2001-02 school year.

A pilot test of Pennsylvania's BMI reporting requirement in the fall of 2003, which involved 4,390 students at 10 schools, produced similar results.

"When you have a kindergartner who weighs 80 pounds, that's concerning," said Nancy Alleman, a nurse at one of the test schools, Sylvan Heights Science Charter School in Harrisburg.

But Dr. Reginald Washington, a Denver pediatrician who co-chairs an obesity task force for the American Academy of Pediatrics, said the recommended doctor visit is a simplistic solution.

"If you're a general practitioner, you see patients probably every 10 minutes. It takes about an hour of counseling and evaluation to even begin to do something about obesity," Washington said. "To say, 'Here's a piece of paper and the world will be right,' is foolish."

A districtwide BMI-notification program that the East Penn School District in Emmaus instituted in 2001-02 got off to a rocky start, partly because parents weren't informed ahead of time, said parent Lisa Lechmanik.

School officials also didn't consider that in some cases, muscle contributed to a high body-mass index, she added.

"They have athletes that are training year-round, and some of the premier athletes were getting these letters," including two of Lechmanik's children, who have since graduated, she said.

The furor died down after the district made several changes, including giving parents the option of not getting the letters, she said.

Schools should be prepared to help children address weight problems by educating them about proper nutrition and providing adequate exercise time, among other things, said Ivy Silver, founder of A Chance to Heal, a Rydal-based advocacy group for people with eating disorders.

"They should develop programs so kids who are possibly at risk have the wherewithal to better manage and take care of themselves," Silver said.

Beth Trapani, spokeswoman for Pennsylvania Advocates for Nutrition and Activity, a nonprofit group that is helping the department publicize the BMI screening, said remedies need not be complicated.

"We're talking about simple, easy changes that can make a big difference _ switching to skim or lowfat milk, eating more fruits and vegetables," Trapani said.

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I think this is a terrible mistake. This will destroy whatever shred of self esteem these overweight kids have. I can not think of a better way to help children develop eating disorders. I think parents can see their child has a weight problems without the school "grading" them on their body fat content.

This doesn't offend me - school's check hearing and eyesight too. This is just another means to identify a general health issue that can impact a student's performance in school but needs to be addressed at home. My problem, though, is that the basic BMI calculation can be useless, especially for the older students who are already heavily involved in sports.

I don't see how letting parents know where their children fall on a standard growth-type chart could damage a kid's self esteem. I am certain parents are aware when their child is overweight but they may not recognize how far above the curve they are (by the time kindergarten starts kids aren't necessarily getting the regular assesments by their pediatricians that they did as toddlers). I assume they aren't getting letters that say "Your kid is fat" but just a notice stating "this is average - this is how your child compares." I just don't think that will lead to eating disorders for children. Now, remaining obese, and being teased throughout your school career THAT could lead to an eating disorder.


That's my 2 cents, anyway.

I'm not sure how this will destroy their self-esteem. Maybe if they were given the results or if they were posted in the cafeteria but they're sending them to parents. I also hold out hope that involving schools will make them more accountable for that horrible cafeteria food.

MAYBE in a million years, we can compare BMIs of schools with decent cafeteria programs against schools that still don't feed their kids a healthy menu.

I have mixed emotions on this, mainly because I've even recently seen evidence that standard weights/bmi etc. aren't always presented well. I work with a woman who at 5' weighed 155 at her last doctor's visit. The doctor told her that she was obese and then pretty much sent her on her way. Even with our socialized medicine there was no offer of even evaluating her current eating patterns / diet info etc.

Of course her bmi is 30.27 (but 30 is obese, so she's obese). As someone who has been overweight from childhood (and almost certainly fell into the obese area) my parents didn't need to be told. They tried to help, but although both carried extra weight, didn't really help.

I agree though, better nutrition in the school lunch system would likely be a good place to start. We didn't have school lunches available until high school, but I remember lots of fried food always served with french fries.

Anne

I think that parents are already aware with their child's weight without the school telling them so. I can see what will happen is that it will be additional pressure on kids to be within sort weight range to be accepted. I think it sets a pattern for children to judge the worth of themselves and others based on weight.

It would be nice if BMI and the weight on a scale were treated as just plan factual information. It is not and I think we all know that. How would you like to be judged on your weight every time you go in for a work evaluation with your boss? Do you think this is a fair assessment of the value of your work and do you want to have to account for your BMI to your employer? If you gain 10 or 20 lbs between evaluations do you want to have to explain why to an authority figure? How is that different from having a child's weight being placed on a report card? Do you think that in high school when everyone is weird about their body to begin with that getting a quarterly report card telling you are abnormally fat is helpful? People have begun eating disorders like anorexia or bulimia based on smaller criticism that this.

And the article states that the parents can opt NOT to receive the letters.

Yes, I do think this could be helpful to them. First of all, it is going to show them a curve that defines "healthy" for their height and possibly prove that they are much closer to it than they think. This could have a positive impact on kids who are of healthy weights but THINK they are fat. And, lets be honest, if you are much more than chubby as a teen you are very likely being told that you are abnormally fat every day by some of your peers - and in a much more damaging manner than a form letter to your parents.

I swear I'm not trying to be argumentative, but I don't see the correlation. These students aren't being "judged" they are being given matter of fact information. They don't have to justify their weight to anyone - nobody is getting expelled for being overweight. Student's weights aren't being considered when their classwork is being graded.

Wow, I can't think of a clearer example of a straw man fallacy. Your analogy is completely off base. No authority figure other than a parent is interacting with the child. No one is asking for explanations and no one is devaluing the child's grades based on their weight. It's completely different because it's not even close to being the same. If you're going to refute the point, you can't make up what the original position was and say that's it exactly what the article was saying.

You have a point and I am sure that my position is based in part on emotion but it is also based on past experience. When I was in school we had a program very much like this. At that time they went by the old height-weight charts. Three times a year we were all measured and weighed. All the kids who were somewhat heavy dreaded that day like you can not believe. I can say for a fact that it was perceived by the other students as permission to judge others based on weight. It was also perceived that way by several teachers. Every time that was a birthday and parents brought cookies or cake the fat kids got an earful from the students if they ate any of the sweets. Many of the students and the teachers took it upon themselves to monitor what we ate a lunch and to make a point of correcting us as to our eating choices as object lessons for others. This program was designed to help overweight students instead it made the situation million times worse. There were about 30 of us in the school who really suffered under this program and it did go on to have a profound effect on our adult lives. In theory this is not supposed to be an evaluation by an authority figure but in actually it was. Every time we had to climb on that scale were where made more than aware we where abnormal. We already knew we where heavy as did our parents. It is very disheartening to try your best to control your weight but still having to take the letter home telling your parents you are fat.

During years after the brain storm that got this program going they then decided to "help" those kids who were too short. Those who did not seem to grow in height as was the norm had their parents informed and were encouraged to take their kids to the doctor for an assessment and growth medication. Sadly as adults they developed bone cancer at an alarming rate due to the medications. I was one of the kids who was deeded too short besides being too fat. Luck was on my side and my mother did not take me in for evaluation. Today I am 5'10" so it seems the school jumped the gun for nothing.

I am suspicious of do good program like this is school because there are often unintended consequences. BMI measurements are not exact and kids bodies are growing and changing. If the school want to do something productive why not stop cutting out PE classes and make it as important as academic work. Kids need a safe place to play which they may not have where they live. Classes in nutrition should be taught and kids should be taught to calculate their own BMI when their math skills are equal to it. Basic stuff like offering healthy food a school is an option.

I am sorry if I have been overly emotional in my defense of my position. I do not wish to offend anyone. It is just that this is not a theory to me. I have lived it and it did not work. It did hurt students although that was not it's goal. I can say for a fact not one of the overweight kids involved in this program came out with anything like enhanced self esteem and certainly did not gain a healthy relationship to food. I attended other schools after that one. Of course there was teasing about weight but it was nothing like the constant industrialized put down we experienced under the height weight reporting program.

I agree that I used to dread getting weighed in when I was in grade school because I've felt fat my entire life even though I wasn't really overweight until my parent's divorced and my emotional eating thing started when I was 13. On the other hand, I really think it's a good idea for the schools to tell parents that hey, your kid is overweight! Sure it might hurt a little but it's better to be aware of a situation and do something about it than let it go. If my mom would have been more aware when I was younger I might not be overweight now. I'm not trying to pass the buck and blame my parents for my weight problem but if I would have been taught more about health and been a little more monitored when I started overeating things could have been different. Besides, it's not like the parents have to run to their kids and be like you're fat! They can just consciously start to make a change in what's being eaten in the home. And cafeteria food... BLAH... more like caFATeria food. Maybe it costs more to make real food or something... Stupid school idiots... heh. I never really ate in the cafeteria. I was just a lazy a$$ who ate garbage when I went home after school. Oh well! I am done ranting! Thanks. Peace!

I'm in Arkansas, and the schools started doing this last year. I agree that I've always despised the dreaded weigh-ins at school, being one of the very biggest kids myself, but it's something they always have done and always will do. Although I'm sure they could find ways to do it much more discreetly. But the fact that they're now sending home the child's BMI doesn't really change things in any appreciable way that I can see. I think it's kind of redundant really, I mean I know if my kid is fat or not, I don't need the school to tell me that. But if they're already humiliating them by weighing them in the first place (a practice that's not likely to change anytime soon) then why not send their findings home, it can't hurt. It's not like they're posting each child's weight and BMI on the school bulletin board for all to see. It's a discreet little letter sent directly to the parents of, and the kids have no idea they're doing anything other than the same 'ol weight and height tests.

Now, a little off topic, but in conjunction with the nasty school lunches they deem perfectly acceptable nutrition wise to feed to our kids, we had a new mandate this year stating that we could no longer bring cupcakes or "unhealthy" snacks or drinks for birthdays or class parties. So, apparently, it's not okay to have a yummy treat every once in a while, but you can still eat this crap every single day! Ugh! Un-freaking-believable!

Sorry for my little rant gone wild! But it just doesn't make sense. I know they're trying to help, but you just can't fix something this broken. I believe the whole program needs to be overhauled. To just start over from scratch and try to get it right this time.

Okay, I'm done now!

Beverly

I understand the emotional response. As a child, I too dreaded weigh in days because I was always overweight in elementary school. At least the staff did it discreetly as I remember but I am still very much against this practice. Not even because of the emotional issues of the children, but because I don't see what it accomplishes.

The parents who care are already taking their child to the doctor on a regular basis and trying to help their kids make healthy choices; those who don't care aren't going to care about the letter either. I don't trust all of the staff at all of the schools to do the right thing; I think some of them will use those charts to get kids overly concerned about their weight. Obviously, if a child is very much overweight, the child & the parents need to discuss what they are going to do as a family to living healthier. At the same time, kids go through growth spurts and they may be a little chubby right before they get taller. I for one don't want slightly overweight children who are getting ready to sprout being made to worry about their weight.

i got told i was to fat by the school nurse all the way through school it didn't affect myself esteem at all. what you say about getting judged by your weight when going for a job evaluation well it happens now. people don't get jobs because they are fat just the same as some positions don't get filled due to racism sexism and any other isms we can come up with. the point is that these stats are already taken and now they are just telling the parents believe it or not many parents don't realise when their child is overweight what is often described as puppy fat and nothing to worry about is something to worry about. i wasn't fat untill i hit 9 years old when i broke my knee cap falling off my bike. but even before that i was probably a bit porky but people said i was ok.

TakinBabySteps, at least they were discreet on the weigh-in. When I was in elementary school (in the late 50s and early 60s), we all got in a line to get weighed, and the weight was shouted to the person who was recording it. It was humiliating! I still remember that I weighed 114 lbs. in the fifth grade, when everyone else weighed under 100. Of course, I was the tallest person in my class at 5'4" (I reached my full height of 5'9" the next year), but that didn't matter whatsoever. I got teased because I weighed more than anyone else in my class and everyone knew it.

On the whole BMI thing, well, I'm just glad that all my children are out of school. Everyone for and against has valid points.

I agree completely that they are serving a lot of crap to the kids. Remember way back when (the Regan administration, I think) when they deemed KETCHUP a vegetable?

Unfortunately, it all boils down to funding which we know is lacking in many public schools. Cafeteria managers are under the gun to stay within a certain budget and a tight one at that. School cafeterias must remain financially self-sufficient. That means serving items that kids are likely going to want to buy - fried chicken, hot dogs, french fries, and the like. It is a business and they have to stay in the black. Fast food is such a big part of so many kids' lives away from school that it anything else becomes a difficult sell.

I figure my best bet is to teach my kids as much as I can about the importance of eating well and help them develop tastes for healthier foods at home. With any luck that will translate to them making better choices for themselves when they are away from home.

I'm stuck in the middle as I am a teacher. I don't have enough books in my classroom, but someone wants to buy scales that give BMI readings to the kids.

Part of me says that the schools need to stick to schooling the kids, and the medical stuff should be a private matter between the family and the doctor.

The other part of me says if we don't educate the families and make them aware, the kids aren't going to be alive long enough to teach. I know that sounds a little extreme and morbid, but I think you get the point.

I also know that our school serves the cr*piest lunches known to man. Maybe this BMI thing will lead to even stronger legislation about lunches. You would not believe how corners can be cut when it comes to funding food.

I'm stuck on this one.