Measuring BMI in Schools

Do kids want their weight and body mass index (BMI) measured at school?

“I think it’s kind of wrong, says 16-year-old Ngan, “because it’s taking away privacy of the kid.” Bevelyn, 17, agrees: “Some people are even kind of reluctant to get weighed at the doctor’s office. So why at school?” And 16-year-old Robin is even more emphatic. “It’s your own number. No one else should know about it.”

But 17-year-old David has a different opinion. “I think it would be a fine idea. But incorporated in that, you would have to include more physical education.”

Do overweight kids really need to be reminded they are overweight? Experts say some, along with their parents, do.

Recently, the Institute of Medicine of the National Academies presented Congress a sweeping report that would require public schools to measure kids’ weight and BMI every year.

Dr. Mary Danielak, a licensed psychologist, explains: “One of the major psychological defenses they use is denial. And so the body mass index, given to the parents, may help the parents break through their denial that their child is heavy.”

Still, she says, it’s one thing for a child to be overweight. It’s another to give that child a number in front of his or her classmates. “Having a general category that you’re heavy or you’re thin is markedly different than having a number that you could actually compare somebody to. Or you compare yourself to. So not only would they get targeted perhaps more viciously,” she says, “but they would also run the risk of feeling worse about themselves.”

She says if a child has a weight problem, the solution begins at home rather than school, because there is no one who can help that child more than a parent. “They have to be a role model. By being outside, by exercising, by eating healthy and focusing on health and not fat and not body weight … and help their kid learn how to focus on good choices and health.”

The report lists several other actions schools and parents should take to combat childhood obesity. They include requiring nutritional standards on all brand-name foods and beverages sold at school and daily exercise periods or physical education classes. The report also says parents must provide healthier food at home and limit television and computer time to less than two hours per day.

According to the Centers for Disease Control and Prevention, about 9 million American children are obese. One-third of American children weigh too much, and the percentages of overweight and at-risk kids are about equally divided. These statistics have tripled for those between 6 and 11 and have doubled for children from 2 to 5 and 12 to 19. And with two-thirds of American adults currently overweight or obese, what are our children seeing as their future? The American obesity epidemic is becoming a long-term public health issue, on par with curbing tobacco use and wearing seatbelts. However, no quick or easy solution exists for altering social norms and attitudes.

The nation’s first mass weigh-in of schoolchildren, mandated by Arkansas state law, was among the most aggressive moves by any state to fight childhood obesity. Public schools statewide recorded the height and weight of each student and sent the figures home to parents. The results from one of the most detailed analyses of children’s weight to date hints that the epidemic of childhood obesity might be worse than previously thought. Though Arkansas is known to have a higher percentage of overweight children than other states, an alarming 38 percent of Arkansas public-school students weigh more than they should.

Congress requested a report by the Institute of Medicine (IOM) of the National Academies after IOM issued broad recommendations on how to tackle childhood obesity. The report suggests:

• School health officials should measure every student’s weight, height and body mass index (a ratio of weight to height) annually and give the results to students and families.
• All brand-name foods and beverages sold on school grounds, including what’s in vending machines and peddled through fundraisers, should meet certain nutritional standards, including standards for fat and sugar content. The Department of Agriculture along with other experts and organizations should establish these standards.
• Students should participate in moderate to vigorous exercise at least 30 minutes each day through physical education classes, intramural sports, activity clubs, and walking or biking to school.
• Parents must provide healthy foods at home and limit television, video game and computer time to less than two hours a day.
• Kids should be encouraged to avoid sugared soft drinks and other high-calorie, low-nutrient beverages.

Indications of obesity are determined differently in children than adults. A child’s levels of body fat changes as he or she matures. Excess weight for a child between 2 and 20 is determined by plotting his or her body-mass index (BMI) on an age and gender-specific growth chart.

When a child’s BMI is in the 95th percentile or higher for his or her age and gender, the child is deemed overweight. A child whose BMI is between the 85th and 95th percentile is deemed “at risk” of being overweight.

Remember that BMI is only a gauge for determining body mass. In certain circumstances, a child registering in a high percentile on the chart may not be overweight. For example, an extremely muscular child might be in a high percentile because muscle mass weighs much more than fatty tissue or skeletal mass.

• To determine BMI, divide your child’s weight by his or her height squared, then multiply by 703.
• To compare your child’s BMI to what experts consider normal and healthy, visit the BMI chart

Aetna Intelihealth
The Centers for Disease Control and Prevention
Institute of Medicine
KidsHealth
USA Today
The Wall Street Journal