Yesterday I wrote a letter to my daughters’ elementary school principal requesting that they be excluded from the annual, school-wide BMI (Body Mass Index) “health” screening. Accordingly, I won’t be getting a BMI Report Card in the mail that details my children’s heights and weights along with the designation of either “UNDERWEIGHT,” “NORMAL,” “OVERWEIGHT,” or “OBESE.” This year, my kids won’t endure the awkward experience of being corralled into the nurse’s office and ordered to step on the scale in a misguided attempt at predicting their risk of future disease and other health implications. They receive regular pediatric checkups and so, I already know – without the school wasting precious budgeted dollars on taking every child out of the classroom in order to line up, remove their shoes and suck in – that both of my girls are privileged (AND I DON’T USE THAT WORD LIGHTLY) to fall into the “NORMAL” BMI category.
Why then have I opted them out of this screening? I’ll give you my top six reasons:
- BMI is not an accurate predictor of health outcomes.
BMI is a calculation developed in the 19th century by a mathematician (not a medical professional) that divides a person’s weight (in kilograms) over their height squared (in centimeters). Two hundred years ago this calculation was used to determine proper allocation of governmental resources. It wasn’t used to assess individual health. BMI doesn’t take into account a person’s body composition of bone, muscle and fat. Nor, does it provide the valuable data offered by blood tests, imaging, medical history, and other examinations. If you need more reason to question the reliability of BMI as a health indicator, get this – the thresholds for the various BMI designations (normal, overweight, obese) were established, in large part by the International Obesity Task Force an organization that receives massive sums of money from the weight loss drug industry. Big Pharma has diet pills to sell, of course they’ll swing the numbers in their favor.
- In the absence of proper medical advice, the BMI report card is useless.
Pediatricians are well equipped to assess and accordingly advise the health of their patients, certainly more so than school personnel. They have a history and hopefully a rapport with our kids. They see the bigger picture of large fluctuations in height and/or weight measurements over time that could be indicative of health risks. And they have the proper education in order to further examine findings and counsel parents and children based on those results. Without such involvement, what is the purpose of the BMI “health” assessment? And what is a parent to do with the information short of putting their elementary-aged child on a diet (which is proven to do more harm than good when it comes to weight management and self-esteem)?
- School BMI screenings encourage fat fear, fat shaming, and bullying.
Because BMI testing focuses on weight it perpetuates the obesity stereotype that fat is BAD and that individuals who are fat are inferior, morally lacking, or lazy. Though school officials are unaware of whether a child with a “normal” BMI is employing unhealthy methods to maintain their weight, such as food restriction or excessive exercise, thin is considered GOOD – a passing “grade.” Fat, on the other hand, earns an already stigmatized and likely teased kid a wag of the finger, a letter home and possible participation in other weight-based school programs, regardless of the child’s nutrition or activity level. When fat becomes the problem our kids are either afraid to get it or ashamed of having it. They’ve been trained by the culture both in and outside of school to “be good” and “do their best.” BMI assessment provides them an opportunity to continue their pursuit of excellence by having an optimal weight and sadly also provides much heartache for those who fall above the line.
- BMI “health” assessments may lead to disordered eating behaviors in kids.
It’s been reported that one in three families with school-aged children ( ages 6-14) identified worrisome nutrition and physical activity behaviors as a result of obesity prevention programs in schools, such as the BMI report card. You see, the underlying assumption with BMI assessments and other such programs is that they will decrease our nationwide obesity rate by encouraging weight loss in children, most notably through dieting. Excuse me while I bang my head against the wall. Let’s get something straight – there is no (THAT MEANS NOT EVEN ONE) effective, scientifically-proven diet that promises long term, permanent weight loss.
Diets don’t work. Instead of the intended results, most attempts at food restriction create physiological chaos that triggers binge eating, increased stress hormones, and fatigue. Diets are also responsible for perpetuating feelings of disappointment, inadequacy and a mistrust of biological cues of hunger and fullness. Sadly, when food and body are vilified and children are made to feel like failures, they are at increased risk for developing eating disorders. Children as young as 5 years old have been diagnosed and it’s no surprise considering 81%of 10-year-olds admit to dieting, binge eating, or a fear of getting fat.
- There are better ways to spend school funds.
Wellness is most certainly an important aspect or raising our adorable world-changers. However, I do believe that the limited public school health budget would be better spent on programs other than BMI reporting. Why waste funds on staffing, equipment, paperwork and stamps all to report an almost arbitrary number (that’s obtained by taking our kids out of the classroom) when we could provide educational and enjoyable programs for our kids that encourage physical activity, promote body diversity and acceptance, emphasize mental health, and highlight nutritious foods? I’d prefer that our schools plant gardens with our children rather than plant the seeds of body dissatisfaction, wouldn’t you?
- BMI reporting is ineffective.
I’ll keep this final one short and sweet. There has been no supported correlation between the BMI measurements in schools and decreased childhood obesity rates. Likewise, improved health outcomes have not been identified. So, given the five aforementioned concerns – what exactly is the point?
My heart’s desire is for our precious kids to fare better in the world of weight stigma and body shame than our generation has. Declining the BMI Report Card isn’t the ultimate solution, but it’s certainly a step in the right direction.
As always, if you have any insights, ideas or questions comment below or send me an email at firstname.lastname@example.org.