BMI Checking at School--Another Crazy Idea

A therapist I share patients with just emailed me. She was upset to learn that her son, a high school student, would be weighed and measured and his BMI calculated as part of the school's fitness testing. This parent did some research and found out that her east coast state mandates that high schools do BMIs. She asked me what I thought about BMI checking at schools. Here is what I told her:

Frankly, weight and height checking at school is crazy. I know from my own patients that it can trigger bona fide eating disorders from anorexia through binge eating. At the very least school-wide weight checking makes students anxious and embarrassed. Not to mention, there is a lack of research showing that involving schools in BMI assessments is helpful at all. For a number of years, California has been assessing BMIs in school and sending home "BMI report cards." As far as anyone can tell, the effort had NOT made a difference.

There is no point in complaining to your child's school because the mandate comes from the state. You and other concerned parents need to organize and complain directly to the governor. Go get 'em!

Check out my "talking points" and a few from the Academy of Eating Disorders's guidelines to help prevent childhood weight problems. Feel free to use any and all in campaigns to stop the dangerous trend of taking BMI into school and triggering poor self-esteem and eating disorders in children.

1. Assessing body weight should only be done by qualified medical professionals (physicians, physician assistants, nurse practicioners, and registered dietitians) who have access to the child's growth curve and medical history.

2. Only a medical professional can assess weight in the context of pubertal growth and development, musculature, ethnicity, and existing medical conditions such as eating disorders. All of these factors need to be considered before the safety and health of a child's weight can be evaluated.

3. When weight is assessed, gender-specific BMI percentile growth charts or curves must be used. Because a child's growth in height and weight will follow about the same percentile curve throughout childhood, current weight and height need to be plotted on this growth curve. Growth charts are kept by primary care providers who record height and weight from age 2 on.

4. Determining normal or abnormal growth in children should be dependent on the consistency of their growth over time and not just the percentile at which they are growing. Childhood overweight should be defined as an upward weight divergence that is abnormal for an individual child, which can be determined only by comparing the child to him- or herself over time. This can be accomplished by consulting an individual growth chart, rather than an arbitrary BMI cutoff.

5. Weighing students should only be performed when there is a clear and compelling need for the information. The height and weight of a child should be measured in a sensitive, straightforward and friendly manner, in a private setting. Height and weight should be recorded without remark. Further, BMI assessment should be considered just one part of an overall health evaluation and not as the single marker for a student's health status.

6. Weight must be handled as carefully as any other individually identifiable health information.

Marcia

Nutritionist Marcia Herrin and Nancy Matsumoto, co-authors of The Parent's Guide to Eating Disorders, Gūrze Books. Marcia is also author of Nutrition Counseling in the Treatment of Eating Disorders (www.marciaherrin.com). Copyrighted by Marcia Herrin and Nancy Matsumoto