Submitted by Dr. Steffanie Sperry
Sally’s mother comes home from work and finds 9 –year-old Sally withdrawn and visibly upset. Upon questioning her daughter, she discovers that Sally had been given a BMI report card at school earlier that day. Sally tells her mother that she does not want to be ”fat”, and she wants to know what is wrong with her. She just wants to be like the other girls in her class that are in the “normal” range. Sally’s mother is taken aback and does not know what to say or how to respond to her daughter.
There has been much controversy in recent years surrounding the provision of BMI report cards in the schools. An increasing number of US states have jumped on board with what is argued to be a public health intervention aimed at reducing childhood obesity rates.
What is BMI? BMI stands for Body Mass Index. The BMI statistic takes into account a person’s weight and height and provides a way of standardizing and comparing weight status while controlling for a person’s height. BMI ranges have been created to provide a general idea of one’s ideal weight range. In children, a BMI above the 85th percentile is considered overweight, and a BMI at or above the 95th percentile is labeled as obese.
Proponents of the BMI Report Card policy argue that awareness is a key factor in thwarting the growing rates of obesity and related diseases in children and adolescence. It is suggested that BMI should qualify as a health condition eligible for school-based screening due to high prevalence rates and growing public health concern surrounding childhood obesity and significant health comorbidity, such as heart disease and diabetes.
Although this sounds reasonable on the surface, I fear that providing body weight information to children at school can cause more harm than good. I find it quite bothersome that at growing number of school systems across the country are willing to embark on a “public health intervention” with essentially no data to support its efficacy, or more importantly, rule out negative consequences of the intervention. As a psychologist specializing in the treatment of children and adolescents with eating and weight disorders, the practice of providing body weight information to our children at school, without consideration of their resources or emotional health, is quite disconcerting for several reasons like the following:
Knowledge and sensitivity is key
The thought of providing information to our children suggesting that they are overweight or obese without proper delivery and support is careless. A plethora of research supports the notion that our children, especially our girls, have become increasing preoccupied with weight and appearance over the past several decades. Many of the eating disorder patients that walk through my door have a history of being overweight, and most can recall triggering situations during which they were made to feel ashamed and insecure about their weight. These triggering situations often played a role in the development of their eating disorder. Body weight information should be provided by a health care professional if intervention is indicated, or by a loving and supportive parent who can monitor the reaction of his or her child.
If your child brings home a BMI report card, please handle with care. There are health care professionals that can help you and your child manage his weight in a kind, nurturing, and effective way. If your child or teen is struggling with weight, poor body image or eating concerns, we can help. Contact Rice Psychology Group in Tampa to schedule a diagnostic evaluation and treatment planning session. Through our scientifically supported treatment programs, we can help.