Back to school: A new report card to measure if your child is obese?

ludwigIt’s a long-honored tradition: several times a year, parents receive report cards showing how their children have done scholastically. But with continuing increases in childhood obesity rates, school districts and states across the country are considering a new type of parental notification: the BMI report card.

BMI, short for body mass index, is a way of measuring weight relative to height. For the more mathematically inclined, BMI is determined as weight (in kilograms) divided by height (in meters) squared. Among adults, a BMI of 18 to 25 is normal, 25 to 30 is overweight and above 30 obese. Because children grow and develop, absolute cut points can’t be used in pediatrics. Instead, a BMI between the 85th and 95th percentile is considered overweight, and above the 95th percentile obese.

Of course, individuals differ not only in fatness, but also in relative amounts of lean tissue. A teenager engaged in regular, intense physical activities may have a high BMI due to extra muscle. But most kids today, as with most adults, look more like the Pillsbury Doughboy than Arnold Schwarzenegger. For the vast majority, BMI is a very good measure of weight status and risk for obesity-related conditions like type 2 diabetes.

So, should schools send annual BMI report cards to parents? The latest statistics show no end in sight of the obesity epidemic gripping the country. Childhood obesity threatens to shorten life-expectancy and cripple the economy if nothing is done about it. In fact, excessive weight has become so common that many parents don’t realize when their child has a serious weight problem. In addition, efforts to deal with the problem may be more effective in childhood than any other time in life. For these reasons, BMI reports cards make sense, with one important qualification.

The problem is . . . schools are part of the problem. In a terribly misguided effort by government and school districts to cut costs, the lunch room has become little more than a fast food court; hallway vending machines peddle junk food between classes, and physical education has been slashed or eliminated. It’s the height of hypocrisy to notify a parent that a child has a weight problem, while simultaneously undermining their efforts to do something about it.

The next time you get a BMI report card, first give serious consideration to whether your family (like so many others today) needs to improve eating habits and increase physical activity level. If your child’s BMI percentile is already high, or climbing fast, discuss the issue with your pediatrician.

Then, check out your child’s school, and give them a report card. If they don’t offer truly nutritious foods at lunch, and regular physical activity and after school recreation opportunities, give them a poor grade! And direct them to suggested actions for local governments released this week by the Institute of Medicine, and other suggestions by us.

David Ludwig, MD, PhD, is the director of Children’s Optimal Weight for Life Program. He is the author of many academic papers on childhood obesity and Ending the Food Fight, a book that gives parents practical advice on keeping their children healthy.

Do you think BMI report cards are a good idea?

Does your child’s school send them out?

If so, do they provide any helpful information or resources that can help you improve your child’s health?