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?

10 thoughts on “Back to school: A new report card to measure if your child is obese?

  1. As sensitive practitioners at Children’s hospital we need to be congnicent of the labels that we place on children such as “fat”. These negative titles only further damage the emotional well being of the child who is already challenged with obesity and the social struggles that come with it. The title of this article sets a negative tone immediately by including such negative social stigma’s as “fat”. A hightened awareness from health care providers in regards to the terminology used is essential to support positive clinical outcomes for all patients.

    1. Thanks for letting us know. You’re right that we need to be sensitive to the challenges faced by our patients and all children struggling with weight issues. I’ve changed the title of the post to reflect your concerns.
      Matt

  2. Last week Dr. David Ludwig wrote a blog about the new BMI report cards that will be going home to 1st, 4th, 7th and 10th graders in Massachusetts this year. We agree with Dr. Ludwig’s main point that obesity is a very real health concern. we also acknowledge that schools are part of the problem because many of the cafeteria and vending machines do not have healthy snack or beverage options. However, we do not agree with his analogy about what most kids look like today. We believe that childhood obesity is a sensitive topic that should be handled carefully.

  3. Alas that our own cafeteria is a cuprit in offering a wide selection of extremely unhealthy food. what message are we sending to children their aprents nad professionals who visit us

  4. Today my eight year old, nine in 5 days came home with a FitnessGram. She read it over before she gave it to me. Her Body Mass Index says she is at some risk. As a mother of three girls in a society that values thinness over health, with magazine pictures of altered stick thin starved models, an overall emphasis on body image, anorexa and bulimia as a major concern, this Fitness Gram concerns me! Why would a school send a young girl home this information? This young girl who will be nine on Sunday already has to worry about her body changing, filling out, getting itself ready for puberty and now a new worry, her BMI index. REALLY? Now, I have to say my daughter is not a stick thin girl, however, there has never been a worry about her being unhealthy. She gets regular doctor check ups and she has never been told this information. I was upset by this news that my daughter may be at some risk as well. I went on several different websites, one which is the center for disease control–check it… http://www.cdc.gov/healthyweight/assessing/bmi/childrens_bmi/about_childrens_bmi.html

    I plugged into this BMI calculator as well as several other online calculators the weight and height listed on this FitnessGram. These calculators clearly state that my daughter is at 80%, a very healthy BMI. I do not know anything about this FitnessGram, however, I do know what not to send home with a young girl about to face the biggest body change she will ever experience.

    Please get my permission and most importantly do not send it home with her! It would be good if the information was acutally accurate as well. I had to sit down with my child and explain this whole BMI thing to her (as much as a child can understand) and why this FitnessGram says she is a risk and why the other calculators says she is healthy! Not to mention the fact that even if she was at an unhealthy weight, it is no other person’s business other than her parents, herself and her doctor.

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