Schools Take on the Role of Obesity Police

There seems little question that the increasing rate of obesity, particularly among children, in America is a concern and a real public health issue. Various measures can and should be implemented to reverse this trend. However, expecting schools that are already stretched thin by budget cuts and testing mandates to take on the additional role of body mass police seems inappropriate. But that is exactly what many schools are now doing, as reported in the New York Times:

In Obesity Fight, Many Fear a Note From School

BLOSSBURG, Pa. — Six-year-old Karlind Dunbar barely touched her dinner, but not for time-honored 6-year-old reasons. The pasta was not the wrong shape. She did not have an urgent date with her dolls.

The problem was the letter Karlind discovered, tucked inside her report card, saying that she had a body mass index in the 80th percentile. The first grader did not know what “index� or “percentile� meant, or that children scoring in the 5th through 85th percentiles are considered normal, while those scoring higher are at risk of being or already overweight.

Yet she became convinced that her teachers were chastising her for overeating.

Since the letter arrived, “my 2-year-old eats more than she does,� said Georgeanna Dunbar, Karlind’s mother, who complained to the school and is trying to help her confused child. “She’s afraid she’s going to get in trouble,� Ms. Dunbar said.

The practice of reporting students’ body mass scores to parents originated a few years ago as just one tactic in a war on childhood obesity that would be fought with fresh, low-fat cafeteria offerings and expanded physical education. Now, inspired by impressive results in a few well-financed programs, states including Delaware, South Carolina and Tennessee have jumped on the B.M.I. bandwagon, turning the reports — in casual parlance, obesity report cards — into a new rite of childhood.

Legislators in other states, including New York, have proposed them as well, while some individual school districts have adopted the practice.

Here, in the rural Southern Tioga School District, the schools distribute the state-mandated reports even as they continue to serve funnel cakes and pizza for breakfast. Some students have physical education for only half the school year, even though 34 percent of kindergartners were overweight or at risk for it, according to 2003-4 reports.

Even health authorities who support distributing students’ scores worry about these inconsistent messages, saying they could result in eating disorders and social stigma, misinterpretation of numbers that experts say are confusing, and a sense of helplessness about high scores.

“It would be the height of irony if we successfully identified overweight kids through B.M.I. screening and notification while continuing to feed them atrocious quality meals and snacks, with limited if any opportunities for phys ed in school,� said Dr. David Ludwig, director of the Optimal Weight for Life program at Children’s Hospital Boston. [full text]