So, I'm a little late to the game. Apparently, for a few years now, some schools have been including a BMI (Body Mass Index) score on children's report cards. In 2011, The Huffington Post reports that BMI scores are "the latest weapon in the fight against the growing obesity epidemic in children". I'm sure you can already guess my reaction to this, but before I get into the more objective reasons, I'll include a little personal history.
You all know I was an overweight kid. An overweight kid who carried a lot of shame about both her body and imperfections. Those imperfections included my less-than-stellar grades in math. Report cards, a necessary evil, filled me with anxiety and dread every quarter. Why? I knew, deep down, that I wasn't a perfect student; I occasionally turned in homework late and periodically made careless mistakes on tests. I held a deep level of shame due to these peccadilloes - I feared I was a bad person because of it. I feared my parents' reaction to it and hated myself around report card time. "I should be doing better", I would mutter to myself.
Can you imagine the amount of shame I would have had if BMI's were added back in the 90's? Can you imagine the ridicule I would have gotten from fellow students? Can you imagine the reaction from "trusted adults"?
"Well, your BMI is 4 points too high, and therefore, you need to lose weight, Amanda..."
So. Here are my reasons for banning BMI report cards.
- Let doctors and nutritionist do their jobs, and let teachers do theirs. Is it important that we model a healthy lifestyle for children in our schools? Absolutely. Teaching them to obsess about a number is not modelling a healthy lifestyle. Especially when schools continue to pack their vending machines with candy bars and less-than-healthy foods. Hello, mixed messages? More importantly, who are the people who are trained to deal with an individual's weight, activity and nutrition level? Their PCP. Their PCP can do a much more thorough job of determining whether or not a child is healthy or unhealthy. Better than an index number. And better than an untrained teacher or administrative personnel who is transmitting this information to a child. (I'm not knocking teachers, I just think it's clear kids' personal doctors are probably better equipped to assess that stuff.)
- BMI's can trigger, but not cause, an eating disorder. I'm a firm believer that a multitude of factors need to be in place to cause an eating disorder. But, an environmental trigger like a BMI report card can trigger a child who is already predisposed to having one. Kids at school are already influenced by bullies at school telling them they need to weigh less, wear better clothes, or don more makeup. But if adults told them this? We may forget adults in our lives wielded an unusual amount of power, power that has the ability to influence us for decades and haunt us. Some kids may not care two ways to Sunday if a trusted adult in their life tells them they're fat. But a vulnerable child? A child who comes from a traumatic home or has low self-esteem to boot? They'll take that as truth, and they'll run with it. People vulnerable to eating disorders tend to be people-pleasers, and if someone tells them to lose weight, they'll do it. I personally know someone who has been triggered by BMI report cards. This is no joke.
- BMI's are not the most accurate predictor of fat mass. In general, can it tell you if you need to lose weight? Probably, I'm not a doctor. But there are other scales - two are Body Fat Mass and Percentage of Body Fat. It's completely possible to have an obese BMI and a normal or overweight score for BFM or PBF. I've also known people who weight train, lose inches from their waist, and watch their BMI scores rise. Go Kaleo talks a LOT about this (she's a WARRIOR, check out her blog/fb page). And, here you can see how she's clinically overweight by current indexes. Ridiculousness.
- BMI scores are not going to change a perpetually unhealthy household. I'm guessing that national health advocates are hoping that BMI scores will "wake up" parents who don't keep a good eye on their child's nutrition. As in, maybe they'll change their family food habits if they see their kid weighs too much. Mmmmkay. I believe this might work for a total of two weeks. Why the cynicism, you ask? Well, I'm going to take a wild guess and say that the majority of households who constantly feed their kids donuts, soda and McDonalds may not have access to food that is healthier and therefore, higher-priced. So, there's financial blocks, and there's mental blocks too. I'm going to go a step farther - which may get me in trouble here - and posit that these same families may not be in the best place mentally or spiritually. And the solution to this is not a number on a report card. It's a change in family communication patterns or beliefs. You don't work from the outside in and put a band-aid on it; you treat the actual wound. Bottom line, NUMBERS NEVER HELP PEOPLE TO LOSE WEIGHT OR CHANGE LIFESTYLE BELIEFS.
- Isn't the medical profession's oath "Do No Harm"? I can't take credit for this one. A couple of weeks ago, on Good Morning America, one of their medical correspondents "weighed in" on this subject. GMA had interviewed several teenage girls who had communicated that the BMI scores ultimately made them feel bad about themselves. The reporting medical correspondent insightfully noted the medical profession's possible betrayal of its oath. If GMA's small-scale interview translates to the rest of the teenage population, then harm is being done.
Is obesity healthy? No way. But neither are eating disorders. Our nation has missed the mark and swung the opposite way with food obsession. We uselessly obsess about gluten and sugar and numbers. And I've harassed you all before about the dangers of obsessing about food and numbers. Obsession about numbers = obesssion about outside appearance = not solving your food issues. But working from the inside out works every time. Building your child's self-esteem through encouragement of esteemable tasks? Works. And modelling a balanced diet and positive self-esteem will protect your children from any imbalance. But an index number? No way.
More from health