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Are "fat letters" from school harmful or helpful?

Maria Mora is a freelance writer and single mom fueled by coffee, questionable time management skills, toaster oven waffles and the color orange. She lives in Florida with her two young sons. If you see her on Twitter, tell her to stop p...

Should schools screen kids for BMI?

How would you feel if you got a letter saying your child was overweight?
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Florida mom Kristen Grasso received a "fat letter" from her child’s school letting her know that her athletic daughter — who at 5 feet 3 inches tall weighed 124 pounds was at risk of being overweight.

This mom spoke out and prompted a greater conversation about BMI testing at school.

Childhood weight issues are a difficult subject. With no distinct lines between normal body diversity and obesity that puts children at risk of serious health issues, how do we keep kids healthy without damaging them emotionally? We asked parents to chime in on the school system’s role in monitoring weight and health.

How do “fat letters” affect kids?

In Kristen Grasso’s case, a sealed health letter was sent home in her 11-year-old daughter’s backpack. Kids are kids. It isn’t reasonable to send sensitive information home with a child — especially when that information could prompt serious problems with body image and eating habits. Though a quick BMI test might not directly increase bullying, it certainly causes distress in kids who are already concerned about weight and body image. Shouldn’t these screenings and reports be conducted with greater sensitivity and a focus on mental health as well as physical health?

Moms chime in on BMI screenings at school

“Kids worry too much about body size and whether they are skinny or fat — just ask my 5-year-old. I don't think they need to have it pointed out to them. If a child is overweight, the parent and doctor should be the ones concerned, not the school,” says Deanna.

“Does anyone really think that parents who have children that are overweight don't know this already? Do they really need something in black and white to tell them?” asks Liz.

“Having had a borderline eating disorder in high school, [weighing] 110 pounds at 5 feet 8 1/2 inches tall, and now struggling with my weight on the other side of the spectrum (down to size 12 from size 18), I can honestly say shame is the major cause of weight issues and schools putting sticky bureaucratic fingers in the mix will only exacerbate the problem,” says Heather from United States of Motherhood. “Kids will be kids and no matter how private the screening, there will be pressure and curiosity and yes, I think bullying.”

“I am bothered by the types of personal matters schools get involved in, but neglect to get involved in real issues like bullying,” says Tara.

Abbie is happy with the approach her child’s school takes. “I don't know if it is the best way but there has to be a way to teach health in PE,” she says. “It is done privately and they even make the kids promise not to share their own weight. They aren't allowed to ask or share.”

“Parents need to be responsible for these things,” says Christine. “Food, activity, good habits. Schools have curriculum to worry about.

“I'm opposed to it because I think it's just one more way for kids to be ostracized. The whole notion of lining up kids in school and weighing them — whether publicly or privately — is wrong and just lays the groundwork for the stigmatization of those at the top or bottom of the list,” says Jacquie. “It also provides just one more place for schools to deliver armchair health lectures about healthy eating and exercise from people who have no particular expertise in the subject matter.”

What about the kids who fall through the cracks?

The overwhelming response from parents who responded to the “fat letter” issue on Twitter and Facebook is that that weight issues should be left to a pediatrician. Boy eating fruitMany parents also said that parents already know when a child is overweight and don’t need letters from school. However, according to Pediatrics, a 2004 study showed that 86 percent of mothers with a child with a BMI at greater than the 95th percentile did not identify the child as overweight.

If parents aren’t aware of health risks or don’t take their children for yearly check-ups, schools may be the only safety net left to try to curb serious obesity. With that in mind, how effective is a letter if parents don’t have the understanding or means to take healthy next steps, such as better nutrition and regular physical activity?

Potential dangers and stigmatization

BMI screenings aren’t meant to define a child’s overall health or strength. A note from school should prompt checking in with a family doctor or pediatrician, who will suggest further action if needed. BMI should not prompt sudden dieting, shaming of a child or any kind of vigorous attempt to lose weight. When parents disregard screening letters, is this because results — such as those given to Kristen Grasso — were not applicable, or because parents aren’t being given enough information?

Could it be that kids who are most at risk of obesity don’t have the resources to see a doctor or eat right regardless of a BMI check at school? While issues like increased rates of childhood diabetes and obesity cannot be ignored, it seems like BMI screenings at school may be causing more stress than change.

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