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Paige Waehner

Should Schools Track Your Child's BMI?

By February 5, 2010

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I got an interesting comment on a recent post about parents' perceptions of their children's weight and it raises a number of questions about whether schools should track your child's body mass index (BMI). Jean says:

"I just recieved a letter from my daughter's school saying she is overweight, not even at risk of being overweight. My daughter is 9 yrs old and swims on a swim team twice a week, besides just playing outside. I was really upset because I make sure she makes healthy choices and does not sit in front of the tv. She is all muscle, but that is not taken into consideration. Furthermore, the school sells ice cream and honey buns for snacks at lunch. I checked her BMI using other calculators and she comes up being at a healthy weight. I really feel if the school is getting involved they need to consider all factors, including what they serve for lunch. I also do not see any instructional material for parents or children about healthy eating or exercise presented. They really need to practice what they preach and consider the repercussions of their actions."

I'm sure many parents would be upset by getting a note like that from the school, whether it's accurate or not, and it does raise some questions about whether, and how, schools should monitor a child's BMI. There's an interesting study about this in the journal Pediatrics, discussing different ways schools track and use BMI numbers. Some schools, such as those in New York use a 'survellience' method of tracking BMI. The purpose is to gather BMI data anonymously to monitor and track the general obesity levels student-wide.

Other schools, like Jean's, use BMI as a screening tool to help reduce childhood obesity and keep parents informed about their children's weight and health.

Jean's comment raises a number of concerns about the use of BMI as a screening tool. First, should schools even monitor a child's BMI in the first place? Is it an effective tool for reducing childhood obesity? Do we risk putting pressure on kids who may already have problems with body image and fitting in at school? And then there's Jean's concern, that the calculations they're using aren't accurate and that the school isn't taking some responsibility for the problem.

Then there's the issue of BMI itself, which is already a questionable method for determining whether a person is overweight, at least for some populations. Not only that, while it's fairly easy to determine if an adult is overweight, kids are different. They haven't finished growing and the calculations we use for adults won't work for them. There are even special charts and calculators specifically for kids and different ways to determine whether they're overweight.

What's happening in your schools when it comes to BMI and what do you think about it? Are they monitoring this kind of thing in your kids and keeping you informed? Should they? Leave a comment and tell us what's going on and what you think about it. What would you do in Jean's situation?

February 5, 2010 at 8:28 am
(1) Chris says:

That’s a big no, especially since the schools in general don’t provide the best meal choices and secondly because 99% of the schools sell junk food to raise money. Parents are the responsible parties for raising their kids. Schools can educate on good choices but in the end it is up to the parents

February 5, 2010 at 8:51 am
(2) Mark says:

I agree it is up to the parents; however 99% of the parents are over weight. So leaving it up to them doesn’t seem to a viable option now does it?
If something is not done NOW our nation well crumble under its own weight.
Yes Do the BMI! For God sake stop the insanity

February 5, 2010 at 9:22 am
(3) NF says:

If schools do track BMI, are they also going to send letters and raise concern over children whose BMI’s show that they are underweight?

February 5, 2010 at 9:32 am
(4) Sarina says:

NO NO NO schools should not track a childs BMI. Two weeks ago I got a letter printed on hot pink paper that stated that my son was over weight, and had high blood pressure. The child is 9 years old, and plays basket ball (1 practice and 2 games a week) and he also swims on a team. I immediately made a appointment with the Dr. and he checked him and told me he has no idea why they do that to parents, my son is clearly a healthy child, with no weight issues. I struggle with my weight so my son is kept on a very strict diet. Knowing that the apple does not fall far from the tree, and having already struggled with my oldest sons weight, I am very careful about the choices we make concerning our diet. I told the school not to send any more of those letters, we have a very good doctor and he will help me keep an eye on the situation.

February 5, 2010 at 10:30 am
(5) Karen says:

Every Year I get a letter from the school “informing” me that my daughter is significantly overweight and at risk for obesity. And every year, it sparks a drama with her classmates,spearheaded, by the “skinny girls.” My daughter has become quite adept at redirecting the attention when asked about her height/weight when she steps out of the “privacy” of the nurses office to face her classmates. My daughter is extremely athletic, the tallest person in her class, and as my family likes to say “solid” She comes from a long line of “solid” women and she will most likely never have a BMI that fits into a convenient chart, unless she develops an eating disorder. My daughter makes healthy choices 90% of the time and I am pleased with that. I wish her school would focus on making positive choices as much as it does collecting data. I spend a lot of time stressing positive body image, self respect and “owning” your own choices. I would rather raise a child that loves herself and her body, no matter how big or small it might be at any given time. I wish the schools would realize their generic form letter letting us know a child’s BMI is just that… a generic form letter. Why not spend all the time and resources they use collecting BMI data and use it for more positive outcomes such as more/different exercise options and nutrition education? Those are things that everyone can use throughout their lives to make positive choices.

February 5, 2010 at 10:45 am
(6) JC says:

I don’t believe the school should be doing this. For one thing it puts a big emphasis on it and could cause major embarrassment for the children. I, myself was underweight as a child and would have found weighing in at school embarrassing. I think instead the school should be promoting healthy food choices and exercise. We live in a cold weather state and when the temperature are too cold to be outside my son is stuck in a library to watch a movie. What does that promote??

February 5, 2010 at 11:23 am
(7) scout09 says:

It isn’t enough to track BMI. If you are going to do that you should be prepared to stay involved in reducing it and preventing obesity to begin with. BMI isn’t enough, you must consider body type, general health, activity level, nutrition, etc.

When my children were in high school, about 95% of the girls in their school were overweight or obese. This 95% seemed to have a problem seeing their bodies as they really were, since the muffin top was clearly present on most days. It is one thing to be anorexic and quite another to complacently accept being overweight.

I’ve noticed that being about 20 pounds overweight is the new normal. For example, the woman on the Jenny Craig commercials that claims she needs to lose 30 pounds appears to need to lose between 50 and 80 and Bertinelli should not be a spokesperson either, since she is clearly about 20 overweight herself. These are not good role models for children. Nor is obsessive dieting. It is all about lifestyle, eating family dinner together, enjoying and savoring food and making the right food choices, along with being active.

February 5, 2010 at 12:08 pm
(8) fanny says:

Schools should not track BMI’s. What they should do is the following:

1- Educate teachers on Healthy eating. My daughter’s second grade teacher would not allow unhealthy snacks, I thought GREAT. Till she told my child she couldn’t have chocolate milk, but juice was OK and when I found Ring Dings in her bag (my kid hated cake) that the teacher gave as a reward I was like really?

2- Fix the meals at the schools. Lower the sodium, stop offering junkfood and why are selling my kid french fries?

3- Stop focusing on the number and start focusing again on health. They just publishe a study that healthy weight people are actually at risk just as much as those with unhealthy BMI’s because they have a hig percent of fat.

4- Certainly don’t do it in a group setting. Hello haven’t these schools heard about the group support for Bulimia and Anorexia? Also if you are going to send a note home telling a parent the kid has an unhealthy BMI are you sending guidelines on helping the issue?

The biggest problems with schools tracking this stuff is that the schools are sending these letters home, but not educating parents or kids on the subject. What they should be doing holding seminars for teachers and parents, sending home information on healthy eating, how poor habits effect your kids. My sister-in-law and her kids are thin, so she thinks OK to let the kids eat whatever, one day I was there she fed them donuts, then cupcakes, then candy, this was a normal day. Doesn’t anyone see that eating junk is bad no matter what your BMI is. It should be more about getting the potato chips removed from the regular diet and adding in veggies and fruits. Not about BMI or WEIGHT. The problem is HEALTHY not about looks which is the impression that BMI give, I am considered OBESE and while I am overweight, I wear a size 12, when did that become obese?

February 5, 2010 at 12:48 pm
(9) Mark says:

The ONE meal a day at the schools is just a drop in the buck. What good is that one meal when they go home. sit in front of the TV with Play station and a bag of chips and “diet coke”
Please. it is not happening at home ppl.
The home cooked meals have become a thing of the past. Processed 3 minute meals in that nuke box is now the norm.
The BMI in schools might just be the wake up call these parents need to let them know that little Johnny won’t see his 40th birthday.

February 5, 2010 at 5:56 pm
(10) sw says:

I am a pediatrician and have seen the kids who receive those letters. In our city, the schools screen for acanthosis nigracans as well as BMI but I’m not sure what criteria they use. The only thing I can say is that I have picked up on kids who were pre-diabetic, had elevated cholesterols, and other health concerns. I see a lot of parents who never think of their kid as overweight and they would never have brought the kid to the doctor otherwise. It’s unfortunate that some of the kids and their families feel slighted by this but you kinda need to look at it for the vast majority of overweight kids out there who’s parents aren’t ensuring a healthy diet and lifestyle like you. These screenings are getting the messages to families that may not hear it anywhere else.

February 5, 2010 at 11:57 pm
(11) robert c. says:

Schools should not be involved in such things as this. When is the line crossed between educators and parenting? Schools have enough to worry about without overstepping boundaries. Besides unless the faculty looks like pro athletes where do they have the right to speak about being overwieght. Just stick to what you are paid to do and leave the rest to the parents. That is why I am glad my kids home school.

February 6, 2010 at 2:52 am
(12) Arlene says:

They are educators not doctors. A BMI reading doesn’t even begin to tell how healthy the person really is. A person could be muscular and they say their BMI is high because of that muscle. All of this is getting way out of hand. When will it stop? Now if your doctor says something is wrong that is a different story. Find out what they mean and go from there. Doctors are Doctors and Schools are Educational Institutions. End of argument.

February 6, 2010 at 11:26 am
(13) Bob says:

The most important thing is for a school to create a healthy environment, with fitness programs and nutrition and positive emotional support.

Unfortunately bureaucrats and accountants love to have things they can measure, and think that if they do that, then somehow they can transform education.

Having said that, it is also good for a school to track kids’ fitness; it is good for parents to know how the kids are doing. I personally don’t think BMI is a good marker, and our school doesn’t use it. And then it is up to parents and school to help keep it all in perspective, which is difficult when kids themselves, being human, start to play their peer pressure games, which are predictable and unavoidable.

However, knowledge is always better than ignorance. It sounds like many of the people who have commented here are themselves well-informed about BMI and their kids fitness levels and health, and so they do in fact keep it in perspective, and it sounds like they also make sure their kids are active. That’s the way it should be, and hats off to those parents.

It’s just that different schools do a better job than others at the total package. This is also true with Math, English, and basketball, and so on. Hopefully you have thoughtful, caring administrators and teachers in your school.

February 6, 2010 at 12:00 pm
(14) Melissa says:

I’m a nursing student stationed at a local elementary school with the school nurse. We have to write journals about our clinical experiences, and my last journal was about the BMI tracking method this school uses. I was performing health screenings on the kids, and one 3rd grader showed an overweight BMI. The nurse preceded to tell her that she was overweight and a note would be sent home to her parents, and asked the child questions about her food intake and her activity level. I focus in my journal on how appalled I was, and how I think if they should change the program. Telling a young child, especially a girl, that she is fat is just asking for lowered self-esteem and higher risk for eating disorders. If they are going to track childhood obesity, they need to use other methods besides BMI! As this wonderful article states, BMI is not an accurate way to track weight alone, ESPECIALLY for children!!!! Fat to muscle ratio is a much better tool. The schools need to reconsider their approach, and quick, before we start seeing more and more girls with eating disorders and self-esteem issues.

February 6, 2010 at 11:05 pm
(15) Mary says:

I would find out who at the school is the one obtaining the child’s height and weight and calculating the BMI. Yes, it is notoriously inaccurate in some situation (most WorldCup soccer players’ BMI’s are in the “overweight” to “obese” category due to their muscle mass). However, as a School Nurse, usually my assessment is followed by a nutritional interview with the child *24 hour food recall, etc.), and sometimes, if I can get in touch with them (many phone calls not returned), the parent. After that, it’s pretty easy to make an assessment of whether or not I’m dealing with a WorldCup soccer player or not. Also, I am an Olympic distance triathlete with normal lab values who eats a plant based diet (No red meat, no dairy, no aspartame, no high fructose corn syrup, etc.) and yet I have hypertension. It is possible to be within range on ht/wt and/or BMI and still have health issues. Many families do not have a “Medical Home” and even more, with the economy and layoffs, don’t have insurance. School Nurses are it for them. Those are the kids we want to reach. It seems short sighted to me to say schools should not be concerned about students’ health. Kudos to you parents that monitor your child’s nutritional intake and physical activity. As noted by the epidemic of childhood obesity in this country, know that you are the exceptions.

February 6, 2010 at 11:34 pm
(16) JR says:

Determining BMI in schools IS fine if the following criteria are met…

1. The assessment is part of a larger program focusing on health and fitness.
2. Done in confidence with trusted adults taking the ht/wt measurements
3. Allows for a well publicized opt-out if parents and/or students do not want to participate
4. Uses the Child BMI which is drastically different from the adult BMI
5. Results are mailed to parents making them aware that a BMI reading is just one health assessment.
6. Lessons and discussion regarding body image coincide with this Body Composition assessment

I have included BMI results for the past 5 years for my Fifth Graders with two parents not wanting to participate. The number of complaints / concerns have totaled ZERO. We assess students in so many other ways today. What curricular area is more important that a child’s health? Not reading, not math… nothing.

February 7, 2010 at 12:07 pm
(17) ltyler says:

Why are the schools even tracking this? It’s none of their darn business. It is a parents responsibility to see to it that their children are healthy. Let the schools educate and the parents parent.

February 7, 2010 at 2:36 pm
(18) JR says:

If more “parents would parent”… i.e., kill the television, push kids outside, drive past the fast-food, etc. etc…. would this question have even been raised? Good discussion here.

February 8, 2010 at 7:47 pm
(19) Heather Brunk says:

I am a mother of 4 and a personal trainer. My kids’ schools do give them a fitness assessment with BMI included. While I am not a big fan of BMI in general, I do recognize that it is being used more widely for adults to determine health insurance costs. I believe that we should have a means to measure our children or a benchmark of which we can compare them year to year and be able to explain to them what it means.

February 8, 2010 at 10:22 pm
(20) massmuscle says:

I agree to BMI measurements were taken, but the main factor is the parents. nearly 90% of children following the lifestyle of their parents, especially in terms of eating, so no wonder the parents are overweight the child also generally experience excessive weight.

February 9, 2010 at 12:53 pm
(21) amelia says:

no. that is the most ridiculous thing. i’m so glad to know that schools are more worried about a child’s BMI than their education. i’m not a parent, nor am i any longer a student, but i am pretty disgusted by this country’s idea of education anymore. a hot pink letter that says your healthy 9 year old is obese? please. parents don’t need that; parents need their children to come home from school and say, “today i learned that an apple is a healthier snack than potato chips!” schools forget that kids aren’t stupid. if you teach them, they will learn.

February 10, 2010 at 3:17 pm
(22) PhilB says:

BMI is not very good for predicting whether or not someone is healthy. I’m a male, 5′ 10″, 190 lbs. which according to the BMI is overweight…but I have a 32 in. waist and can bench press 300 lbs.

I could probably lose 10 lbs. if I wanted to show off my six pack better at the pool but even then I’d still be at the low end of overweight – obviously this number is irrelevant.

June 13, 2010 at 2:02 pm
(23) Yayama says:

My 9 1/2 year old son has a BMI of 17.1 (61st percentile), height of 34th percentile and weight of 50 percentile. What totally upsets me about these numbers is how BMI or weight percentile is calculated. Commenter Mary above described it perfectly and ironically my son IS a competitive soccer player. He is shorter in stature but plays soccer up to 15 hours per week in older leagues. His metabolism is off the charts and eats massive amounts of calories to keep up and have energy. We provide balanced meals, vitamins and also have to STILL give him nutrional boosts such as drinks to compensate. NOW to describe his physique….. He can wear a waist size 5 Toddler……. his arms, face, legs, stomach have NO visible fat. You cant pinch an inch on this kid. He has a sixpack for abs. To say he is a lean muscled machine would be UNDERSTATING it. He DOESNT look like a skeleton, he looks lean and muscled with definition. Honestly he looks like the perfect specimen of a human this age. This isnt to brag because no one here knows who he is. This is to rant and ask WHY it appears as if he is unbalanced in his body, i.e in the upper category for weight/BMI and yet lower category for height… Appears as if he had a weight problem….. BMI DOESNT WORK. DOESNT take into account the fact that like Mary said, some kids are World Cup soccer players. So now he worries since his school weighed etc with clothes hiding his skinniness if he should “lose weight”… OUTRAGEOUS!!! HE HAS NO FAT IN HIS ENTIRE BODY!!!!! We struggle to try provide a little fat into his body because humans do need some! NOW I have to convince him that he doesnt need to lose weight…. Lean kids need to be treated cautiously same as fat ones. BACK OFF SCHOOLS! It ISNT your area! You are trying to take control of PRIVATE lives and quite honestly you are using questionable calculating methods!!

November 16, 2010 at 10:56 pm
(24) john says:

Oh wow you going to cause little children not to like themselves really and on top of that if they are overweight they probably already get bullied so why do you wanna pile on by telling them their fat? thats one thing they already know!!! This is stupid make the school have healty food and sports. And I have seen an elementary school sell hot cheetoes so the school better check themselves first.

November 30, 2010 at 1:03 am
(25) person says:

schools shouldn’t weigh kids. im a student and I know this. we had a girl at my school become severly depressed because the school said she was overweight, even though her doctor said she was fine. im surprised she is still sane, because she already had a low self esteme.

March 8, 2011 at 9:49 pm
(26) cindy says:

To commenter SW, a pediatrician. Why didn’t you catch your patients diabetes, obesity, etc.? As a doctor, isn’t that your responsibility? I trust my child’s doctor to tell me about medical issues and I trust my child’s teacher to teach him his abc’s and 123′s.

May 27, 2011 at 1:12 am
(27) vicky says:

My kids and Foster kids range in size from under to over weight.I still believe this should be between our Dr and our family rather than school.

Our underweight kids are weighed backwards to help with eating disorder treatment.We have had to talk with our schools about the danger of public weighing.

Our over-weight kid is in medical treatment for kidney issues.So we know he is short and chubby.

Our kids do not get junk foods often maybe once a month.

January 8, 2012 at 9:54 am
(28) Carol says:

My almost 7 year old granddaughter got letter from school a few weeks ago and read it because it was not in an envelope or sealed shut. Now, she is refusing to eat saying she is fat. When she does eat something she is counting calories. She will be 7 in March.

January 12, 2012 at 11:23 am
(29) Marie says:

this is an invasion of privacy and can be insulting and detrimental to childrens self esteem, they are CHILDREN and should not be duped into the American obsession with attacking people who are overweight. a lot of the problem has to do with additives in foods that no one can do anything about short from growing your own food, a lot of it has to do with genetics this obsession is ridiculous

March 9, 2012 at 3:33 am
(30) Chris Morris says:

We got one of these letters. My son is active. Moreover he is 10, so some of his cohort are entering puberty and some are not. At that age, I don’t know how to make sense of percentile figures – ten year olds aren’t really a single population.

April 4, 2012 at 12:44 am
(31) CE says:

I think parents need to sit up and take notice of the shifting in what practices have become acceptable for schools. My daughter in grade nine was asked to do not only a BMI but also measurements of her waist, hips, bust and thighs, all under the guise of measuring fitness. Outrageous!!

My questions are:

what training in interpersonal communication, physical health, nutrition and mental health do those who measure have?

is there a dialogue before and after these measurements about the other factors that influence a person’s size – genetics, muscle mass, metabolic rate, etc.?

is any of this placed in the context of media awareness?

And most importantly is there a deeper discussion of the inherent value of each and every child no matter their size and shape; the beauty of each person’s gifts to the world?

The fact is a large child knows they are large and they are not wage earners and must eat what their parents provide, indeed what their parents can afford. They cannot control a lot of that. We need to look at some of those larger issues of class, of access to quality foods, of the safety of neighborhoods so that children can play outside, at access to recreation.

September 20, 2012 at 11:06 pm
(32) DH says:

I do not think it is any of the schools business in providing health care for my child. That is why we have a doctor. Further more, when my child is being examined by the doctor, I am there supervising the situation. The school is there to teach my child not to provide health care.

April 10, 2013 at 11:42 pm
(33) Carrie says:

I send my children to school to learn and I take them to the Doctor’s for their health where we get regular BMI updates. The information from the Dr. is private and the school really doesn’t have any business repeating what a “real” Dr. has already done. We are informed. Weighing and measuring children at school isn’t going to make an obese child NOT obese. It’s going to make them feel worse than they already feel. If their parent’s have allowed them to become obese, what is a letter from the school going to do. Do the schools really believe they have that much authority? Do people really believe parent’s can’t tell their child is overweight and that a letter is going to “open their eyes”. You’re kidding yourselves. This is invasive to me. If this has to be done at school there should be a well publicized Opt-Out included for those of us who choose not to just as there is an opt-out for the proof of dental check up. I know there are many not so good parent’s out there but there are many very good parent’s too that want to be able to raise there children and who are doing a darn good job without the schools poking their noses in everything. Just teach my children and let me do the rest please. My children are not part of a collective, they are my children.

April 22, 2013 at 11:57 pm
(34) mrslearn says:

My child’s body weight, her BMI, and anything else regarding her physical health is between me, my husband, my daughter, and her pediatrician. She is there for an education. She does not attend school to be parented. That’s MY job.

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