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Joanna Dolgoff, M.D.

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Should Schools Send Home "Weight Report Cards?"

Posted: 02/19/10 12:17 PM ET

It has been widely reported that a mother is outraged after receiving a note from her school claiming that her healthy, sporty, five-year-old daughter is overweight and at risk of heart disease and cancer. The girl is 1% outside the healthy category based on her body mass index. Her mother Susan, 38, said no child of that age should be thinking about their weight or worrying about their appearance. She is wrong.

Several states now send home "weight report cards" to parents. The school reports the child's body mass index and informs parents if their child is considered underweight, normal-weight, overweight or obese. The note home also includes nutritional tips and guidelines. Yet parents around the country are fuming! Should schools get involved in this arena? Is it appropriate for a parent to receive such a letter?

In my opinion, the answer is yes!

Quite honestly, I don't understand what all the uproar is about. The information is completely confidential and parents can do with it what they please.

Studies show that the majority of parents of overweight children fail to recognize that their kids are overweight. And if they don't realize that their children are at medical risk due to their weight, they will not take the appropriate steps to help them.

A 2007 study from the University of Michigan C.S. Mott Children's Hospital found that only 13 percent of parents with obese children ages 6 to 11 rated their child as being very overweight, compared with 31 percent of parents with obese children ages 12 to 17. And, less than 10 percent of parents with obese children ages 6 to 11 said they were "very concerned" about their child's weight.

One out of every three children in this country is overweight and at risk for medical disease. Our children are developing medical conditions that used to be seen solely in adults. And according to the CDC, this generation of children will be the first to die younger than its parents. We clearly need to do something to help these overweight children.

Some parents are concerned about the cost of such a program. School budgets are already stretched thin. Parents are complaining that this program is simply an unnecessary expense.
Schools have always mandated that doctors send them information on each student's height and weight. So they have had this information but have not done anything with it! The only change is informing the parents of the results. The cost of this program is truly nominal!

Eating disorder activists worry that this program will cause overweight children to develop disordered eating. But studies show that if you treat an overweight child in a sensitive manner and give them the necessary tools to lose weight, you actually decrease the incidence of disordered eating. These children are at a much higher risk of medical disease from being overweight than they are of developing an eating disorder. The key is to handle the situation appropriately. That is why schools are not giving the information directly to the child. Nobody is telling a student that he/she is overweight. The school is simply giving the parents the information along with some nutritional guidelines. It is then up to the parent to handle the situation appropriately.

We are in the midst of an obesity epidemic that is shortening the life span of our children. As a society, we need to do everything we can to help the each child of the next generation live as long and as healthy a life as possible. I believe that informing parents, who may be unaware, that their children are overweight will help. When it comes to a child's health, ignorance is definitely not bliss!

 
 
 

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It has been widely reported that a mother is outraged after receiving a note from her school claiming that her healthy, sporty, five-year-old daughter is overweight and at risk of heart disease and ca...
It has been widely reported that a mother is outraged after receiving a note from her school claiming that her healthy, sporty, five-year-old daughter is overweight and at risk of heart disease and ca...
 
 
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11:44 AM on 02/26/2010
Oh, we are becoming a GPS for eating disorders with this! First of all, if schools want to promote healthy behaviors in kids, they need to serve healthy food and re-instate phys-ed, as well as recess. And not the phys-ed we grew up with, but a class that promotes physical activity for EVERYONE, not just the popular kids and the jocks.
Everyone complains that it's too expensive for schools to serve healthy meals, but some schools have created programs in which they buy healthy foods, including produce, at cost, and end up spending LESS than they spent on junk food. They also get a better academic performance from their students, as well as fewer behavioral issues. And it may be the only healthy food some kids get all day.
Forget BMIs and healthy "report cards," lets go back to the basics! We MUST make good, healthy food available to EVERYONE!

Phew! OK, stepping off the soapbox now.
04:22 PM on 02/23/2010
The research does not support BMI report cards as an effective tool. http://pediatrics.aappublications.org/cgi/reprint/121/6/e1495
04:52 PM on 02/21/2010
You are asking the wrong question. The question that needs to be asked is why the role of the school nurse has been so constricted to sick child sitter and pill dispenser?

Most people who went to public elementary school before the 80s had regular contact with school nurses, who were seen as first responders to public health and learning disabilities amongst their charges. Most of the memories I have of my school nurse are her giving us height /weight and agility tests, as well as testing our hearing and making sure we weren't developing foot or bone problems. She also visited our classrooms to talk about nutrition, and was available during PTA night to talk about family health issues. But most importantly, she spoke to my parents about using alternative forms of punishment instead of spanking.

Until the role of school healthcare is fully supported by true allied medical professionals (nurses and physical education teachers -- usually the first personnel to be strung across several different schools), simply looking at BMI charts and sending notes home will not solve the obesity epidemic in the US, particularly for Asian and black children for whom the BMI chart is problematic due to bone density. Until schools are given back the tools it once had to combat health problems and serve community health issues through its children, those notes will only be statements in the obvious.
01:32 PM on 02/21/2010
I say no. All children have to have health checks before the school year begins. The doctor should be the one to alert the parents.
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Rosewren
The power of kindness is infinite
11:00 AM on 02/21/2010
I went to elementary in the 50's, there was a place on my report card for my height and weight to be recorded every six weeks. No one considered it a big deal, what is all the fuss.
01:30 PM on 02/21/2010
But did they comment on the results?"
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Rosewren
The power of kindness is infinite
10:49 PM on 02/21/2010
There weren't very many overweight kids when I was growing up. Back then, kids did not have unrestricted access to junk food and their food was portioned out to them. There weren't all these processed foods like there are today. Further, your kids were expected to do whatever work around the house or farm that they could do and the rest of the time they were outside playing not sitting in front of a TV or computer. There is nothing wrong with watching television or computer games but people now tend to let them be babysitters because they are too busy making a living or doing their own thing, or even doing the work their kids should be doing. Society was different then and it does make it harder but parents have a responsibility to their kids to keep them as healthy as possible and if they may not know the consequences of their kids weights and eating habits they need to hear it from someone.

I could write three or four pages of how we are destroying the future of our kids today but this isn't the forum for it.
08:14 PM on 02/20/2010
NO they should not. If a parent cannot tell if their child is too overweight then a note from school will not help. Schools should be serving healthier foods and a more balanced lunch, with low fat and NO sugar and NO snacks and requiring exercise daily as part of their education. It worked for my generation!
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awa611
She's a snarl-toothed seether.....
04:18 PM on 02/20/2010
NO. NO. NO. Why do schools have to do anything other than teach? It's getting ridiculous. Teachers get paid way less than what they deserve, are overworked, get bashed all the time for all the problems of other people's kids, and now they have to get pulled into their students' fitness levels. Bu//$hit. Our education system is so screwed up now and teachers aren't allowed to just teach anymore. Yes, it's a shame that America is turning into such a fat nation. If a parent can't see that their lifestyle is causing their children to be fat and unhealthy, that's their problem, not the school systems'.
07:37 PM on 02/20/2010
"Why do schools have to do anything other than teach?"

Because parents don't raise their kids to be responsible anymore.
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awa611
She's a snarl-toothed seether.....
10:38 PM on 02/20/2010
Well, ya, I know that. But these parents are the ones that get bent out of shape when a teacher does make any little comment that they feel infringes on their parental abilities. Because of all this non-school related stuff that teachers are become more and more responsible for, they barely have enough time and support to teach the essentials.
01:13 PM on 02/20/2010
I am kind of amazed at all of the comments here, in which people are freaking out. I don't see what the fuss is about, either. I am a teacher at a private school. And of course, I agree that schools have a long way to go to do a better job and that the nutrition and health value of most school lunches would make a medical professional cry. I would like to see doctors and politicians and citizens advocate doing something about the atrocious food served in most public schools in this country.

That said, if we have a school nurse who checks basic health issues like hearing, vision, and height and weight, why in the world wouldn't parents want to know if a child might have an issue or need further help from a doctor, parent, caretaker, etc.? I for one see that children are with us four to eight hours each day, 9 months a year, so don't kid yourself, schools take on a lot of roles. What about children who don't have insurance or see a doctor? What about children who have no breakfast, or health care, or after school programs if it weren't for schools?

I understand that being called "fat" in our society unfortunately can be an insult or suggest some moral failing (which is ridiculous), and I wonder if this is the reason for such defensiveness.
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awa611
She's a snarl-toothed seether.....
04:36 PM on 02/20/2010
You're absolutely right about the terrible food served in the public school systems. But that isn't the problem. It's the terrible food and lack of proper activity in the students' own homes that is the issue. So, now they want the schools to be responsible for grading how physically healthy a student is, which is basically grading the parents on how well they're feeding their children and making them get exercise. That shouldn't be the responsibility of a teacher or school. That should be the responsibility of the family doctor and the parents. I don't know about private schools, but having a mother and many family members and friends teaching in public schools, and hearing what little time the have to actually focus on teaching, adding another responsibility that falls outside of their control is just wrong. I know we have to find a way to tackle obesity and unhealthy habits in this country. But it shouldn't be the teachers' responsibility. They're already spread to thin.
05:21 PM on 02/21/2010
I hear you. And I know, teachers are definitely spread very thin. My sister told me about her friend who is a public school Middle School teacher. She was asked to call each of her student's parents every grading cycle. She had 120 students. The phone at school hung on the wall of a hallway outside the bathroom.... you get the idea.

However, I think that if the info comes from a health official tied to the school, like a school nurse or traveling medical person, then it wouldn't place any further burden on teachers themselves. And I hope that height/weight/health info sent home wouldn't be presented as judgment or a "grade," but as information for parents..sort of like a hearing test or speech information. I'll never forget that it was a teacher who sent a note to my mom, telling her that I was having trouble seeing the board. Turns out I was very nearsighted and my mom had no idea! Let's keep hoping that advocates focus on the lunches served in schools--I'm with you--and hope that we can all do anything in our power to improve the health of our children. The statistic that one in three U.S. children today is overweight or obese is just staggering...and it will eventually put a burden on our government and health care system that will be astronomical.

Peace.
11:35 AM on 02/20/2010
This blog is slightly disturbing. I remember when I was a kid I was very active. My mom was one of those parents who would kick my brother and I out of the house as much as possible instead of letting us sit in front of the TV all day. She also wouldn't let us eat a ton of junk food. We ate healthy foods in our house and weren't allowed things like Kool Aid or pop or lots of candy (these were 'every once in a while' treats).

Having said all of that, I was a chubby kid. I wasn't what I would call fat, but I'm pretty sure I would have fallen into that 1% over the 'acceptable' BMI. It wasn't until I hit puberty that I lost all of the 'baby fat', gained more in height and everything evened out. I understand that there are overweight kids in this country, but why do we use such harsh standards with such young kids?
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Nicole Dixson
10:18 AM on 02/20/2010
No, they shouldn't. Stick to the business of educating children, which by the way, they are doing a piss poor job of. I would find it demeaning to receive a report card on my son's weight. My son happens to fall on the other end of the weight spectrum, which is too skinny. He is in the 7th grade and weighs 69 pounds. I know this and more importantly, his pediatrician knows this. I don't need the school to "inform" me of something I already know.
07:45 PM on 02/20/2010
"Stick to the business of educating children, which by the way, they are doing a piss poor job of."

Blame the teachers for parents' failings? There are horrible teachers out there, but a large percentage of children's problems in education come from their home. With some exceptions, a love for learning and attaining an education comes from their parents, not the teacher.
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Nicole Dixson
10:16 AM on 02/21/2010
LegalCodex, yes, they are doing a piss poor job of educating students. I am talking about the public education system as a whole, not teachers (although some of them suck too), who I realize are mainly following he guidelines the government sets forth. By the way, I do my part as a parent and that is reflective in my child's grades and the fact that he stays out of trouble.

I do stand by the school minding their own business when it comes to what my child weighs.
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WYHKTai-Tai
Wyoming, Hong Kong, Tai-Tai
03:05 AM on 02/20/2010
I'm 48 & I remember clearly in primary school, the school nurse always weighed and measured each student's height. I don't know if public schools still do that, my kids go to a private one that does, (They also have a good PE program). If schools do this, it would be the school nurse. Don't public schools still have those? & they're not giving it to the children, but to the parents; whose job it is to monitor their kid's meals anyway. I would probably feel insulted at 1st, if this were my child, but ultimately I think it's very helpful to know where your child stands in the range of normal or healthy. Until they are old enough to feed themselves, It is my job to develop their eating habits.

Parenting didn't come with a manual, It's on-the-job-training. I appreciate help/input from well meaning sources, even if I find it off-putting at 1st.
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brooklyncitizen
Quaerite primum regnum dei
11:35 PM on 02/19/2010
No.These days it seems like schools get involved in everything but teaching and giving kids an education
11:18 PM on 02/19/2010
Calling people fat is not the same thing as having a sane public health policy.
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Mister Biggles
01:24 PM on 02/20/2010
Compared to allowing so many people live in denial, sacrificing their health for their ego, it actually seems like a good first step towards a sane public health policy.
11:14 PM on 02/19/2010
When the schools are able to (1) competently educate children so that I don't have to use private schools for my own, and (2) providing food that is not utter crap at subsidized breakfast and lunch...
then and only then might it be appropriate for schools to start weighing in on the health of children.

Sure, this might scare some families into dealing with their kids' weight problems. Probably put a new generation of girls on crash diets and help them learn to barf at a wonderfully precocious age.

Girl, I mean Dr. girl, if you think that a family that has a kid 1% over BMI needs to get that letter then I pity your patients because your bedside manner must be atrocious.

Are there ways to bring more health into the lives of children through the schools? Sure. Improve school lunches. Bring back home ec so kids can learn about basic nutrition and cooking. Make gym classes rigorous again. Bring outdoor education into elementary programs.

Next time you are 1% off on something, maybe your taxes, maybe your tipping at a restaurant, maybe your diagnosis of a patient, I hope someone brings the hammer down on you. And may you have the children you deserve. Self-righteous people usually do : )
07:48 PM on 02/20/2010
"Girl, I mean Dr. girl, if you think that a family that has a kid 1% over BMI needs to get that letter then I pity your patients because your bedside manner must be atrocious."

You do realize that a healthy BMI is a relatively large range, don't you? To use your tip example, it would be as if the acceptable range for tips was 5%-20% and you decided to tip 4%; yes, you are only one percentage point off but the range of acceptable values was 15 percentage points and you STILL managed to fall out of it.
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TFT
High-Stakes Tests? Opt out.
10:07 PM on 02/19/2010
Teachers have nothing else to do, so why not?

Seriously, weight is a problem, agreed. But, schools are being slammed from every direction. Maybe someone other than teachers can save the world?

And maybe citizens could get together and try to bring back all the things schools have given up in the name of high test scores, like p.e., music, libraries, drama, and all the other things that humans have traditionally done.

I am so sick of schools being the focus to the detriment of so many other things, like our social structure, income gap and lack of economy.