11/01/2013 06:14 pm ET Updated Jan 23, 2014

Dear Parent... Your Child Is Fat!

Why are teachers handing certain students letters to take home to parents with information about their BMI? This is outrageous on several levels, and my guess is that the real goal of decreasing at risk kids' health problems goes by the way side as issues related to privacy, boundaries and the manner in which we communicate come to the foreground.

First of all, I will go on the record as saying that childhood obesity is a massive health problem. There are a variety of medical issues, emotional problems and long-term ramifications associated with obesity. I strongly advocate for healthy eating habits, regular physical exercise and the development of realistic weight-related goals for all children (not just those who are overweight) and adults.

Conversations about a child's health status (e.g. weight, emotional health, abilities and deficits) should be discussed amongst parents/caregivers and pediatricians. If school personnel, such as a teacher or school nurse, are concerned about the way a child is eating (or not eating), or if they have other specific concerns, then the proper method of communication is to reach out to a parent directly and schedule a meeting or conference.

Handing a kid a letter to take home to mom or dad -- when the whole class knows what it says -- is absurd. Who knows if the letter even makes its way home? If the child reads it, does he even understand its true intention? Probably not -- kids think letter = fat = shunned.

It doesn't really take a letter to tell kids they are overweight. They know this, and so do their parents. If the goal is trying to help families make real changes, a letter home stating a child's BMI is not really going to do anything.

Consider some real and practical steps schools could take that would address issues related to obesity and other health concerns:

  1. Include health-related information during parent-teacher conferences. Invite a dietician or a nutritionist to talk to all parents about how to make food choices and even show pictures of food that is served in the school's cafeteria highlighting optimal food choices. These discussions should be for all children.
  2. Discuss how the cafeteria addresses portion control and the replacement of sugary drinks with better choices, such as water and low fat milk.
  3. Re-evaluate the physical education program -- what happened to gym every day or even every other day? I work with several kids who are given wonderful choices for physical education (Zumba, yoga, weight training), while other kids I work with gym very minimally.

For those children who are obese and show concerning behaviors (e.g. overeating, inability to exercise, limited mobility), schools should have a conversation with parents and be prepared to offer solutions and strategies. If schools are going to all this effort to write letters, who not concentrate these efforts and offer real support to families who may not understand the health risks by providing more information, or helping lay out an exercise and eating plan (with the help of a dietician and or referral to a pediatrician).

If you want to get involved, great. Just do it in a way that is non-shaming and actually helpful. Sending 50 letters home seems pretty ineffectual, is getting everyone angry, and is making going to school just one bit harder for the kids who may already be getting teased or bullied.

Rachel Busman, PsyD, is a clinical psychologist at the Child Mind Institute, whose website,, offers free parenting resources as well as a wealth of information on childhood psychiatric and learning disorders.