School polices that let parents know when their children are overweight or obese appear to have little impact on the problem, according to a U.S. study.
In the last decade, almost all public schools in California collected information about the height and weight of fifth, seventh and ninth graders, but only some schools opted to send the results to parents — giving Kristine Madsen, at the University of California, San Francisco, a chance to evaluate the impact of that notification.
She found that, years later, children whose parents were told they were overweight were no more likely to have lost weight at that point than children whose parents were not notified, according to a report published in the Archives of Pediatric Adolescent Medicine.
So perhaps schools should concentrate their efforts on interventions that have the most impact, such as making sure that school lunches are healthier, and increasing the use of physical activity.
“Physical education is probably the most underused public health tool we have,” she told Reuters Health.
“We really would urge schools to make sure their environments are supporting physical activity to the extent possible.”
Her findings were based on data from nearly 7 million children.
Letting parents know their children are too heavy could still have an impact, Madsen said, noting that most parents were notified by letter, which some may not have gotten.
In addition, almost none of the letters used the terms “overweight” or “obese,” instead referring to body mass index (BMI) — a measure of weight relative to height — which some parents may not have understood.
Health experts are currently divided over the benefits of schools screening children for BMI. Currently, the Institute of Medicine recommends it, along with parental notification, but other agencies such as the Centers for Disease Control and Prevention, and the American Heart Association, maintain there is not enough evidence to support the practice.
The nation’s schools reflect that division. As of 2006, 41 percent of school districts required officials to measure children’s height and weight, and three-quarters of those schools informed parents of the results.
That the current system is not having an effect is not a huge surprise, Madsen said. Even if parents modify the home environment by providing healthier meals, for example, if nothing changes at school — where children spend most of their time, it’s going to be hard to see any impact.
In addition, a single letter may not be enough to convince parents to make drastic changes at home, she added.
“Most parents are already doing the best they can,” she said.
School polices that let parents know when their children are overweight or obese appear to have little impact on the problem, according to a U.S. study.What do these letters consist of, besides BMI? What resources are being made available? Should these letters be sent and, if so, what should they say in order to achieve the desired effect?
Furthermore, it’s interesting – at least, to me – that the letters don’t use the terms “overweight” or “obese” in them. I wonder if I can find the rationale behind that. Thoughts?
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When I was in high school (three years ago) I got this letter. I hated it. All it did as make me cry and my mom called the school that afternoon and told them to not send them to us.
I know that sounds like ignoring the problem, but believe me, I knew I had a problem. My doctor pulled out “the chart” at every visit, people laughed at me in school and on the streets, and I was wearing pants bigger than my mother. It just felt like one more “bully” telling me how fat I was. I don’t believe that it makes a difference because you already know if you’re “overweight” or “obese,” you don’t need a letter, and neither do the parents. I’m not sure what the solution would be, but as a person who had the letter, I can tell you that the letter isn’t it.
They didn’t send out nutrition information. They didn’t stop selling me pizza and rib sandwiches, nor the cookies and cream cakes. They didn’t make gym any nicer or the teachers any more understand that embarrassing an overweight kid doesn’t motivate them anymore than normal. All they did was send home a letter telling me what I (and my mother) already knew.
I started losing weight when I left that school and haven’t looked back sense.
I think there’s still a lot of stigma around calling someone obese or overweight, since it implies that there’s a specific weight they should be at without any way of gauging what that is. When you use BMI – though inaccurate – it acts like there’s a scale in which to say: “This is how much you should weigh and why”. But these are my observations, I am unsure if other people feel similarly or if this was the rationale behind the word switching.
In terms of the article suggesting that more schools should utilize PE – I have mixed feelings. Phys. Ed was the bane of my educational existence and even in college I had to take more athletic courses. I wasn’t pleased. Part of this problem is that for many schools (not including college), the classes are really boring and don’t engage children at all. I had to run the mile in 5th grade. Even than I walked it. Didn’t change much when I became a teenager.
In high school, if a teacher had come up to me and taken a keen interest in me (with athletics) I may have been more apt to try out for teams and whatnot. Whereas I lacked the self-esteem to motivate myself as a teenager.
But I think also – when you talk about PE, you talk about access and economics. Which schools can afford certain equipment? Can maintain their fields?
There needs to be stiffer penalties on the parents and require them to attend parenting and nutrition class. I mean I would never let my kids overeat and not participate in some type of sports program!
Now I am against changing the food/nutrition in the cafeteria, because that infringes on the kids who are at a healthy weight. I mean, I am 36 yrs. old, and I look back when I was in school and there weren’t that many overweight kids then (all through school), and we had GREAT lunches with a range of meals (fried chicken, beans and rice, etc…), but P.E. was no joke and worked the hell out of us; and then we would play like crazy at recess. So not that many overweight kids then.
In addition, my kid’s school tried that healthy lunch meal plan for one year, and all the kids complained our nasty and tasteless. Even the cafeteria director said that the kids were wasting all of that food and trashing it.
I want my kids to eat, not come home starving.
“Now I am against changing the food/nutrition in the cafeteria, because that infringes on the kids who are at a healthy weight.”
I do want to question this, though… the same foods that are going to help overweight children lose weight are the same things that help not-overweight children maintain their weight. Trying to say certain kids have the “honor” of eating the crappy food is a strange way to approach that. :/
That happens. A lot.
I was at a fat camp and small kids got special bands that allowed them to get more food than the rest of them.
We live in a culture that if you “look” fit, no one cares what goes in your mouth. Only when it starts to catch up to you do you have a problem. That goes for schools too.
I highly doubt that a punitive system is going to help the obesity situation. Our society already provides penalties for being overweight and obese. Yet, the number of overweight people continues to rise. Perhaps providing nutrition classes or a dietitian helpline as a means of support instead of punishment would encourage parents who receive these high BMI letters.
Financial assistance may assist some of these students with their weight. In my local community, folks using food stamps are finally able to use them at the farmer’s market. When a pound of peaches are $2.97 and a pound of pork spare ribs are $1.97 (actual prices from this week’s grocery circular), nutrition becomes heavily impacted by short term fiscal matters.
I still remember Olympic skier Picabo Street stating in an interview shortly after her gold medal win that according to the BMI chart she was overweight. Every standardized test will have its weakness.
I think you are on to something with that PE statement. My PE teachers worked us to the bone also and I don’t remember morbidly obese classmates either. I also remember playing outside after school. Now that I think about it, I can’t remember the last time I heard kids outside playing. Hmmm…
With all due respect, why do some folks believe that expensive equipment is necessary for physical education? I’ve seen kids who grew up in slums improvise- all sorts of activities that involve exercise, fun and interaction for kids- and all they needed was an open space.
I am actually seeing this happen. My hairdresser and her son are very overweight. He is 8 years old and the school now has a nurse working with the family. She told me that the woman is getting on her nerves because she harasses her constantly! The only good thing she has done is recommend a food journal but has not discussed calories, BMR, nothing like that. She told my hairdresser to cut out all starches (for an 8 year old!) and only give him plain chicken breast (no seasonings!) and a salad with NO DRESSING! When the boy lost 2 pounds the nurse was mad because she wanted him to lose at least 5 pounds a week. The nurse scolded the mom when she allowed her son to eat normally for Thanksgiving. The boy has joined the YMCA and exercises now but the nurse is pissing off his mom so much that she is about to report her and just say screw it. It hurt my hearts so much because the boy is really fat and his mom was trying but the attitude of the school help is turning her off. And the price of ‘healthier’ foods is a hardship for the mom but she made the sacrifice for her son. It’s a sad situation all around…
There was a grandmother on MyFitnessPal who posted about her granddaughter receiving that letter along wit a photo. Your initial concerns about BMI are right. The little girl was actually small frame wise but she was tall for her age (she was 5 but looked about 7-8). She wasn’t short and chubby like I was. 🙂
The letter upset the little girl and the grandmother. The grandmother expressed how she felt they were creating poor body image early on. I agreed. I think it’s unhelpful to 1) say the child is overweight based on a simple chart, 2) not offer information on being healthy, and 3) focus on size over health….which it seems is going on here.
There is a definite stigma surrounding calling someone overweight/obese, and that contributes to the reason that telling someone they are overweight does not inspire them to lose weight. Fat has been held up as the primary source of not only life-threatening health issues, but also sadness, loneliness, and any number of other unpleasant feelings for the past decade. Fat has been made the face of negativity. American society, in my experience, equates the overweight person with the fat itself. That’s why the “societal penalties” a previous commenter mentioned do not work. Calling someone fat, when everything they’ve been taught screams that fat is BADBADBAD, naturally engenders a defensive response. That response either takes the form of denial(I’m not fat!) or rebellion(Fat isn’t bad!). Both of these responses are common to the point of ubiquity, and supremely counterproductive, as neither of them lead to the actual problem being addressed. In fact, both responses generally lead to the problem being exacerbated rather than alleviated, a trend the same commenter pointed out. I have been through this most of my life, and it was only within the past year or so that I realized just what it was that made me so defensive. Once I separated my identity from the fat, it was a lot easier to address. I think of it as having or carrying excess fat, not BEING fat. Once the fat isn’t a part of you mentally, it’s a lot easier to let go of it physically.
I think the rationale behind not including certain words is because they are offensive and upsetting to some people and may turn them off to the truth or reality of what the letter is actually saying. I think we need to focus less on “weight” and “BMI” and more so on healthy eating habits and exercise. Not everyone who is skinny is healthy just like not everyone who is overweight is unhealthy. Labels often ostracize and stigmatize people. School lunches should absolutely be healthier (or as healthy as they can be while being cost effective and edible). It boggles my mind when people complain about certain people wanting to improve school lunches and yet failing to realize that unhealthy kids/people will cost all of us in health insurance and government money far more than addressing the initial problem (poor eating and exercise habits).
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