Texas, Don't Use Report Cards to Combat Childhood Obesity

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This article first appeared in the Austin Statesman on February 7, 2005:

Texas state Sen. Leticia Van de Putte's new bill, which would require all Texas school districts to note a student's Body Mass Index on his or her report card, brings the battle against obesity to a new front. Clearly, childhood obesity is a problem, but this approach, while well-intentioned, is misguided. It's unlikely to produce the desired effect and might even result in serious negative consequences.

Will report cards really help parents properly address their children's weight issues? Many parents of overweight children already might be aware that their children need help. Having a school point that out would likely just be one more frustration in the already daunting task of trying to keep a child healthy. And as for the parents who aren't aware, is this really the best way to clue them in?

If we're going to approach obesity from a legislative standpoint, let's use our government's energies to launch public health education campaigns and give parents useful resources for treating the problem -- like information on how to shop for healthy foods and how to exercise with their children. Let's not give them simple numbers and restatements of obesity/disease links.

Placing a child's Body Mass Index (BMI) on a report card is likely to do little to motivate parents or help them address their child's obesity. In fact, it could make the problem worse.

Report cards are a place for reporting a child's academic performance, not personal characteristics or non-academic habits. The cards include math, science and English -- not toothbrushing, sleeping and weight, despite their significance to a child's health -- because we depend on schools to teach children, not grade them on their health.

This bill might cause undue focus on body image, resulting in stress, anxiety and possibly even eating disorders, already a serious and prevalent concern in schools. Most of us can remember when comparisons of our appearance lowered our self-esteem. Officially "grading" children on their bodies would likely cause even more distress.

Moreover, using BMI as an indicator of overall weight health oversimplifies the issue. Van de Putte's bill does not state how BMI would be calculated, except to say it involves weighing each child. This might mean the school-calculated BMIs don't include all four of the measures -- weight, height, age and gender -- that are important in determining children's BMIs. And any BMI measure neglects two key facts: that muscle weighs more than fat, and that simple height and weight measurements don't come close to giving the whole picture of a person's weight-related health.

Just as a report card grade on "blood pressure" wouldn't give parents a complete picture of a child's health, neither does one only for BMI. The BMI "grades" could cause unnecessary worry for some parents; for others, the grades could give a false belief that parents need not worry about other aspects of their children's health.

Schools can play a role in helping promote healthy habits, and Van de Putte is right to look to them for solutions. But perhaps that means offering students more classroom instruction on healthy habits, having school nurses call home if they have concerns about a child's weight and health, or sending information to all parents about how best to keep their children healthy and how to seek help if a child is overweight.

The answer might be found in any number of school-based approaches -- but it isn't in the report card.