The ongoing battle against childhood obesity may see a new front: the report card. Texas state Senator Leticia Van de Putte introduced a bill (SB 205) that would require all Texas school districts to print students' body mass indices (BMIs) on report cards sent to parents. For children whose BMIs indicate they are overweight, the report cards would include information for parents about the link between high body weight and health problems.
Clearly, childhood obesity is a problem that needs to be addressed. But this particular approach, while well-intentioned, is misguided; it's unlikely to produce the desired effect and may even result in some serious negative consequences.
Will report cards really help parents properly address their children's weight problems? Many parents of overweight children may be aware that their kids need help; having the school district point that out would likely just be one more frustration in the already daunting task of trying to keep a child healthy. And if parents aren't aware, is this the best way to tell them? 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 some useful resources for treating the problem (such as information on how to shop for healthy foods and how to find ways to exercise with their children) rather than simple numbers and restatements of obesity/disease links. Placing BMIs on report cards is likely to do little to motivate parents.
Report cards are a place for reporting on school performance, not a child s characteristics or non-academic habits. There's a reason report cards include math, science, and English, not toothbrushing, sleeping, and weight (despite their undoubted significance on a child's health). This plan might cause undue focus on body image, resulting in stress or even eating disorders, also a serious problem in schools. Most of us can remember times in school when comparisons of appearances lowered self-esteem; officially "grading" children on their bodies would likely be even more distressing.
Moreover, using BMI as an indicator of overall health oversimplifies the issue. The bill does not state how BMI will be calculated, except to say it involves weighing each child. This may mean the school-calculated BMIs don't include all four of the measures (weight, height, age, sex) that are known to be important in determining children's BMIs. And any BMI measure neglects the facts that muscle weighs more than fat and that simple height and weight measurements don't give the whole picture of a person's weight-related health. Just as a report card mark for "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 and give others the false belief that they need not worry about other aspects of their children's health.
Schools can play a role in helping promote healthy lifestyles and habits in children, and Senator 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 in any number of school-based approaches, but not in the report card.
Lynnea Mills is a research intern at the American Council on Science and Health.
