The Controversial Way To Fight Child Obesity That Parents Hate

Finally, schools are getting involved and sending out letters letting parents know when their child's BMI is in an unhealthy range. It’s about time.

Nineteen states, including Maine, Alaska, and California are sending out these missives that have been dubbed “Fat Letters.”

It’s a great way to deal with a problem that has been in desperate need of attention and, yet, people are outraged. Why? Stigma.

Because of phenomenon called obesity stigma, the work of getting kids healthy is increasingly difficult. We have to stop with the “fat equals dumb or ugly or lazy or worthless or whatever” equation. There are plenty of thin people who are all of the above. There are certainly some “fat fit” people just as there are unhealthy skinny or “skinny fat” people.

Obesity is a health issue. A big health issue. And these letters are a strong step in the right direction, telling the truth without judgment and shining light on something we’ve been spending too much time keeping in the dark.

According to The Centers for Disease Control and Prevention, "The percentage of children aged 6–11 years in the United States who were obese increased from 7% in 1980 to nearly 18% in 2010. Similarly, the percentage of adolescents aged 12–19 years who were obese increased from 5% to 18% over the same period.”

So the school sending home a letter isn’t judging the parents or the child. It’s alerting the parents to a health issue that maybe didn’t get the full attention it needed. And there are a heck of a lot of kids to whom this applies.

Lauren Schmitt, a registered dietitian in the San Fernando Valley was tasked with checking out the weight of hundreds of preschoolers in the area. She reported that 200 of the 900 2 to 5-year-old children she looked at are listed as obese. Because results like this are on par with the numbers we see all around the country, Dr Schmitt thinks we shouldn't be stigmatizing children who are overweight.  “It shouldn’t be a stigma. It’s not a way to categorize someone. It’s just showing that this child has increased risk to be obese as an adult, which then could lead to quite a few chronic diseases,” said Schmitt.

If a teacher thought your kid had cancer, you’d want to know that, right?  Or if your child showed signs of being abused? And yet when it comes to weight, suddenly, parents are screaming, “Mind your own business!” at the very institutions charged with educating our kids and keeping them safe.  

The letter sent to parents is all about reporting BMI. That’s all. In case you’re unfamiliar, “body mass index (BMI) assesses weight relative to height. It provides a useful screening tool to indirectly measure the amount of body fat.”

To calculate BMI, weight in pounds is multiplied by 703, divided by height in inches, and then divide again by height in inches. “In children, the Centers for Disease Control and Prevention defines BMI-for-age at or above the 95th percentile as being overweight.” It’s numbers. Not judgment. Just numbers.

Weight has become too emotionally charged for its own good. It isn’t healthy for children to be obese. Period. It leads to overweight teens, overweight adults, and a legacy of health problems that will cost them personally as well as cost the health system at large.

American children are facing a real health crisis. Our former Surgeon General, Richard Carmona, even went so far as to say that, “because of the increasing rates of obesity, unhealthy eating habits and physical inactivity, we may see the first generation that will be less healthy and have a shorter life expectancy than their parents."

That seems like more than enough to warrant a skin-fold test and a form letter.  Let alone the fact that, according to the American Heart Association, obesity puts children at risk for  “high blood pressure, type 2 diabetes and elevated blood cholesterol levels. There are also psychological effects: Obese children are more prone to low self-esteem, negative body image and depression. And excess weight at young ages has been linked to higher and earlier death rates in adulthood.”

The letter should be sent in the mail. It shouldn’t judge or dictate behavior. It should provide the child's height, weight, and BMI, as well as a recommendation to seek out additional information from a doctor. No shaming of the parent(s) or child.  

Looks to me like the Maine school system got it exactly right:

And so did Massachusetts:

We shouldn't judge parents who have overweight children. Maybe they didn’t realize it had gotten quite so bad. Maybe one of them is obese and is having trouble facing the issue and a friendly reminder to protect their child is in order.

Regardless, I don’t see who gets hurt. A child’s BMI is not a judgment call, it’s matter of fact. If a parent loves a child, it seems bizarre that he or she would be offended by the school looking out for the child’s well-being.

So good for you, schools, for sending out those letters. Now it’s in your court, parents. Let your child’s doctor help you plot out a healthy plan for your kid.

Obesity makes people sick. It ends their lives early. Knowing your healthy weight (as well as your fat to muscle ratio) and maintaining it is key. So checking in with your doctor, no matter what size you are, is always a good idea.

And if it’s good idea for adults. It’s a doubly good idea for kids.