Western Courier

Issue date: 4/16/07 Section: News

Media Credit: MCT Thirteen-year-old Dominique Thompson, left, has her height measured by school nurse Kathleen McLaughlin at Shafer Middle School in Bensalem, Pennsylvania.

Media Credit: MCT Sarah Baturka, 8, right, has her body mass index measured by nurse Kim Glielmi at Hillcrest Elementary School in Drexel Hill, Pennsylvania.

PHILADELPHIA - Down the hall from the cafeteria and away from the gym, schools are deploying one of the latest weapons in the fight against childhood obesity - mandated measurements of body mass index.

On a recent afternoon, seventh graders at Robert K. Shafer Middle School in Bensalem, Pa., waited as school nurse Kathleen McLaughlin recorded their heights and weights, the first step in tabulating BMIs. Each child's score, an indicator of body fat, will be mailed home in letters some have dubbed "obesity report cards."

Concern over childhood corpulence has led at least a half-dozen states to require in-school BMI calculations, intended to alert parents of a present or looming weight problem.

Pennsylvania expanded screenings to grades five through eight this year after launching the program in all elementary schools in the 2005-06 academic year.

Those involved with BMI tests say they step carefully around emotional land mines - and not just with kids.

Adolescents "are more aware of body image," McLaughlin said. "You have to be careful how you're talking to them."

At Shafer, she inquired about activities and snacks, no judgments made. McLaughlin also pushed fruits, vegetables and calorie-burning extracurriculars.

Some parents and experts are concerned that so much talk of BMI - and students do compare, say nurses - may distort a child's body image, especially among older girls at risk for anorexia and bulimia. In addition, perceptions of heaviness vary among racial and ethnic groups.

"You're going to put another label on a kid," said Wendy Cramer of the Renfrew Center, a Philadelphia treatment facility for eating disorders. "I definitely worry about what's going to happen when this gets to high school."

In Pennsylvania, that will be this fall.

Arkansas lawmakers, who passed the nation's first BMI bill in 2003, curtailed the screenings this year because of parent complaints. Testing is now every other year; 11th and 12th graders are exempt, and parents can opt not to have their children participate.

The laws stem from a huge increase nationally in the number of overweight youths - four times more than 40 years ago - and concern for their future health. Groups such as the Robert Wood Johnson Foundation, which this month announced plans to spend $500 million on programs to give children more exercise opportunities and affordable, healthy food, hope to reduce the number of kids whose obesity puts them at risk for adult diseases.

In a 2003 pilot program, BMI screenings at 10 Pennsylvania schools found 38 percent of students were overweight or at risk.

Children in the 95th percentile or higher are considered overweight. (Experts do not use the adult term "obese.") Those between the 85th and 95th percentiles are at risk for being overweight, while those below the fifth percentile are underweight.

Districts consider the BMI letter home an aid to parents, who are encouraged to consult their child's doctor.

The idea is "to detect health issues early," said Allison Topper, head of Pennsylvania Advocates for Nutrition and Activity, which worked with the state on educational materials.

"It is a screening," she emphasized, "not a diagnostic tool."

Experts caution that BMI numbers aren't foolproof tests. A child's height and weight may change dramatically from year to year, and athletes can score high because of muscle mass.

"It's really intended to be a measure for adults and morbid obesity," said Kim A. Logio, an assistant professor of sociology at St. Joseph's University who studies body image.

At Shafer, nurse McLaughlin counseled a self-conscious student that adolescence can be a time of weight gain and encouraged him to join an after-school activity. He passed on swimming and karate but considered the walking club.

At 13, Dominique Thompson, who is almost 5-foot-1 and 120 pounds, plays field hockey and devours green beans and grapes. She was surprised to find her BMI just over the at-risk line. Most middle school girls, she said, "talk about being on diets." She would like to shed a couple of pounds, but plans to turn to exercise.

That's the goal, said McLaughlin: to focus not on weight, but "on kids making better choices."

Page 1 of 1

Article Tools