As schools in the US take an expanding role in the fight against obesity, they are increasingly flagging at-risk children using an imperfect weight measure called the Body Mass Index (BMI), a ratio of weight to height. However, while schools are doing their best to improve child wellness, critics and parents have argued that BMI testing in schools does more harm than good to a child’s wellbeing; causing bullying, eating disorders and a more intense pressure to diet.
One such affected child was the daughter of Jennifer Dreller, who was discreetly weighed during gym class as part of a routine fitness assessment. However, the experience severely impacted the 10-year-old’s self-esteem. During a forum on childhood obesity, Dreller told a panel of health experts, ‘“How much do you weigh?” became the question of the month among fourth-grade girls. My daughter has cried many nights worrying about her weight since this experience.’
BMI screening can be misleading, but it has remained the primary tool for classifying if you are normal weight, overweight and obese. According to the Institute of Medicine, school-based BMI screenings are specifically recommended because research shows that many students don’t have access to a primary-care doctor. Paediatrician Lynn Gettleman Chehab, who runs the school clinic obesity programme at Evanston Township High School, explained, ‘Schools have a changing role in wellness because that’s where kids spend most of their waking time. It’s a crucial time for prevention, but many kids aren’t going to the doctor unless they’re sick.’
While obese children have a 70% chance of being obese as an adult, putting them at risk for heart disease, type 2 diabetes, stroke, several types of cancer and osteoarthritis, BMI may not be the best way to tackle the problem at an early age. Yes, a high BMI level correlates with future health risks, but it can be problematic as a screening tool for individuals. The relationship between your BMI and body fat can be influenced by your age, sex, ethnicity and muscle mass – which BMI screening doesn’t account for – and it can’t distinguish between excess fat, muscle or bone mass. This means that healthy athletes, muscular individuals and racial and ethnic minorities with different body compositions can have a high BMI.