BMI's and ABC's: Should the state of a child's health be a grade on a report card?
by Karen E. Giunta, MA, LMFT
Reprinted with Permission from Minuteman Newspapers

In an effort to reverse the declining state of children’s health in our country, there is a trend in state legislation requiring that schools report a student’s BMI, body mass index, to parents in the form of a health report card. Many states, such as Connecticut, have implemented legislation addressing changes in school practices, including nutrition offerings and physical education requirements. On a local level, initiatives include the formation of nutrition and wellness committees, changes to school lunch menus to include salad, fresh fruit and whole grain products, and removal of high sugar sodas and drinks from vending machines, as well as high fat snacks. In addition, schools have minimum physical education requirements, and in some instances, before and after school intramural programs are provided. At present, reporting of BMI in Connecticut schools has not been mandated.

So, what is BMI, and is it helpful or harmful for schools to provide these health reports? BMI, or body mass index, is a calculated measurement of body fat based upon gender, height and weight. There are two categories: youth (2 years through teens) and adult. The results are plotted on a graph and grouped into health categories: underweight (<5th percentile), healthy weight (5th – 85th percentile), at risk of being overweight (85th – 95th percentile), and overweight (> 95th percentile). The research suggests that BMI is similar to other forms of body fat determination, such as underwater weighing. However, it is important to understand that BMI is a screening tool, NOT a diagnostic tool. And as such, BMI alone is not necessarily an accurate assessment of one’s physical health. Additional factors such as family and personal history, bone structure, nutrition habits, and lifestyle practices must be considered for a more accurate assessment.

What appears to be happening in the schools providing BMI information is a mixture of help and harm. Some states report that families who receive this information are taking it a step further by obtaining medical advice regarding the child’s health. In other cases, children are becoming fearful, some are restricting food intake, and many are feeling they have done something wrong, since the school has reported this information to their parents. There is concern that reporting BMI in this manner could possibly increase, rather than decrease, the prevalence of eating disorders and low self-esteem among children.

In today’s society, children (and adults) are bombarded with messages about body image. Lean physical appearance is idolized; overweight is ridiculed. There is a strong behavioral component to eating disorders, resulting from a need to fit into the mold, a need to be idolized. Eating disorders speak directly to one’s own sense of self, a need to comfort, a need to have control, and much more.

With these behavioral patterns in mind, a very important caution in the use of BMI is to educate parents as to the efficacy of this tool, and how to apply the information to their family appropriately, without fear or harm to the child. Since Connecticut has not yet mandated the reporting of BMI, parents aren’t presently in this predicament; however, we are not immune to the trend of our children’s declining health, or issues with self-esteem.

What can parents do now? Become more aware of yourself as a role model, and your family’s health behaviors. Understand your family history and the risk factors associated with weight related illnesses. Consider your family’s health as a group effort, not singling out any one individual. Talk with your children about healthy eating, exercise habits and relaxation. Have a family dinner at least weekly, and take the opportunity to do something active as a family, such as hiking, walking or cycling, as often as possible. These are only a few simple practices that will provide your children with the message that physical health is an important component of life.

If you have concerns, consult your pediatrician, family health provider, or a behavior specialist for specific advice and counsel. By all means, even if there are no immediate concerns, become aware of how physical and mental health play an important part in your family’s overall health and happiness. And finally, enjoy the time and experience with your children, and nurture your emotional well-being as well.

Karen E. Giunta, MA, LMFT, is a licensed marriage and family therapist, master’s degree exercise professional, life coach and group facilitator. With over 20 years experience in behavior modification counseling, Karen provides therapeutic and coaching services to individuals, couples, families and groups on a variety of topics including parenting, anxiety and mood disorders, trauma healing, individual and family wellness, couples and family relationships. Karen is in private practice at the New Learning Therapy Center, 1200 Post Road East, Suite 107, Westport, CT, and may be reached at kgiuntalmft@snet.net, or 203-226-0100, ext. 224.