Bill Aims to Rein in Childhood Obesity

Everyone agrees that childhood obesity is spiraling out of control, but a proposal by Maryland legislators to screen school children for body fat is dividing health professionals.

Two bills being considered in the House and Senate call for assessing the body mass index (BMI), which measures body fat, of every first-, third-, fifth-, and eighth-grade student and giving parents a confidential “report card” with the results. Senator Robert Pinsky, who introduced one of the Maryland BMI measures, says the report card—which parents can opt out of—is a “flag” for those who don’t know or are avoiding the issue of their child’s mounting weight gain. Twelve other states are considering similar legislation.

“The idea of screening is a good one,” says Noralyn Mills, a registered dietician and spokesperson for the American Dietetic Association. “The education of consumers is always going to be a good thing. If you’re a parent and you have a child who’s overweight or obese and your health care provider has never said to you that your child is overweight and here is what you need to do,” then a school program can yield positive results, she says.

Other health professionals, however, say that BMI screening belongs in the pediatrician’s office, not in schools, which are ill-equipped to provide follow-up exams. Dan Levy, president-elect of the Maryland chapter of the American Academy of Pediatrics (AAP), says focusing on physical education and nutritional school meals are better solutions.

About 16 percent of American children age 6–19 are overweight, according to the U.S. Centers for Disease Control, a number that has tripled over the past two decades. A child with a BMI over 85 percent is considered overweight and someone with a BMI over 95 percent is at risk for heart disease, diabetes, and other weight-related diseases, says AAP.

Another shortfall is that BMI assessments can also put kids at risk for eating disorders, says Margo Maine, a clinical psychologist, author, and founder of the National Eating Disorders Association. “There is no science that supports that BMI is a prime indicator of health, especially for children whose growth is uneven,” she says, adding that the new measure could also lead to an increase in bullying and teasing because test results can easily become public knowledge.

There’s also the issue of genetics. Despite the belief that people can control their weight, 40–70 percent of a person’s weight is genetically determined. “Weightism is the politically correct prejudice today,” says Maine. “But some kids are supposed to be bigger.”