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Letter from The School Nurse: Your Child is Overweight

Posted by Joan Salge Blake  August 19, 2013 10:22 AM

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Source: NIH
In an article in today’s journal, Pediatrics, Dr. Michael R. Flaherty, DO, of Baystate Medical Center and Tufts University School of Medicine, reminds us that sending the kids back to school is just around the corner.  Unfortunately, so are the heated debates surrounding the weight and health of America's youth.

From his perspective, Dr. Flaherty outlines the public health benefits when schools screen and inform parents, by a letter sent home, of their child’s body mass index (BMI) and risk of obesity.  BMI is a measure of an individual’s weight in relationship to their height.  Massachusetts is one of 21 states that have policies in place for this type of screening although several Massachusetts state representatives are looking to prohibit the Department of Public Health from doing this in public schools in the future.

According to Dr. Flaherty, this type of school-to-home screening program is intended to inform the parents, so if need be, they can have further discussions with their child’s pediatrician.  Obesity is a growing problem among American children.  Approximately 12 percent of children ages 2 to 5 are obese and 18 percent of those ages 6 to 19 are considered obese.

Because research suggests that an obese child or adolescent is at a higher risk of becoming an obese adult, intervening earlier in life, rather than later, can be an important strategy to combat and reverse adult weight issues.  In the late 1970s, only 15 percent of American adults were obese. This number has more than doubled as over 35 percent currently fall into this category.

Critics of the program point out potential problems such as bullying, increased prevalence of disordered eating, and the misinterpretation of BMI in student athletes.  For example, at 6 foot 4 inches and 225 pounds, Tom Brady has a BMI that would land him in the overweight category.  Clearly, the man is not over-fat but has a large amount of muscle mass that is driving his current weight upward on the BMI charts.

When implemented correctly, the program could work.  According to Josefine Wendel, MS, RD, School Nutrition Coordinator at the Cambridge Public Health Department, “Height and weight have been collected by the Cambridge Public Schools for many years, as part of the PE [physical education] curriculum, but in 2003, we piloted a program to share this information, along with the results of each child’s fitness testing, with the families. The program was evaluated and the majority of parents said that they wanted to see the information.”   The additional good news is that obesity among Cambridge public school children (K–8) decreased from 21 percent in 2004 to 15 percent in 2013.

However, sensitivity and confidentially are important in communicating this information to the parents, says Wendell.  “The report was mailed in a closed envelope addressed to the parents rather than sent home with the child in the backpack.  It is up to the parent to share it with the child.”

For resources on Healthy Weight for Kids and Family, click here

What are your thoughts regarding this issue? 

                                                          Follow Joan on Twitter at: joansalgeblake
Originally published on the blog Nutrition and You!.
This blog is not written or edited by Boston.com or the Boston Globe.
The author is solely responsible for the content.

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About the author

Joan Salge Blake, MS, RD, LDN, is a clinical associate professor and registered dietitian at Boston University in the Nutrition Program. Joan is the author of Nutrition &You, 2nd Edition, More »

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