School Health Initiatives and Childhood Obesity: BMI Screening and Reporting

Abstract

The prevalence of childhood obesity has reached an epidemic status especially in the United States. Agencies such as the Institute of Medicine, Surgeon General's Office, and the American Academy of Pediatrics have called for action. Schools have been provided with guidelines to address obesity prevention. School-based body mass index screening and parent reporting programs have received a significant amount of attention in the literature. Intended to raise awareness for parents and provide a first step toward intervention for children who are overweight, there is to date limited outcomes of their success. However, one state, Arkansas, with mandated screening has reported success in that following screening in its schools, obesity rates were not increased. A significant concern with screening in schools is its potential harm to children around teasing, body image sensitivity, and possible unhealthy dieting. These controversial issues are explored, and recommendations are suggested for nursing's role in obesity prevention especially in schools.

Weighing the Options: A Legal Approach to Childhood Obesity

“…The most obvious is simply to measure weights, but such a measurement fails to take account of the extreme variations in the development of children, including differences in sex, height and build. 122 Alternative weight measurements include simple weight measurement or extensive body fat testing.…”

The Massachusetts BMI letter: A qualitative study of responses from parents of obese children

“…In addition, BMI performs better in identifying body fatness among obese children than in over-weight children [9]. BMI notification programs have also been criticized for a lack of evidence to show efficacy as an intervention for reducing childhood obesity [10,11] and the potential risk for disordered eating behaviors and heightened body dissatisfaction [10,12,13]. Examining research on parent and student reactions to BMI screening and notification programs can help elucidate future research needs in this area to improve communication strategies.…”

Student and Parental Perceptions of School-Based Body Mass Index Screening and Notification

“…Over one third of children and adolescents aged 2-19 years are overweight or obese [1,2]. Although children from all racial, ethnic and socioeconomic circumstances are affected, children from lowsocioeconomic and minority groups are disproportionately affected [3][4][5].…”

“…However, there is limited evidence to demonstrate the efficacy of these programs and controversy exists surrounding their use. There is some concern that parents may initiate restrictive diets in children and that children may be stigmatized as a result [2,12].…”

“…This approach has been adopted by several states and school districts [2]. The programs are intended to increase awareness of childhood obesity among parents and may serve as a vehicle for engaging families in the initial stages towards behavior change [2,11].…”