The Report Card on BMI Report Cards

Abstract

Half of states in the U.S. have legislation requiring that schools conduct body mass index (BMI) screening among students; just under half of these states report results to parents. The effectiveness of school-based BMI screening and reporting in reducing childhood obesity is not established and the practice has raised concerns about the potential for increased weight-based stigmatization. Recent experimental studies of BMI screening and reporting have not demonstrated a positive impact on students' weight status. However, the language and formatting of BMI reports used in studies to date have been suboptimal and have likely limited the potential effectiveness of the practice. This article reviews the recent literature on school-based BMI screening and reporting and highlights important areas for future inquiry. The present review suggests that evidence to date is not sufficient to support definitive conclusions about the value of school-based BMI screening and reporting as a childhood obesity prevention tool.

Self‐perception of overweight and obesity: A review of mental and physical health outcomes

“…To date, the effectiveness of "weight feedback" interventions has received limited testing 23 and therefore one concern is that if intervention approaches that draw attention to body weight do not also address the stigma of self-identifying as having overweight, they may inadvertently promote rather than prevent or reduce overweight and obesity. 46 Moving beyond intervention approaches that provide weight feedback, the findings discussed here support calls for overweight and obesity public health interventions to more carefully consider the stigma associated with heavier body weight and to ensure that they do not serve to further stigmatise overweight and obesity.…”

“…This widely held belief has informed obesity intervention efforts. For example, in school and health care settings and public health websites in the United States and United Kingdom, it is common to provide feedback on the objective weight status of children and adults, [23][24][25] under the assumption that correcting misperceptions about weight status should motivate better weight management.…”

Parents Recall of, and Reactions to, School-Based BMI Reports

“…2 BMI reports are intended to compel parents to make healthy dietary and physical activity changes for their children with overweight or obesity, leading to improvements in child weight status. A recent systematic review suggests that current school-based BMI reports do not reduce childhood obesity, 3 warranting a critical analysis of the presumed mechanism by which BMI reporting might impact child weight.…”

“…Prior research demonstrates that parents have poor recognition of their child's weight status, 6,9,10 particularly parents of children with overweight or obesity. 11 While providing parents with a BMI report containing their child's weight status, along with healthy behavior-modification tips, could help parents more accurately recognize their child's weight status 4 and compel positive weight-related changes, 3,12 current evidence in this area is mixed. Prior studies conducted among primarily white populations 6,9 suggest that parent accuracy in identifying their child's overweight status does not significantly increase following BMI reporting.…”

Understanding Parents’ Perceptions of School-Based BMI Screening and BMI Report Cards Using Perceptual Mapping: Implications for School Nurses

“…A recent review of research about BMI screening programs (Thompson & Madsen, 2017) concluded that BMI report cards alone—without additional interventions for improved physical activity and nutrition environments—are insufficient to have a positive impact on children’s weight. Further, the review called for additional research to focus on the impact and development of BMI report cards with “appropriate and easy-to-understand language” and noted the lack of research focused on the reports themselves (Thompson & Madsen, 2017).…”