Body Mass Index (BMI) is quickly making its way into schools to monitor the growth of young kids. But is it a beneficial tool to use for our children’s health?

What is Body Mass Index (BMI)?

Body Mass Index (BMI) is a mathematical formula that uses a person’s height and weight to produce a separate numerical value, and allows for comparison of one person or population against others. BMI is often used to classify a person into weight categories. In children, BMI takes into consideration age and uses percentiles, but still yields numbers which can be categorized on the same scale (Ikeda, 2006).

BMI Monitoring at Schools

One way in which schools are monitoring “obesity” in children is through “BMI monitoring.”  This is a practice in which all children are weighed and their BMI is calculated (Ikeda, 2006). The data can either be used for population reports, or reports can be sent home to the parents indicating if the child is outside the range labeled as “normal.”  The problems with this practice are numerous.

First, the BMI is a calculation off of a person’s height and weight.  It does not take into consideration natural body frame and muscle tone.  Athletes, those who have a lot of muscle, or those with naturally larger frames, yet with a healthy range of body fat percentage are often categorized as “overweight” or “”obese.”  In fact, the conception of the BMI was not originally meant for individual diagnosis, but for tracking averages and population trends (Taylor, 2010).

Trained Medical Professionals Needed

Those who are calculating children’s BMI in schools are not usually trained medical professionals, as nurses cannot always attend to the entire student population.  Furthermore, those who are seeing these numbers are not always medical professionals who are qualified to evaluate a child’s health in any meaningful way.

Second, when these numbers are sent home to parents, the number can further be misinterpreted and cause undue alarm, even causing parents to place their children on restrictive diets in an attempt to produce weight loss. Children, based on where they fall on the BMI chart, may develop body image issues where there were none previous. Furthermore, these children could be singled out and encouraged to be more active and eat certain foods solely based on their appearance, or simply their BMI. That would be special treatment based on weight, and special treatment can lead to stigma connected to body type, which in turn could lead to negative body image, depression, and eating disorders.

An individual child’s medical information should be left to the privacy and expertise of a pediatrician who can evaluate and give parents a full picture of their children’s health.  The doctor’s office can also be used to track population trends. While the schools certainly have access to children, they do not have a representative sample as their population leaves out children who are educated at home or in schools that do not perform BMI monitoring.

Pursuing Health at Every Size™ 

Children who face maltreatment from adults and bully from their peers are more likely to suffer from eating disorders later in life (Fosse, Holden, 2006). Eating disorders have the highest mortality rates of all mental illnesses (National Association of Anorexia and Related Disorders). Even teems  who never experience  a full-blown eating disorders may begin a pattern of dieting and restrictive eating, which can lead to weight cycling. Weight cycling has been found to be harmful to metabolic, cardiovascular, and psychological health (Shutz, Dulloo, 2015). 

A better approach may be to ditch scales and BMI altogether  and encourage health in all areas–mental, social, physical, and spiritual health–for all children regardless of their weight and body type. Encouraging positive health behaviors improves health regardless of weight (Bacon, Loan, Derricote, Gale, Kazaks & Stern, 2002). 

 

Sources

Ikeda, J. P., Crawford, P. B., Woodward, & Lopez, G., (2006). BMI Screening in schools: Helpful or harmful. Health Education Research, 21, 761-769.

National Association of Anorexia and Related Disorders. (n.d.) Eating Disorder Statistics. Retrieved April 9, 2014.

Taylor, R. S. (2010). Use of Body Mass Index For Monitoring Growth and Obesity. Paediatrics & Child Health, 15, 258.

Fosse, G., & Holden, A. (2006, January 23). Childhood maltreatment in adult female psychiatric outpatients with eating disorders. Eating Behaviors, 404-409.

Montani, J., Schutz, Y., & Dulloo, A. G. (2015, February). Dieting and weight cycling as risk factors for cardiometabolic diseases: Who is really at risk?

Bacon, L., Keim, N., Loan, M. V., Derricote, M., Gale, B., Kazaks, A., & Stern, J. (2002, May 30). Evaluating a ‘non-diet’ wellness intervention for improvement of metabolic fitness, psychological well-being and eating and activity behaviors.