Apr 10, 2009

Doubts raised about childhood weight screenings

The founder of an eating-disorders group based in Newton had expressed grave doubts about a weight screening program that won state approval Wednesday and is set to begin in Massachusetts public schools this fall.

The childhood screenings, modeled after initiatives in Arkansas and New York City, won unanimous approval Wednesday from the state's Public Health Council.

When the state Department of Public Health sought comments about the childhood weight screening, the responses from medical associations and physicians were almost entirely supportive.

But Rebecca Manley, founder of the Multiservice Eating Disorders Association in Newton, questioned the reliability of body mass index screenings, known commonly as BMI. And she also challenged the wisdom of sending those reports to parents.

"Mandatory BMI reporting laws force parents to walk the fine line between encouraging healthy eating and promoting unhealthy weight loss strategies," Manley wrote in a letter to the agency.

Starting in the fall, public schools across Massachusetts will send reports home to parents alerting them if their child weighs too much or too little - the centerpiece of a campaign to shrink bulging waistlines and halt obesity-related diseases once rare in children.

Students in the first, fourth, seventh, and 10th grades will be measured and weighed so school health officials can calculate their body mass index score, a standard measurement used to gauge the appropriateness of someone's weight.

The initiative will be phased in during the next two school years, with more than 286,000 students expected to undergo evaluation before the end of the 2010-2011 academic year. The letters issued to parents won't just be a scorecard, state authorities promised; they will provide suggestions on where to turn for help.


Nearly one-third of adolescents weigh too much, and the toll of that crisis is evident in school nursing offices, where nurses encounter children with high blood pressure and a form of diabetes that in previous generations struck adults almost exclusively.

"We don't want 12-year-olds having heart attacks, and that's exactly where we're headed as a society if we don't deal with the health and wellness of children and, especially, obesity," said Kathy Hassey, president of the Massachusetts School Nurse Organization.

State health authorities said Wednesday that they are familiar with the concerns of eating-disorders groups - and with the worries of school committees - and have attempted to address them.

Parents, for example, will not be forced to have their children evaluated. Still, if the experience in Arkansas holds true, virtually all Massachusetts students will wind up being screened, and when they are, it will be conducted in private, with no mention of the resulting BMI reading made at that time.

"Nobody wanted to create an environment in which we are going to induce more unhealthy behaviors rather than healthful behaviors," said Dr. Jewel Mullen, director of the Bureau of Community Health Access and Promotion at the state health agency.

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