Controversy surrounding 'fat letters' discussed

(HealthDay)—Despite the potential stigma surrounding "fat letters," school body mass index (BMI) measurement programs may be beneficial, according to a perspective piece published online Aug. 19 in Pediatrics.

Michael R. Flaherty, D.O., from the Baystate Medical Center in Springfield, Mass., discusses the controversy surrounding "fat letters," whereby parents of children in public schools receive letters detailing their child's BMI percentile and weight category.

The author notes that BMI measurement programs in schools were designed for surveillance and screening, to collect data on trends among children and identify children at risk for weight-related health problems. Several studies have indicated that childhood BMI correlates with adult obesity and development of coronary artery disease. Critics of the public school measurement system highlight the potential for bullying, increased prevalence of eating disorders, and invasion of privacy. However, over four years of the program in Arkansas, no negative consequences have been identified, including no increases in inappropriate dieting. In addition, there has been an increase in the number of children signed up for exercise classes as well as improvements in nutrition patterns. BMI screening letters can serve as an awareness tool, promoting conversations about healthy eating, exercise, and weight.

"No parent would be proud to receive a letter stating their child is in the overweight or obese category, but the awareness and acknowledgment that he or she could have a weight problem begins the process of a multidisciplinary approach to change," the authors write. "It is time to put aside this pride for the future of our children's health."

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