Our school district wants to weigh children and send notes home to parents if their children are either under or overweight. Do you think this is a good idea?

Many school and health departments are being asked to document childhood obesity, in particular, and do something to turn the alarming trend around. However, we have to consider several issues to protect our children's mental and physical health: 

1. The stage of a child's pubertal development will impact weight. So, for example, a child that is farther along into puberty, will tend to weigh more than a child who has not yet started puberty. Stage of puberty is best assessed by the child's pediatrician. 
2. Genetics affects weight. There are some people who are going to be "short," or "skinny" naturally. 
3. Assess hunger. Children can be hungry and be either over- or underweight. For children who appear lethargic, or complain regularly of headaches or stomach aches, or exhibit behavior problems, ask: are you hungry? Is there enough food in the home to eat? 
4. Does your school provide a breakfast and lunch program? Breakfast is critical for learning. Most schools offer a free or reduced price lunch program, however breakfast programs may not be in all schools. Summer feeding programs, administered by the state department of health, are also critical in providing much-needed nutrition for children living in poverty. 
5. The simple act of weighing a child who is overweight and already self-conscious, will only add to their discomfort. If the weighing is done in a public area, where children are lined up and aware of other children's weight, there may well be additional embarrassment, and emotional trauma. 
6. What will the impact of a letter home be on the child? Chances are that parents are aware of their child's size. Just ask any parent who has tried to go clothes shopping with a child who does not fit the standard sizes.  If a parent receives a letter stating that their child is overweight, what will happen? Will the parent feel that the child should be punished? Put on a diet? Take a potentially dangerous weight loss supplement? Will the parents feel like they have failed, or that their child is inferior or a failure? These would be tragic consequences. Children who are placed on restrictive diets are often denied nutrients needed for growth and development. 
7. Obesity is a national problem. No "one" is responsible. And as Surgeon General David Satcher advised, it really "takes a village" to combat obesity. 
8. One of the most important factors leading to the rise in obesity is our population's sedentary lifestyle. The school or community health educator, and family physician should assess media use (television viewing is directly linked to obesity; the more we watch, the fatter we are). See the American Academy of Pediatrics' web site: www.aap.org for their position statement on television viewing, as well as their excellent "Media Matters" tool kit which includes a media history form. Why not start a school or community-wide campaign to turn off the television, and enjoy physical activity as a family? 
9. Rather than single out overweight children, how about offering nutrition information and suggested fitness activities to every child? 
10. Assess physical education classes in the school. Are they mandatory? Are they fun? Are they daily? Do children have breaks in the day for physical activity? Are there after school sporting activities for ALL children. Often teams are limited in size. But what about the kids who are "cut" from the teams? Are there recreation leagues as an alternative? Is there transportation for children who want to stay after school for a sport or planned recreation program? 
11. Assess recreation facilities in your community. Are there safe neighborhoods, walking or biking trails? Are school gymnasiums open after hours for family play? 
12. Assess the kinds of foods sold in schools. Soft drinks, juice drinks that are less than 100% fruit juice, snack cakes, chips, donuts, fast food--all are considered high in calories, but low in nutrient density. In other words, they deliver a lot of calories and not much else to support healthy growth and development. Many schools depend on the sales of such foods to raise money, but surely there are alternatives. As one educator asked: "What is the cost of osteoporosis, or a root canal?" We must consider the long term effects of such foods on our children when consumed on a regular basis. 

Good luck!

Melinda Hemmelgarn, M.S., R.D., Former Nutritional Sciences Specialist, University of Missouri-Columbia