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Academy for Eating Disorders opposes BMI reporting

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On June 2, the Academy for Eating Disorders publicized their press release concerning their position on BMI reporting and 'fitnessgrams' in schools. BMI report cards have emerged as a way to alert parents that their children are overweight or obese, and were sent home with over 870,000 public school children this spring by the New York Department of Education. These report cards have been innocuously dubbed "fitnessgrams," and are seen as a way to combat childhood obesity; however they are more harmful than they appear.

The New York Department of Education began these reports as a means of "helping students set personal goals" concerning their weight and lifestyles. However, the measure for overweight and obesity in this case is body mass index (BMI), which is known to be a poor indicator of weight among adults and children. This is because BMI is calculated using height and weight and therefore does not take into account lean muscle mass or other influences on weight. A child receiving a report card with a BMI that puts them in the 'overweight' category may not technically be overweight.

However, this error is not just a hypothetical one; it is a reality. There have been numerous accounts of children labeled either overweight or obese that do not fall into those categories. One 10 year-old girl was described as overweight because she weighed one pound heavier than the average weight for children her age and height. The child later expressed worry over her 'non-existant' fat, confirming concerns that these report cards could lead to weight and shape preoccupations.

Additionally, interventions using BMI as an indicator of health have not improved student's goal setting or physical or psychological health. Instead, they pose more danger than benefit, by detrimentally affecting students' self-esteem and leading students to obsess over their eating and weight. If the results of the fitnessgrams become known in school, other students could alienate or shame students in the overweight and obese categories.

Fundamentally, BMI report cards represent a concerted "fat-shaming" effort on behalf of the Department of Education and offer no tangible benefits, with multiple negative consequences. The Academy for Eating Disorders takes this position and has created guidelines for addressing childhood obesity in a non-shaming and more constructive way. Perhaps it is time to look at the evidence and wake up to the fact that we could be causing more problems than we are solving if we continue to address obesity in this manner.

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