There would be thousands of “fat letters” going home if this area followed the lead of some U.S. jurisdictions that are weighing and measuring schoolchildren to single out the overweight ones.
Calculating each child’s BMI (a height-to-weight ratio) and sending letters to parents of every child who is deemed overweight or obese is a method that’s been criticized as inaccurate, psychologically damaging and an invasion of privacy.
But the letters, called “fat letters” by critics, are employed in about a quarter of all states. And this week they gained sudden legitimacy with the publication of a paper from the American Academy of Pediatrics that argues they’re a necessary tool to combat the “alarming” rise in the number of children and teens who are overweight, inactive and spending too much time staring at TV and computer screens.
Forty-two per cent of local youth are considered overweight or obese, a number that is — according to one study — almost 15 percentage points higher than the provincial rate.
“We recognize that Windsor-Essex County has higher rates of childhood obesity,” said Dr. Gary Kirk, CEO of the Windsor-Essex County Health Unit. In April, the health unit proposed a $10-million strategy to bring down the rate by 20 per cent over five years.
“Fat letters” shouldn’t be part of the strategy, said Kirk, a pediatrician who believes they could do real damage.
“You don’t want to single out individuals and make them feel worse about themselves,” said Kirk. “The idea is through positive action create some positive behavioural changes that will help that individual and society in general.”
The reason for the higher-than-average local rate of childhood obesity is that kids emulate their parents, Kirk believes.
Local adults have a higher overweight or obesity rate — 61 per cent versus 52 per cent provincially — they are less active and they eat fewer fruits and vegetables.
“The odds are good if you’re an obese child, you’ll become an obese adult,” Kirk said.
Obesity can lead to many serious and life-shortening health problems including diabetes and cardiovascular disease. The local cost of unhealthy eating, physical inactivity and unhealthy weights is estimated by the health unit at $298 million a year when all the extra hospital admissions, prescription drugs, lost work time and premature deaths are taken into account.
While letters home from school shouldn’t be part of the local strategy to combat childhood obesity, “there are plenty of reasons to try to tackle it proactively,” according to Kirk, whose proposal includes an array of possible initiatives that — once it’s approved by the province — will be examined to decide which will work best here.
Samantha Grant, a spokeswoman for Health Minister Deb Matthews, said this week that the health unit’s proposal is being reviewed along with others that were submitted following the Ontario government’s release of its Healthy Kids Panel report on reducing childhood obesity.
The report recommendations included regulating junk food and gathering data on children’s BMIs, but doesn’t go so far as sending letters home.
The American Academy of Pediatrics paper says there hasn’t been enough research to show whether the letters home strategy is working to change behaviour, but in Arkansas, where it’s been studied the most, parents who’ve received the letters have been shown to sign their kids up for sports or other physical activities and have improved their family nutrition.
Luciana Rosu-Sieza, interim executive director of the local Bulimia Anorexia Nervosa Association, believes weighing kids in school could create a backlash that could contribute to children developing eating disorders and other negative issues.
“Sending this home, creating a panic, it creates a lot of shame and blame in a family which I don’t think solves the problem,” she said.
Trisha Howlett, a registered dietitian with the Windsor-Essex County Community Health Centre’s teen health program, said she sees a “boatload” of problems associated with the strategy. “I think it could be quite devastating.”
She fears it could lead to children developing eating disorders and bullying by peers.
“I think everybody should be focusing on increasing physical activity and eating well,” said Howlett. “It shouldn’t have anything to do with numbers on a scale.”
One major criticism of the strategy is that BMIs can be a poor indicator of whether kids are overweight. There are stories of muscular wrestling champs who get letters home because of high BMIs.
Howlett said children should be seeing their family doctor at least once a year, and those doctors should be the ones telling parents if there’s a concern. “You don’t need to weigh them and calculate their BMI for them to know they’re overweight,” said Howlett.
Schools have an interest in making sure kids eat healthy and are active — they perform better academically in school.
But Sharon Seslija, a teacher consultant at the public board who focuses on health and physical education, thinks the letters home strategy goes too far.
“Whose job is it to police children’s health? I think to me it’s an issue that needs to be addressed between the family and their health care provider,” said Seslija, who outlined some of the initiatives already in place in schools: 20 minutes of daily physical activity, government rules that mandate what healthy foods can be sold, a Jump Start nutrition program that provides healthy snacks to kids and a pilot project that was part of the International Children’s Games that promotes healthy eating and physical activity.
Still, there’s nothing preventing older students from going out at lunch to buy nachos from the local variety store, or all students from bringing bad choices in their lunch, said Seslija, who has heard of kids who bring a bag of chips, a chocolate bar and a Coke for lunch.
“We have them for six hours a day; the advertisers, the parents and every place they pass has them for the rest of the time.”