Obesity Screening for Kids?

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Here at Diabetes Flashpoints, we’ve often covered topics related to childhood obesity — from food ads targeted at children to the role of fast food to bariatric surgery for children. But we haven’t discussed many of the difficult and often delicate issues that arise when it comes to actually dealing with overweight or obesity in a child. These include realizing when your child’s weight reaches a potentially unhealthy level (many parents fail to notice when this happens), fostering dietary changes in your child, and encouraging weight loss while also making sure your child maintains a healthy body image. Managing these tasks as a parent can be trying, which may be a factor in the growing child obesity rate.

But in Michigan, the governor is betting that by creating a database of children’s body-mass index (BMI), the state can do more to help doctors and parents identify overweight children. According to a recent article at, Governor Rick Snyder plans to use his office’s authority to direct doctors to monitor the height and weight of children they see, and to provide that information — without the child’s name — to a state registry, the first of its kind. Michigan already has a similar registry of vaccination records, as do other states.

As the article notes, the closest precedent for Michigan’s new rule is probably a 2003 Arkansas law that required schools to send parents an annual measurement of their child’s BMI. That law was amended in 2007 so that measurements now take place every two years, and parents can more easily opt out of the program. There is some evidence that the Arkansas program has had positive effects: According to a 2007 article at, the percentage of children in the state either already overweight or at risk of becoming so dropped slightly from 38.1% in 2004 to 37.5% in 2006. That article and others also give anecdotal evidence of teens and parents who initiated serious lifestyle changes after receiving a BMI report.

Supporters of the move in Michigan note that unlike schools, doctor’s offices are already accustomed to taking health measurements and talking to children about their health habits. There are, of, course, other possible approaches — such as that of California, where students in fifth, seventh, and ninth grade take part in physical fitness testing that includes a BMI measurement but focuses mainly on physical performance. BMI notification is optional for parents, and according to one study of the program, whether or not a parent requests notification seems to have no effect on a child’s BMI in later measurements.

What do you think — is mandatory BMI measurement a good idea, in schools or in doctor’s offices? Should it only be done in the context of a greater focus on health and fitness, so that heavier children do not feel singled out or stigmatized for their weight? Should parents be primarily responsible for making sure that overweight children make needed lifestyle changes, or should schools have programs in place especially for those who need to lose weight? Leave a comment below!

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