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    'Fat Letters' and the Childhood Obesity Debate

    Experts, parents split over schools' role in weight screening

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    This would be a grave mistake, Flaherty believes. "The growing number of children and adolescents seen day in and day out in our clinics with hypertension, high cholesterol, diabetes, and musculoskeletal issues secondary to weight do not lie," he said.

    Flaherty, a clinical associate at the Tufts University School of Medicine, outlines his thoughts in a "perspective" piece published online Aug. 19 in Pediatrics.

    While acknowledging that the effectiveness of such programs remains to be determined, Flaherty notes that school screenings are nothing new, with many states having done so for many years. And in 2005, the U.S. Preventive Services Task Force determined that calculating a child's BMI -- a calculation of body fat based on height and weight -- should be considered the "preferred measure" for tracking weight issues.

    What's more, he suggests that parental fears that BMI assessments may accidently identify healthy muscular children as overweight is a misplaced concern over a relatively rare phenomenon.

    "Additionally, no studies have shown any increased risk in bullying, eating disorders or unhealthy dieting patterns," Flaherty noted. "While these risks exist, they have not been proven in states where these programs have existed for several years."

    The very point is to have a "confidential way of mailing letters directly home to parents where these issues can be addressed in the privacy of the home without any other students being aware of other children's BMI," he said.

    Other specialists are less enthusiastic about school BMI screenings.

    Dr. David Dunkin, an assistant professor of pediatric gastroenterology at the Icahn School of Medicine at Mount Sinai in New York City, cautions that simply legislating parental notification of school screening results will not help curb the obesity crisis without comprehensive and well-designed follow-up.

    "While I feel that the intention is good [to] raise awareness among parents about their children being obese, and thus instilling motivation for behavioral changes or lifestyle modifications, this is unlikely to have effects in and of itself," Dunkin said.

    To bring about change, notifications should include referrals to programs that could help parents make lifestyle modifications for their children, he added.

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