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'Fat Letters' and the Childhood Obesity Debate

Experts, parents split over schools' role in weight screening

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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.

But Dunkin would prefer to see weight issues addressed by a family's pediatrician.

"I think it is the primary responsibility of the pediatrician to discuss obesity on a case-by-case basis with the child and the family, and try to help them with life changes," he said. "As a pediatrician I often speak to the family about this, and can assist them with advice on what to do to improve their child's health."

While Flaherty agrees that pediatricians should measure a child's BMI at every child's well-care visit, he said these check-ups are only performed annually.

"Pediatricians have 15 to 20 minutes per year to deal not only with BMI, but a variety of other preventive health issues," Flaherty said. "The public school system is a universal organization that has been used as a forum to reach children and parents for a variety of other issues: vaccinations, dental exams, and hearing and vision screening."

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