Are You Getting an “A” on Your BMI Report Card: Are BMI Report Cards Aimed at Reducing Obesity or Increasing Eating Disorders- Elizabeth Kadernauth
Obesity vs. Overweight
Obesity is quickly becoming the leading prevalent public health problem in the
In order to curb the growing rates of obesity, public health programs have created interventions that are being aimed at creating healthy lifestyle changes at an early age. One such public health intervention is measuring a child’s height and weight in order to identify his or her BMI. The original intervention was that a letter would be sent home indicating whether a child’s BMI showed that his/her weight was normal or posed a health risk (8). However, there has been an increased rally for the direct placing of a child’s BMI on his or her report card. Among the states leading this crusade has been
Remaining Obese After Being Labeled
The public health intervention of placing a child’s BMI on report cards may label kids from early on in development. The labeling theory suggest that when an individual is labeled as part of a group (in this case as overweight or obese) that individual will tend to internalize and self identify with that label. A study conducted on the population-based longitudinal study of 2,500 teens on issues pertaining to eating disorders, including obesity concluded that in order to prevent both obesity and eating disorder there needs to be a larger focus on health rather than weight. Focusing on weight alone is depreciatory and counterproductive (4).
The words obese and overweight tend to carry a heavy stigma in American society associated with increased discrimination. By labeling a child as obese, we are enforcing this stigmatism because we are subconsciously separating obese and overweight children from their other peers, thus creating anxiety about body image (5). Research has found that obesity defined by BMI was linked to a 25% increase in the odds of anxiety (6). In attempts to diminish anxiety we tend to overindulge in food to reduce stress. The idea of placing a child’s BMI in report cards not only creates a label, but can be part of a continuous snowball effect that can end with overindulgence in food. Instead of making important strides towards a healthy weight, some children may be more likely to continue the lifestyle they have been practicing previously and continue to remain obese.
A New Eating Disorder
On another level, even though BMI report cards may help determine which children are overweight and obese, it does not provide a positive model for which children can change their lifestyle and behaviors pertaining to weight. In not providing a positive model towards a healthy lifestyle, the public health intervention of sending home BMI report cards also fails to take into account the Social Learning Theory. Social learning theory provides that learning is done by observation. The intervention does not account for social learning theory because is does not provide an appropriate model for which a child can effectively change their behaviors about their weight. Without an positive model, sending children home with BMI Report Cards stating that they are obese could lead to a self obsession with weight.
No one can deny that the life of a
Many claim that BMI reports cards may be an important starting point for making children aware of their weight (14), but the model for which children are proceeding with weight loss is unhealthy. Not only is it promoting drastic weight loss, but it is giving the false perception that it can be accomplished in a fairly short time span. Instead of becoming a healthy weight, children might go to the extreme and develop an eating disorder, such as bulimia or anorexia because they are so focused on their weight and trying to resemble the figures that have the media attention (15). Previously, the study of 2,500 teens stated that it is often counterproductive to label someone as obese, but that we should rather focus on lifestyle over weight loss; concluding that it underscores that the more weight per se is talked about the more likely teens are to adopt dangerous dieting habits (4). In order to make effective strides toward a healthy weight and lifestyle, we need not focus on the issue of weight, but on the environment and culture for which children develop their poor lifestyle choices. The BMI report card intervention does not take into account the Social Learning Theory in providing a suitable model for which one can appropriately change his/her behavior, nor does it account for the environment for which one grows up in.
The New Public Health Intervention Fad
A few years ago the media and public health programs held great focus on the issue of eating disorders in the form of anorexia and bulimia. Fast forward a couple of years and the main issue is not the high percentage of teen agers and adults suffering from anorexia and bulimia, but rather the high percentage of Americans that are becoming more obese. Public health interventions are like fads that almost seem to change when the media focus changes. The public health intervention of BMI report cards falls into that stereotype because it only accounts for what is currently on the public agenda.
The Agenda Setting Theory suggests that the mass media has the ability to transfer the importance of objects on the mass agenda to the public. Right now obesity is on the agenda and is more focused on. Issues of obesity and negative publicity has caused fast food companies to work overtime to reformat their menus to include healthier low fat options, while sports wear companies are working to get children from in front of the television and outside. Even with all the healthier options to promote healthy lifestyle behaviors, eating disorders are still an issue that plagues a large percent of all Americans.
Instead of shifting interventions based on what is on the agenda at the moment, public health interventions need to be reworked in order to take care of both extremes at the same time if it wants to promote healthy living and lifestyle choices to the public. Although BMI report cards are also sent home to children that have a less than average BMI, the goal aims to notify whether a child is inherently overweight or obese (2, 5). Over 8 million people in the
For the public health intervention of sending home BMI report cards to work more effectively many factors need to be taken into account: Labeling theory, Social Learning theory and Agenda Setting theory. BMI report cards need to be careful not to uphold the stigmatization of obesity and weight. Rather than putting BMI on report cards, there need to be a method of reporting a child’s BMI with regard that that information stays within the confidential school to parent relationship. Once this form of confidential notification has been established, the school needs to provide some sort of model in order for there to be effective outcomes to the intervention. Whether the model be suggestions of exercise routines or how to eat healthy, the intervention needs to promote these suggestions as a lifestyle change that should encourage all members of children’s immediate families to participate. If there is full participation from the family under an appropriate model, children will be more likely to change their behavior because they aren’t being singled out but rather encouraged. To make public health intervention pertaining to body image, weight and healthy lifestyle effective we need to continuously focus on both extremes of eating disorders. What is necessary is a public health intervention that tackles anorexia, bulimia and obesity on a long term basis so that there isn’t a cycle of progression and regression in statistics pertaining to these issues. It is still early to predict the long term success of the BMI report card intervention. However, until the intervention addresses labeling, social learning theory and agenda setting theory the program will only see limited success and results.
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13. BMI Report Cards: The 'F' Is For 'Futility'. (2006, February 28). Retrieved from The Center for Consumer Freedom: http://www.consumerfreedom.com/news_detail.cfm/headline/2980
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