‘Fat Letters’ Sent to Parents No Laughing Matter

Child photo via Shutterstock

Some parents in North Andover are outraged that their kids’ schools recently sent home so-called “fat letters” alerting them that their children were overweight or obese. The letters, issued by the Massachusetts Department of Public Health (DPH) after children were weighed and measured at school, were sent to the parents of kids who rated outside the normal range on the Body Mass Index (BMI) scale. The BMI gives a reading of a person’s weight status based on height and weight.

Many claim that the BMI is often inaccurate because it doesn’t differentiate between muscle mass and fat, and as a result, it can overestimate a person’s obesity level. However, alternative tests are prohibitively expensive and more complex, so pediatricians routinely use the BMI as a helpful screen for possible weight issues.

I’ve heard countless parents laugh off their kids’ high ratings on the BMI scale, which pediatricians now give at annual check-ups. They say things like “he’s just pleasantly plump” or “she has big bones.” So often those parents seem in denial about the child standing in plain view. Perhaps we’re so used to chubby kids that we hardly notice them anymore.

The sad truth is that 35 percent of kids in this country are, in fact, overweight or obese, a number that has more than tripled in the past 30 years. And according to the Optimum Weight for Life program at Boston Children’s Hospital, “Childhood obesity causes type 2 diabetes, sleep apnea, fatty liver, high blood pressure, and other serious complications.” 

And the worst of it is that kids who start life fat often stay that way. According to a recent study in the Journal of Clinical Investigation, bodies adapt to obesity and work hard to maintain it, thwarting future attempts at healthy lifestyle changes. So, every time you see an obese kid, you are more than likely also seeing a future obese adult.

This crisis in childhood obesity has led to the extraordinary public health measures like those taken in North Andover schools. In fact, the orchestration of the “fat letters” stems from the adoption of the “BMI initiative” by the DPH in 2009, which requires public schools to calculate student BMIs and send the results and guidance for next steps to the parents.

Children who received those letters, and especially their parents, should take the information seriously and pursue the next round of more detailed diagnostic tests to see if the BMI rating was accurate.

While some will continue to argue that government should stay out of family decisions, public health officials have decided the problem is too big to ignore—that parents can’t do this alone—and, based on the evidence, I’d say they’re right. Parents should thank them for the heads-up.