Transcript BMI Report Cards Intended Outcomes & Unintended Consequences

Intended Outcomes and
Unintended Consequences:
Do BMI Report Cards Fail?
Kendrin Sonneville, ScD, RD
Assistant Professor
Eating Disorders
• Eating disorders are a major public health
problem among youth
– What environmental triggers could be
contributing to eating disorders?
– What is happening in schools?
BMI Measurement Policies
BMI surveillance required
BMI screening required
BMI measurement recommended
National Association of State Boards of Education. State School Health Policy Database.
http://nasbe.org/healthy_schools/hs/bytopics.php?topicid=4100&catExpand=acdnbtm_catD
School-Based
BMI Measurement Programs
• School-based BMI measurement programs
were designed to address obesity among
youth
• Several concerns about these programs have
been raised
– Ineffective?
– Harmful?
4
BMI MEASUREMENT PROGRAMS
BMI Surveillance
BMI Screening
(“BMI Report Cards”)
Weigh/measure all students
Weigh/measure all students
Anonymous
Parents notified
Goal
Track obesity rates from year
to year
Motivate obese youth/families
to make behavioral changes
Assumptions
Weighing youth at schools is
harmless
Weighing youth at schools is
harmless
Description
Youth is not aware of obesity
status
Awareness of obesity status is
essential for healthy behavior
Youth and families will have
the necessary
knowledge/resources
BMI MEASUREMENT PROGRAMS
BMI Surveillance
BMI Screening
(“BMI Report Cards”)
Weigh/measure all students
Weigh/measure all students
Anonymous
Parents notified
Goal
Track obesity rates from year
to year
Motivate obese youth/families
to make behavioral changes
Assumptions
Weighing youth at schools is
harmless
Weighing youth at schools is
harmless
Description
Youth is not aware of obesity
status
Awareness of obesity status is
essential for healthy behavior
Youth and families will have
the necessary
knowledge/resources
BMI MEASUREMENT PROGRAMS
BMI Surveillance
BMI Screening
(“BMI Report Cards”)
Weigh/measure all students
Weigh/measure all students
Anonymous
Parents notified
Goal
Track obesity rates from year
to year
Motivate obese youth/families
to make behavioral changes
Assumptions
Weighing youth at schools is
harmless
Weighing youth at schools is
harmless
Description
Youth is not aware of obesity
status
Awareness of obesity status is
essential for healthy behavior
Youth and families will have
the necessary
knowledge/resources
BMI MEASUREMENT PROGRAMS
BMI Surveillance
BMI Screening
(“BMI Report Cards”)
Weigh/measure all students
Weigh/measure all students
Anonymous
Parents notified
Goal
Track obesity rates from year
to year
Motivate obese youth/families
to make behavioral changes
Assumptions
Weighing youth at schools is
harmless
Weighing youth at schools is
harmless
Description
Youth is not aware of obesity
status
Awareness of obesity status is
essential for healthy behavior
Youth and families will have
the necessary
knowledge/resources
BMI MEASUREMENT PROGRAMS
BMI Surveillance
BMI Screening
(“BMI Report Cards”)
Weigh/measure all students
Weigh/measure all students
Anonymous
Parents notified
Goal
Track obesity rates from year
to year
Motivate obese youth/families
to make behavioral changes
Assumptions
Weighing youth at schools is
harmless
Weighing youth at schools is
harmless
Description
Youth is not aware of obesity
status
Awareness of obesity status is
essential for healthy behavior
Youth and families will have
the necessary
knowledge/resources
BMI MEASUREMENT PROGRAMS
BMI Surveillance
BMI Screening
(“BMI Report Cards”)
Weigh/measure all students
Weigh/measure all students
Anonymous
Parents notified
Goal
Track obesity rates from year
to year
Motivate obese youth/families
to make behavioral changes
Assumptions
Weighing youth at schools is
harmless
Weighing youth at schools is
harmless
Description
Youth is not aware of obesity
status
Awareness of obesity status is
essential for healthy behavior
Youth and families will have
the necessary
knowledge/resources
Do BMI report cards fail?
Assumption:
• Weighing youth at school is harmless
Do BMI report cards fail?
Assumption:
• Weighing youth at school is harmless
Do BMI report cards fail?
Assumption:
• Weighing youth at school is harmless
Reality:
• Weight concerns and body dissatisfaction
are already extremely high
• In Arkansas, overweight students report
being embarrassed by BMI measurement
• Weighing students may worsen weight
stigma
Do BMI report cards fail?
Assumption:
• Youth is not aware of obesity status
Do BMI report cards fail?
Assumption:
• Youth is not aware of obesity status
Reality:
• BMI is routinely measured at the doctor’s
office
• When measured at a doctor’s office, other
factors can be taken into account when BMI is
interpreted
Do BMI report cards fail?
Assumption:
• Awareness of obesity status is essential for
healthy behavior
Do BMI report cards fail?
Assumption:
• Awareness of obesity status is essential for
healthy behavior
Reality:
• Overweight youth who are aware that they
are overweight:
• Are more likely to skip meals, use diet pills,
and smoke cigarettes for weight control
Do BMI report cards fail?
Assumption:
• Awareness of obesity status is essential for
healthy behavior
Reality:
• Overweight youth who are aware that they
are overweight:
• Are more likely to skip meals, use diet pills,
and smoke cigarettes for weight control
Do BMI report cards fail?
Assumption:
• Awareness of obesity status is essential for
healthy behavior
Reality:
• Overweight youth who are aware that they
are overweight:
• Are more likely to skip meals, use diet pills,
and smoke cigarettes for weight control
• Gain more weight
Do BMI report cards fail?
Assumption:
• Youth and families will have the necessary
knowledge and resources
Do BMI report cards fail?
Assumption:
• Youth and families will have the necessary
knowledge and resources
Reality:
• Meaningful strategies not provided
• Resources are extremely limited
• Weight is not a behavior
• Youth may adopt harmful behaviors
Do BMI report cards fail?
Assumption:
• Youth and families will have the necessary
knowledge and resources
Reality:
• Meaningful strategies not provided
• Resources are extremely limited
• Weight is not a behavior
• Youth may adopt harmful behaviors
• Creating a healthy and safe school
environment should be a top priority
• There is no evidence that BMI measurement
programs reduce obesity
• BMI measurement programs could worsen
weight stigma and increase eating disorders
• The effects of BMI measurement programs
must be evaluated