Massachusetts schools use Body Mass Index (BMI) to monitor student health. In 2009, Massachusetts’ Public Health Council unanimously passed regulations for school BMI screenings with the aim of reducing childhood obesity. Starting in the 2010-2011 school year, all Massachusetts public schools were required to perform screenings in grades 1, 4, 7, and 10 and to notify parents/guardians of the results.
Before working in school guidance and researching child development and mental health as part of my Masters of Social Work program, I had no problem with this practice. Why wouldn’t I want children to live a healthy lifestyle? I can now look back and see how wrong my assumptions were. Research from a variety of fields including medicine, psychology, and history reveals what scholars and activists call deeply ingrained fatphobia in American culture.
Although many states practice BMI reporting, it has not been shown as effective in reducing pediatric obesity. According to the U.S. Centers for Disease Control and Prevention, “Little is known about the outcomes of BMI measurement programs, including effects on weight-related knowledge, attitudes, and behaviors of youth and their families. As a result, no consensus exists on the utility of BMI screening programs for young people.”
Instead, reporting has been shown to increase harmful outcomes such as disordered eating and negative peer weight talk. In 2014, multiple organizations including the EDC (Eating Disorder Coalition), AED (Academy of Eating Disorders), BEDA (Binge Eating Disorder Association), and STRIPED (Strategic Training Initiative for the Prevention of Eating Disorders) issued statements strongly opposing the screenings due to the level of harm they risk. Research suggests that school BMI screening may additionally increase adolescent dieting, which research reveals, counter-intuitively, to be a risk factor for both weight gain and eating disorders in youth.
If Massachusetts is concerned with the health and well-being of its students, evidence-based practices should be implemented in the schools, rather than programs that are not supported by research. This includes addressing systemic issues such as food insecurity, income inequality, and lack of equal access to health care services. The system that prioritizes weight loss over actual health is fatphobic.
By contrast, schools should adopt a health at every size approach, which will promote healthy lifestyles in ways that are weight-neutral. This can be done by implementing wellness programs that promote body satisfaction, improve self-esteem, and respect body size diversity.
Hanna Vaughn lives in Shutesbury and is a graduate student at Boston University’s School of Social Work.