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F is for fat

Education | Obesity report cards fight childhood bulge, but do they also harm self-esteem?

Issue: "Tortilla wars," March 10, 2007

As a sophomore in high school, Irie Thomas of Hope, Ark., weighed 285 pounds. Two years later, the 17-year-old senior is a svelte 180. Thomas says there's no magic formula for such dramatic results-just the tried and proven techniques of regular exercise and strict abstinence against soda and fried food.

But the health-conscious teen may never have discovered his new lifestyle were it not for a magic bullet-point tacked onto the end of his academic grades. Hope High School sent Thomas home with a failing body mass index (BMI) report card two years ago, outlining the serious medical dangers of his sizable weight problem and recommending he consult a doctor for help. That scholastic intervention pushed Irie's mother, Danita Thomas, to contact the pediatric fitness clinic at Arkansas Children's Hospital. "I already knew Irie was overweight," she said. "But getting that report card was really scary."

Arkansas is one of seven states that require schools to send home reports of students' BMI, a calculation of age, height, and weight that helps determine if people are too heavy. More than a dozen other states are considering whether to adopt the practice. Such widespread concern is rooted in troubling figures from the Centers for Disease Control and Prevention, which indicate that childhood and adolescent obesity have more than doubled since 1980.

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Despite such numbers and success stories like that of Irie Thomas, the Arkansas House recently approved a bill to repeal the state's BMI report card program. Gov. Mike Beebe has likewise expressed reservations with what he says can harm the self-esteem of overweight students. Beebe, a Democrat, told The Associated Press that the BMI reports have "a lot of negative, unintended consequences," and he questioned whether schools were overstepping their proper responsibilities.

Those comments met stiff reproof from former Gov. Mike Huckabee, who spearheaded the state's initial implementation of fat grades in 2004, an unprecedented idea at the time. Huckabee, who recently lost 110 pounds and is now a Republican candidate for president, said that removing Arkansas' trend-setting program "would be a huge step backwards."

Irie Thomas agrees: "Eventually, I could have died if I wouldn't have lost all that weight. Once they told me that, I knew it was time for me to change." Thomas says he got teased for being overweight before anyone wrote it down on a report card. Now, he says, other students approach him for nutrition advice: "I tell them, 'I can show you what to eat, but it's on you to eat it.'"

Not every story has such a happy ending. In fact, Danita Thomas, who works at her son's school, says she has not noticed any significant weight loss in other students. She doubts that many parents take the warning as seriously as she did.

Other students in participating states have taken the warning too seriously, leading to undereating disorders such as anorexia or bulimia. A recent New York Times report documented the story of a 6-year-old girl in Pennsylvania who misread her BMI report card and stopped eating in an effort to lower her score.

Critics charge that obesity report cards burden children and adolescents with undue concerns of self-image and amount to an invasion of privacy. They warn that BMI is not a failsafe indicator of health. Unlike more complicated measurements, such as body-fat percentage, BMI's simplistic formula can falsely label muscular teens as overweight or fail to properly account for some children's unusually slow or rapid development. A recent study in Arkansas revealed that about a third of parents and 15 percent of students are uncomfortable with the BMI program.

But supporters, such as Karen Young, a physician who designed the weight-loss regimen of Irie Thomas, point to results. Young has noted higher enrollment in her fitness clinic, and the state's number of overweight kids decreased slightly in the program's first year of existence.

For Danita Thomas, the results are more personal: "Some mornings Irie didn't even want to get up and go to school," she said of her son's condition two years ago. "Being overweight lowers your self-esteem anyway. Learning your BMI can help you make a difference."

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