A Hand Holding a Letter

Fat Letters Aren’t Helping

One of the murky mysteries of obesity policies is exactly why anyone ever thought it would be helpful to send fat letters home from school to parents. Now we have two studies that find no benefit to students for BMI screening and notification at school. The first, published by Kristine Madsen in 2011, found no impact on pediatric obesity in California. The second, published in June by Kevin Gee, found no impact in Arkansas teenagers.

Of course, not finding an effect falls short of proving no effect. But in the absence of a known benefit, one must consider the possibility of harm. Mary Story of Duke University comments on this aspect of BMI screening at school:

There is so much stigma with being overweight, and children in adolescence are particularly sensitive to that. In some schools, there is no privacy screen when they’re being weighed, and the process is embarrassing for them.

Though noting these concerns, the outspoken doctor blogger David Katz at Yale advocates “to eradicate oblivobesity” from his perch as editor of the journal Childhood Obesity. He suggests that it can be done “with compassion, guidance, and empowerment in the mix.”

No doubt he has good intentions. But most families who are living with obesity will tell you that they get plenty of reminders of their obesity. From an early age, kids with obesity experience social isolation, shaming, bullying, and outright discrimination. What they don’t get is real help to do something about it.

A shift in strategies is overdue: from worrying about awareness to providing access to good options for evidence-based care.

Click here to read the study by Gee, here to read the study by Madsen, and here to read more from the New York Times.

A Hand Holding a Letter, painting by George Romney from WikiArt

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August 12, 2015

2 Responses to “Fat Letters Aren’t Helping”

  1. August 12, 2015 at 12:03 pm, Todd I. Stark said:

    There’s a crucial distinction to be made here between assuming people who are (or whose children are) fat are oblivious of it and assuming they are avoiding the problem or that they consider themselves unable to do anything about it, which can end up looking very similar.

    I suspect that one of the points of contention or confusion is we often do realize we are fat or that our children are fat (thus not technically oblivious by any reasonable interpretation), but we might still act as if we are oblivious when we answer surveys, and also in terms of our efforts at intervention, because we feel helpless. For all practical intents and purposes we don’t expect to be able to do anything about it without extreme measures, we realize that there is a stigma, and we realize that it we are often being viewed (incorrectly) as gluttonous and lazy, so we are often very unmotivated to acknowledge our plight. This is just my own perception of some of what may be happening based on my own experience.

    • August 12, 2015 at 3:17 pm, Ted said:

      Todd, I agree with you completely. And moreover, the medical advice one gets if one seek care for obesity, more often than not, amounts to “get better.”