Failing Weight: Massachusetts Students to Receive "Fat Report Card"

By Rachel Cernansky | April 8, 2009 4:34 pm

report.jpgForget the debate over numbered versus lettered grades: The latest news in report cards is a new issue, and it’s personal. Children in Massachusetts will now be sent home with a “fat card,” or a report card of their Body Mass Index.

Students already have their heights and weights measured annually at school. Now, according to the Massachusetts Public Health Council’s new rule, those measurements will be calculated into a BMI and sent home in a package to parents explaining what the numbers mean and how to fight obesity.

Being weighed in front of the school can be a nightmare for kids; having their measurements sent home as a report card can’t be any less traumatizing. But perhaps the consolation is at least it won’t happen every year—only first, fourth, seventh and tenth graders will be subjected to body-mass report cards. Those who don’t like it can always move to another state—other than Arkansas, that is, which has already adopted a similar practice.

Image: Flickr / Elrenia_Greenleaf

CATEGORIZED UNDER: Food, Nutrition, & More Food
MORE ABOUT: massachusetts, obesity
  • Sarah

    Kids get weighed in front of the entire school now? And here I thought they did that individually in the nurse’s office.

    “Traumatize” is a little bit of an exaggeration. A fleeting feeling of embarrassment seems a little bit better than diabetes, heart problems, and childhood obesity.

  • Mike

    I think it’s great….a little big brother, but we need to do something, it’s dragging our whole country down. There is no excuse for people to be medically or morbidly obese. This is not about being skinny like a model, it’s about little kids not having pre diabetes and hypertension!!!!

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  • Jo

    BMI is meant to be applied to populations — not individuals. It’s a horribly inaccurate indicator of individual fitness, particularly in children. Ethical considerations aside, what’s the point of this, other than to spread a lot of misinformation?

  • Sarah

    Jo, the American Academy of Pediatrics recommends the use of BMI to screen for obesity. It’s done differently for children than it is for adults. It is actually pretty accurate and it’s also cheap. It’s a screening tool that tells you if you should look into your child’s health further to determine if your kid is overweight or obese. That’s all it is. It isn’t diagnosing anything.

    If anyone is interested in learning about BMI in children, the CDC has an article on it here:

  • anne55

    Both my sister and daughter suffered from anorexia nervosa. As a result, I have strong feelings about this proposal. While it is great that parents can ‘opt out’ for their children if they so choose, I fear that many parents will not do this–either because they are unaware it is about to occur or they are unaware of the risks they may be taking if their child happens to have a susceptible psyche and the ‘genetics’ in place for an ED.
    Better than my own words, here are the Academy of Eating Disorders Guidelines on Childhood Obesity Prevention programs. I pray Massachusetts–a state so forward thinking in so many other ways–comes to its senses.
    AED Guidelines for Childhood Obesity Prevention Programs

    Sigrún Daníelsdóttir, Cand.Psych., Deb Burgard, Ph.D., & Wendy Oliver-Pyatt, M.D.

    Studies from around the world show that body weight in youth has increased over the past decades (Chinn & Rona, 2001; Kautiainen, Rimpelä, Vikat, & Virtanen, 2002; Tremblay & Willms, 2000; Troiano & Flegal, 1998), although the most recent evidence suggests that this increase may be leveling off, at least in the United States (Ogden, Carroll, & Flegal, 2008). Concern over rising weights has spurred various community and school-based interventions aimed at decreasing childhood “overweight.” These include the mandatory screening of children’s BMI, banning of “junk food” in school cafeterias, limiting vending machines in schools and promotional campaigns emphasizing the dangers of excess weight. Many health professionals have voiced concern about the safety and efficacy of these interventions, fearing that they have little positive effect and may inadvertently contribute to overconcern with weight and shape, unhealthy weight control practices, and weight bias (e.g. Berg, 2001; Cogan, Smith, & Maine, 2008; Ikeda, Crawford, & Woodward-Lopez, 2006; Neumark-Sztainer, Wall, Story & van den Berg, 2008).

    A substantial body of evidence from the eating disorder literature demonstrates that a general emphasis on appearance and weight control can promote eating disordered behaviors. For example, when important agents in children’s social environment (e.g. parents and peers) endorse a preference for thinness and place an importance on weight control, this can contribute to body dissatisfaction, dieting, low self-esteem and weight bias among children and adolescents (Davison & Birch, 2001; Davison & Birch, 2004; Dohnt & Tiggemann, 2006; Smolak, Levine, & Schermer, 1999). Additionally, weight-control practices among young people reliably predict greater weight gain, regardless of baseline weight, than that of adolescents who do not engage in such practices (Neumark-Sztainer et al., 2006). Thus, it is important to evaluate the unintended consequences of “obesity prevention” programs, which may lead to unhealthy behaviors and weight displacements in both directions.

    Unfortunately, few studies have examined the effects of “obesity prevention” efforts on risk-factors for eating disorders, such as body dissatisfaction and weight loss dieting. Those that have suggest that focusing on health, not weight, may be key to avoiding harm to body image and eating behaviors. For example, Austin, Field, Wiecha, Peterson & Gortmaker (2005) found lowered rates of disordered eating in a school-based intervenion that focused on promoting healthy diet and activity patterns, rather than on weight per se. These findings emphasize the feasibility of simultaneously promoting body esteem and healthy lifestyle behaviors in youth, as others have suggested (Neumark-Sztainer, 2005). Expanding the vision of “obesity prevention” programs to include the prevention of eating disorders and related issues, may help to ensure that they promote overall health and safety.

    Body weight cannot be evaluated in a vacuum. It is not a reliable proxy for eating behaviors and physical activity. Although statistical associations exist between body weight and risk for morbidity and mortality, being heavy or slender is not by definition pathological. Correlation does not imply causation and the middle of the weight spectrum can cloak a panoply of unhealthy practices. Since healthy living is important for children of all sizes, interventions should focus on lifestyle rather than weight.

    The Academy for Eating Disorders applauds efforts to make children’s environments as healthy as possible. However, it is important that special care be taken in the construction and implementation of “obesity prevention” programs to minimize any harm that might result. To this end, the following guidelines have been developed for school-and community-based interventions addressing rising weights in youth.

    * Interventions should focus on health, not weight, so as to not contribute to the overvaluation of weight and shape and negative attitudes about fatness that are common among children and have harmful effects on their physical, social and psychological well-being.

    * The World Health Organization defines health as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Consistent with this definition, interventions aimed at addressing weight concerns should be constructed from a holistic perspective, where equal consideration is given to social, emotional and physical aspects of children’s health.

    * Interventions should focus not only on providing opportunities for appropriate levels of physical activity and healthy eating, but also promote self-esteem, body satisfaction, and respect for body size diversity. Prospective studies show that body dissatisfaction and weight-related teasing are associated with binge eating and other eating disordered behaviors, lower levels of physical activity and increased weight gain over time. Thus, constructing a social environment where all children are supported in feeling good about their bodies is essential to promoting health in youth.

    * Interventions should focus only on modifiable behaviors (e.g. physical activity, intake of sugar-sweetened beverages, teasing, time spent watching television), where there is evidence that such modification will improve children’s health.

    * Weight is not a behavior and therefore not an appropriate target for behavior modification. Children across the weight spectrum benefit from limiting time spent watching television and eating a healthy diet. Interventions should be weight-neutral, i.e. not have specific goals for weight change but aim to increase healthy living at any size.

    * It is unrealistic to expect all children to fit into the “normal weight” category. Thus, interventions should not be marketed as “obesity prevention.” Rather, interventions should be referred to as “health promotion,” as the ultimate goal is the health and well-being of all children, and health encompasses many factors besides weight.

    * School-based interventions should avoid the language of “overweight” and “obesity” since these terms may promote weight-based stigma. Moreover, several of the most effective interventions have not focused on weight per se.

    * Interventions should focus on making children’s environments healthier rather than focusing solely on personal responsibility. In the school setting, these include serving healthy meals, providing opportunities for fun physical activities, implementing a no-teasing policy, and providing students and school staff with educational sessions about body image, media literacy, and weight bias. In the community setting, these include making neighborhoods safer, providing access to nutritious foods, constructing sidewalks and bicycle lanes, building safe outside play areas, and encouraging parents to serve regular family meals, create a non-distracting eating environment, and provide more active alternatives to TV viewing.

    * Interventions should be careful not to use language that has implicit or explicit anti-fat messages, such as “fat is bad,” “fat people eat too much”, etc.

    * Children of all sizes deserve a healthy environment and will benefit from a healthy lifestyle and positive self-image. School-based interventions should not target heavier children specifically with segregated programs aimed at lowering weights. However, this should not discourage efforts to provide physical activities tailored for larger bodies or to address the experiences that heavier children share as a group.

    * Determining normal or abnormal growth in children should be dependent on the consistency of their growth over time and not just the percentile at which they are growing. Childhood overweight should be defined as an upward weight divergence that is abnormal for an individual child, which can be determined only by comparing the child to him- or herself over time. This can be accomplished by consulting an individual growth chart, rather than an arbitrary BMI cutoff.

    * Interventions should aim for the maintenance of individually appropriate weights—that is, that children will continue to grow at their natural rate and follow their own growth curve—underscoring that a healthy weight is not a fixed number but varies for each individual.

    * A sudden shift away from the growth curve in either direction may indicate a problem, but further information about lifestyle habits, physical markers and psychological functioning is needed before a diagnosis can be made. Changes in weight are not always a sign of abnormal development. An increase in weight often precedes a growth spurt in children and some girls begin to gain body fat as part of normal adolescence at a very young age.

    * Weighing students should only be performed when there is a clear and compelling need for the information. The height and weight of a child should be measured in a sensitive, straightforward and friendly manner, in a private setting. Height and weight should be recorded without remark. Further, BMI assessment should be considered just one part of an overall health evaluation and not as the single marker for a student’s health status.

    * Weight must be handled as carefully as any other individually identifiable health information

    * The ideal intervention is an integrated approach that addresses risk factors for the spectrum of weight-related problems, including screening for unhealthy weight control behaviors; and promotes protective behaviors, such as decreasing dieting, increasing balanced nutrition, encouraging mindful eating, increasing activity, promoting positive body image and decreasing weight-related teasing and harassment.

    * Interventions should honor the role of parents in promoting children’s health and help them support and model healthy behaviors at home without overemphasizing weight.

    * Interventions should provide diversity training for parents, teachers and school-staff for the purpose of recognizing and addressing weight-related stigma and harassment and constructing a size-friendly environment in and out of school.

    * Interventions should be created and led by qualified health care providers who acknowledge the importance of a health focus over a weight focus when targeting lifestyle and weight concerns in youth.

    * Representatives of the community to be studied should be included in the planning process to ensure that interventions are sensitive to diverse norms, cultural traditions, and practices. In this spirit, it is important that interventions be pilot tested before implementation in order to collect quantitative and qualitative feedback from the participants themselves.

    * It is important that interventions be evaluated by qualified health care providers and/or researchers, who are familiar with the research on risk factors for eating disorders, as the interventions are being implemented in schools or communities. Ideally, the assessment should not only evaluate changes in eating and activity levels but also self-esteem, social functioning, weight bias and eating disorder risk factors, such as body dissatisfaction, dieting and thin-ideal internalization.


    Austin, S.B., Field, A.E., Wiecha, J, Peterson, K.E. & Gortmaker, S.L. (2005). The impact of a school-based prevention trial on disordered weight control behaviors in early adolescent girls. Archives of Pediatrics and Adolescent Medicine, 159, 225-230.

    Berg, F. M. (2001). Children and Teens Afraid to Eat: Helping Youth in Today’s Weight Obsessed World (3rd Ed). Hettinger, ND: Healthy Weight Network.

    Chinn, S., & Rona, R. J. (2001). Prevalence and trends in overweight and obesity in three cross sectional studies of British children 1974-94. British Medical Journal, 322, 24-26.

    Cogan, J. C., Smith, J. P., & Maine, M. D. (2008). The risks of a quick fix: A case against mandatory body mass index reporting laws. Eating Disorders, 16, 2-13.

    Davison, K. K., & Birch, L. L. (2001). Weight status, parent reaction, and self-concept in five-year-old girls. Pediatrics, 107, 46-53.

    Davison, K. K., & Birch, L. L. (2004). Predictors of fat stereotypes among 9-year old girls and their parents. Obesity Research, 12, 86-94.

    Dohnt, H., & Tiggemann, M. (2006). The contribution of peer and media influences to the development of body dissatisfaction and self-esteem in young girls: A prospective study. Developmental Psychology, 42, 929-936.

    Ikeda, J. P., Crawford, P. B., & Woodward-Lopez, G. (2006). BMI screening in schools: Helpful or harmful? Health Education Research, 21, 761-769.

    Kautiainen, S., Rimpelä, A.,Vikat, A., & Virtanen, S. M. (2002). Secular trends in overweight and obesity among Finnish adolescents in 1977-1999. International Journal of Obesity and Related Metabolic Disorders, 26, 544-552.

    Neumark-Stzainer, D. (2005). Can we simultaneously work toward the prevention of obesity and eating disorders in children and adolescents? International Journal of Eating Disorders, 38, 220-227.

    Neumark-Sztainer, D., Wall, M., Guo, J., Story, M., Haines, J., & Eisenberg, M. (2006). Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: How do dieters fare five years later? Journal of the American Dietetic Association, 106, 559-568

    Neumark-Sztainer, D., Wall, M., Story, M., & van den Berg, P. (2008). Accurate parental classification of overweight adolescents’ weight status: does it matter? Pediatrics, 121, e1495-e1502.

    Ogden, C. L., Carroll, M. D., & Flegal, K.M. (2008). High body mass index for age among U.S. children and adolescents, 2003-2006. Journal of the American Medical Association, 299, 2401-2405.

    Smolak, L., Levine, M. P., & Schermer, F. (1999). Parental input and weight concerns among elementary school children. International Journal of Eating Disorders, 25, 263-271.

    Tremblay, M. S., & Willms, J. D. (2000). Secular trends in the body mass index of Canadian children. Canadian Medical Association Journal, 28, 1429-1433.

    Troiano, R. P,. & Flegal, K. M. (1998). Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics

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  • Jessikanesis

    The BMI is not a health measurement. It is a weight measurement. It’s also none of the school’s business.
    I have to agree with anne55 on this. This proposal would do more harm than good. Yes, there are risks with childhood obesity, diabetes and heart disease, but I fail to see how sending kids home with a note for their parents that says, “Your kid is a fat fatty fatass” is going to combat that.
    Here’s a big shocker: people (including kids) who are fat… are already aware that they’re fat. And so are their parents. Letting them know with a formal weigh-in and a slip of paper is not going to magically shed light on the cause of their heavy-breathing problems and allow them to finally melt those extra pounds away within the year.
    If the schools really want to help, maybe they should overhaul their cafeterias and provide more choices of inexpensive, good-tasting, healthy food. Or offer more fitness equiptment, or better yet, a humiliation-free exercise environment. (A crowded gym class is not exactly a fat kid’s ally in the self-improvement area, and most kids who are already considered “unathletic,” whatever that means, won’t be invited to join in extra-curricular sports, if the coach wants to win bad enough.)
    Otherwise, it becomes none of the school’s business. You can’t just go around grading kids on anything you want. This isn’t an epidemic. Fat kids do not have Fat Fever. The other kids are not going to CATCH FAT from them. So everybody just calm down, and stop turning these already ostrasized young people into the new Swine Flu.

  • Sarah

    “If the schools really want to help, maybe they should overhaul their cafeterias and provide more choices of inexpensive, good-tasting, healthy food. Or offer more fitness equiptment, or better yet, a humiliation-free exercise environment. ”

    Jessikanesis, you’re going to be the one helping to fund that idea, right? Or maybe schools have the funding already; they were just too busy dropping extracurricular activities and laying off teachers (for the fun of it) to think of such an obvious thing.

    Kids don’t get sent home with a note that says “Your kid is a fat fatty fatass.” They get sent home with a note that says their BMI is high enough to cause concern and what that means. I am willing to bet there are reasonable suggestions on how to improve the child’s physical health. Because while you may not think weight and health are related, they are. And a student’s health does affect his or her education and, thus, it becomes the school’s business. It is also the schools business since about 95% of children spend about 1/3 of the weekday under the care of school employees. Out of all the influences children have in the community, including doctors, parents, churches, and media, schools are probably the most powerful source of influence. This is what makes schools an ideal place to… umm… teach. About health, even.

    Kids aren’t “graded” on how fat they are, no matter how some people want to twist this idea around. This is schools being concerned for their students. You may not like the idea of people other than parents being concerned for the well-being of children, but when my health care costs go up because medical expenses directly related to obesity in children and adults totals about $117 Billion each year, I’m pretty ok with anyone who wants to help out helping out.

  • Gina

    Ok….lets first let me say this I am fat. Let me secondly say I have no health issues. Let me say now..I probably will have health issues in the future! I am a vegetarian (strict) and I am fat. I always have been fat…however I know I can lose the weight and have vowed to do it over and over again. NOW let me say..I was weighed in school in front of ALL students in Gym class in 1-9th was the most humiliating experience EVER..mind you I was only 10 pounds overweight by standards in school at the time however everyone was skinny skinnny…OK 30 years later….. still fat still remember that….still traumatized (well not really because everyone I graduated with is now fatter than me so that makes me laugh hysterically beyond anything you can imagine..when I walk into a bar and see a classmate that was a bully to me at (10 pounds overweight ) and actually say (because i dont care ) WOW YOU GOT FAT!!!
    Now beyond this evilness inside of me because my mo always said say At least i am fat and not ugly ass AND i CAN LOSE THE WEIGHT LOL ….This Fat report card is insanely ridiculous….AND I COMMIT TO THIS….If this goes through I am starting a petition in Massachusetts that there be a DRUG DEALER REPORT CARD..A DRUG ADDICT REPORT CARD… A GAY REPORT CARD..AN ANNOYING REPORT CARD..A NON ENGLISH SPEAKING REPORT CARD….A JUST PLAIN OUT ODDITY REPORT CARD…..OH THERE IS MORE!! Cause let me tell ya something I think the United States has alot more to worry about than FAT..yes it is a concern..yes they should help if help is wanted..I get that…but a report card..PLEASE….I swear I am more concerned that all of a sudden my kid comes home with a crack pipe than with a pack of twinkies..or that he is groped by one out of 15 of the gay students in the school system…Look … We are the kids parents we take them to the doctor that is what the doctor is for they handle that NOT THE SCHOOLS!! You wanna see bullying and harrasment….just do what you are will be a nightmare..ONE LITtLE NOTE……. My Girlfriends daughter was asked 2 weeks ago by an ignorant girl in school “hey what u weight” (yes does not speak english to well) and my friends daughter said that is kind of personal I dont think i would like to tell you that….and … ow with 1 day left of school in fron of the WHOLE schol at lunch that girls friend walked up to her and pulled her pants down to her ankles..NOW you see whats going to happen… are cruel…you will see it will be a sad sad stupid not worth a thing thing to do….just watch ….there will be terrible consequences.
    I think they should reconsider
    Dont you…………….?

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  • DavidS

    Gina, a few things
    1) I don’t think projecting your own traumatizing experience onto the system is particularly helpful in understanding what is trying to be accomplished here. Clearly the program could be implemented without these weighings down in public. My school certainly did these activities in the nurses office.

    2) Things that affect your childs education should be looked at by the school, particularly if the school can have a direct impact on it. Those other report cards you mentioned, drugs for example, already get reported to parents if there is suspicion that the student is under the influence of drugs or in possession of them at school.

    3) As was said earlier, no one really needs the “BMI report card” to know they’re fat. The cruel kids sharing classes with the possible overweight student don’t need it either. While I agree, that sort of behavior is both typical in school and cruel, it has nothing to do with this program. I sympathize that you might have had a bad experience in school and were teased about your weight, but telling parents there is cause for a health concern in their child for one of the leading medical problems in the country is hardly the same thing as teasing.

    4) I find your apparent attitude towards homosexuals offensive. The implication that a student is somehow more likely to be groped by a gay classmate or that students being gay is a concern that should be reported to parents is quite intolerant. Homosexuality isn’t a particular health concern and doesn’t apply to the argument here.

    Overall, reporting BMI seems like a rather inexpensive way to help raise awareness about obesity. It’s a leading cause of medical spending and future health problems and if a simple measure already being done can help bring it to parents attention as something to address, I see nothing wrong with that.


    My daughter is on 4rth grade it was just brought to my attention that she was going to be weighed in gym class. I absoltly think this is a bad idea, for many reaons. One being a 10 year girl is just now starting to become acutly aware of her body and how it is starting to change. She is noticing it is different in many ways from some of the other kids. To throw a scale at her to find out her weight is NOT something the school should do. My daughter had her yearly check up with her doctor and every year she is weighed in private there. The school is there to help teach and help her learn lifes lessons. I gaurentee that if you throw a scale infront of a 10 year old girl, in school- there will be bullying- other girls wondering what each one weights and so the snickering begins…:susie weighs how much? wow she is fat!” the little girl gets wind of all this and starts putting a finger down her throat to deal.
    I am telling you it is a very bad idea.

  • Susan

    The school system is not the place for weigh-ins.

  • rebecca

    they do the same thing at my brother’s school in bucks county, pa. it’s nothing new

  • GRK


  • Sally

    I’m so disgusted, not shocked, think that system should receive an F—. How could they? Saving money in the future for health care? Saving children?Who pays the psychological traumatization bills which can take years?
    Have a few questions; How are Mass. schools system finances the last few years? Must not be as bad as Indiana since we can’t even have enough teachers, sports, arts and simple classes that are necessary. Mass. must have money to throw and hurt children. Anorexia can cost a lot also. Loss of self esteem can last a life time and most often does. A lot of wasted bodies and brains for our future. Does Mass. have all the extra curriculum offers to pick up and increase childrens brains and bodies and self esteem. No schoold system that I know of has enough or enough money to do more that is needed to increase involvement.
    May seem silly, I know, but I would like to know what Michelle Obama has to say about this practice. I have no idea.
    I don’t feel that parents should HAVE TO TEACH THEIR CHILDREN TO REFUSE test but they should refuse if necessary. Kids shouldn’t be put in the position of refusing because it will also point them out to other kids and we all know how cruel kids can be.
    When I tried to reread the article on FAT REPORT CARD really did have trouble finding it in Indiana. Didn’t know whether I should hunt online under titles available: Strange, Saving Money, Crime, Business, Health or whatever. It did seem to me that the topic could fit in any of those sections.
    I had a tough childhood in a upper middle class family and if I had also been subjected to a FAT REPORT CARD at age 9, I might have thrown in the towel by 11 years old. At least the kids in Indiana can’t throw in the towel. Towels couldn’t be afforded at this time, I’m told.

  • Sally

    Just had a thought. Maybe Mass. School system could send some of their extra, extra money to Indiana to help out the teachers, children and old defunct schoold buildings. Maybe all the financially well balanced school systems could rally? What a thought.

  • buy online

    This article was definitely a quality read and I like to see good articles on the internet because so much of it’s dupicate. I understand that when it comes to material it’s for all purposes King for the matter of getting a site ranked and so on (most likely the reason I saw this). I’ve managed a couple webpages back when and am working on an online micro jobs marketplace kinda webpage made for people to visit and buy and sell services to one another. So I need to spend some time on writing some blog content and what not on the webpage and what not. Anyway take it easy and continue handing out quality articles.

    • sinyal kesici jammer

      Just had a thought. Maybe Mass. School system could send some of their extra, extra money to Indiana to help out the teachers, children and old defunct schoold buildings. Maybe all the financially well balanced school systems could rally? What a thought.

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  • ortam dinleme

    If anyone is interested in learning about BMI in children, the CDC has an article on it here:


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