Report Cards 'Grade' Kids' Weight

Six states now make schools measure students' heights and weights for so-called body mass index (BMI) report cards.

Other states are mulling rules like those in Arkansas, Florida, Illinois, Missouri, Pennsylvania, and Tennessee. And a panel that includes the American Academy of Pediatrics (AAP), American Medical Association, and 13 other health groups is urging that each child's BMI be checked once a year.

Why? "Among children and adolescents, the incidence of overweight and obesity has doubled in the last decade," says Marc S. Jacobson, M.D., a member of the AAP Task Force on Obesity. "This may be the first generation in U.S. history to not live as long as their parents because of obesity and the resulting diabetes and early heart disease."

So how should you react, in a positive way, if a school BMI shows your child is overweight (85th percentile or above) or obese (95th percentile or above)?

Call your school nurse

"He or she can explain the results, refer you to a primary care doctor if necessary, identify helpful community resources, and give you health education materials," says Shirley Schantz, R.N., Ed.D., A.R.N.P., nursing education director of the National Association of School Nurses.

The nurse can also tell you what your school is doing to help. Is it improving cafeteria fare? Is it trying to work good nutrition into the curriculum? What about physical activity? If the answers don't satisfy you, Dr. Schantz says, lobby school officials.

Call your child's doctor

Your child's doctor can also explain a BMI report and make suggestions. Issues might include your family's TV viewing and eating patterns. How often do you buy fast food or takeout? How many fruits and vegetables do you eat? What do you drink? "Your children should be primarily drinking water and skim or 1 percent milk. Soda should be a rare treat," Dr. Jacobson says.

The AAP also suggests an hour a day of physical activity. "Organized sports are fine, but parents need to get their kids out of the house and just walking, running, playing, riding bikes, and jumping," Dr. Jacobson says.

Involve the whole family

"Don't single out this child as having an individual problem, because the entire family's leisure time and eating habits could probably be improved," says Dr. Jacobson. That approach, he says, also avoids psychological harm to your child.

You don't want your child to feel mortified. You also don't want to raise your child's odds of developing an eating disorder. But Dr. Jacobson says that's rare.