The phrase, “Needs Improvement” seems like a fair way to assess the spelling or cursive handwriting skills of an elementary school student. But the body composition of an adolescent child? Perhaps not.

The parents of one 12-year-old girl in California recently received a letter from their child’s school (PDF) stating that their daughter’s body composition “needs improvement.” As you can imagine, this letter came as quite a shock, especially since the young woman is muscular, athletic and does Jujitsu four times a week. However, according to the Body Mass Index (BMI) grade given by the school, her body isn’t quite good enough.

The BMI and other such indicators are notoriously inadequate measures of an individual’s overall health and fitness. As such, the controversy over the practice of schools sending home so-called ‘fat letters’ to parents is well-founded in a concern that these reports are misleading (at best) and dangerous (at worst). Yet schools in at least 19 states are required to screen kids for obesity and report BMI scores to parents.

The danger here lies in that fact that these reports send confusing messages to parents and children about weight, which may inadvertently serve to promote unhealthy attitudes and behaviors about size and open the doors for eating disorders in an age-group that is already at risk.

For example, did you know that:

• 42% of 1st-3rd grade girls want to be thinner
• 81% of 10-year-olds are afraid of being fat
• 46% of 9-to 11-year-olds are “sometimes” or “very often” on diets and 82% of their families are “sometimes” or “very often” on diets
• Over one-half of teenage girls and nearly one-third of teenage boys use unhealthy weight control behaviors such as skipping meals, fasting, smoking cigarettes, vomiting, and taking laxatives
• 35-57% of adolescent girls engage in crash dieting, fasting, self-induced vomiting, diet pills, or laxatives. Overweight girls are more likely than normal weight girls to engage in such extreme  dieting
• Even among clearly non-overweight girls, over one-third report dieting
• 35% of “normal dieters” progress to pathological dieting. Of those, 20-25% progress to partial or full-syndrome eating disorders

Thankfully, some school districts are taking to heart the message that the practice of BMI screening is dangerous. Massachusetts recently moved to discontinue the controversial practice and many other states are beginning to rethink how they measure a child’s health.

For more information on how to promote healthy body image and detect eating disorders among students, please see the Educator and Coaches tool kits on our website or the book Healthy Bodies: Teaching Kids What They Need to Know by Kathy Kater, LICSW.