Tag Archives: BMI

Should the Boy Scouts Add a “Weight Cycling” Badge?

Proposed (by me) “Weight Cycling” patch

In the wake of my previous blog post about BMI and the Boy Scouts of America (BSOA), I’ve been reading some responses. And the responses I’ve been reading by various members and officials within the BSOA are troubling to say the very least. Let me give you some examples:

1. We haven’t turned anybody away because of BMI. In an article found in the Cleveland Plain Dealer, Adult leader Ron Blasak states, “there was no one in the Greater Cleveland Council who was turned away because of a BMI issue.” However, Blasak also admits that it’s possible “that someone read the requirements and shied away.” To which I reply, hmmm. Do you think so? Do you think that plastering BMI requirements all over the marketing materials and saying they will be strictly enforced just might make a kid fear that he will be shamed and ridiculed at this shindig? Do you find it surprising that your average 13-year-old might choose not to trap himself miles away from civilization with people who are convinced he can’t do anything?

2. We’re turning away kids with high BMI for their own good. In that same article, Blasak also states, “Overweight boys would have a tough time getting around and probably wouldn’t have much fun.” I have to wonder what evidence he is using to form this conclusion. BMI is a simple calculation based on height and weight. It doesn’t tell you anything about the fitness level of a potential participant. A Scout with a BMI in the “ideal” range may be very unfit and may be at greater risk than a stouter scout who exercises more and has greater functional fitness. Assuming that all the overweight kids will be miserable is just that, an assumption. And we all know what happens when you ASSuME.

We’ve given the scouts plenty of time to get thin. In many of the articles I’ve read, BSOA spokespeople are quick to point out that they released these health requirements two years in advance of the Jamboree, which should give the scouts plenty of time to get fit and achieve an acceptable BMI. In an article published by Fox News, BSOA spokesperson Deron Smith states:

“We published our height-weight requirements years in advance and many individuals began a health regimen to lose weight and attend the jamboree. But, for those who couldn’t, most self-selected and chose not to apply.”

To which I say, “You got it half right, but 50 percent is still a failing grade.” Over a two year period, it may be reasonable for a young person to make significant changes to their overall conditioning and fitness level. We know how to do that. What we don’t know how to do is make a fat kid into a thin kid–at least over the long term. We can make a fat kid into a thin kid temporarily. We might even get the timing right and make that fat kid thin at just the right moment to pass his physical and enjoy the Jamboree. But when we look at the statistics for that kid staying thin over the long haul, the success rates are dismal. So instead of teaching fat Scouts how to become thin scouts, we are teaching them the amazing, adult-level skill of weight cycling. This is the process of losing weight, gaining it all back plus a little more, losing weight, gaining it all back plus a little more and so on and so on. In fact, this process of BMI busting in order to make Jamboree weight seems ideally suited to the process of weight cycling. That’s what led me to suggest that maybe the BSOA should just make a “weight cycling” badge and be done with it. (Please see proposed badge design above.)

And what can I say about “self-selected and chose not to apply” other than “see point 1 of this blog”? Yup, if you tell pudgy kids and chubby kids and fat kids that they are not welcome in enough ways, with enough 14 point bold print on your website, they will ultimately get the message, “Don’t bother to apply, because we don’t want you.”

But the real story is not in the rhetoric that is flying back and forth on the airwaves and in cyberspace. The real story is the way that this policy will affect the lives of real kids. Kids like the one referenced in this recent NAAFA press release:

One mother reported to NAAFA in 2009 that her son was having issues attending Philmont High Adventure Boy Scout Camp in Cimmaron, NM. “Philmont has a weight standard and anyone over this standard is labeled unhealthy and cannot participate. I tried to explain to them that my son plays football, wrestles and runs relays, shot put, discus thrower, in track & field and a weight lifter. During the summer he swims, weightlifts and conditions for football. He has been conditioning for Philmont by hiking for 2-3 hours with a 50 pound pack on his back for the last 2 months. He weighs 261 lbs. and has been eating a 1200 – 1400 calorie diet trying to lose weight. Unfortunately he only lost 3 pounds… According to Philmont medical staff if he doesn’t weigh below 246, he will be sent home. It didn’t matter to them if he is active, only his weight number. I have watched my son condition for football and he can run circles around other players that are what society deems healthy.”

This is why this is such a big deal. We have kids who really want to go, who have put in the long hours of training required to be physically prepared for the challenge, who are probably in far better physical condition than many of their younger counterparts who are told, “go home fatty.” Given the rise in eating disorders among young men, I have a hard time understanding not only how this is considered reasonable, but also, how it can be considered responsible.

Maybe we need to help the BSOA along a little and propose some new HAES-friendly, body-positive awards. Got any ideas? I’d love to hear your proposals for new BSOA awards patches that are more likely to help young men accept and care for the bodies they already have and learn to feel comfortable in the skin they are in. Feel free to post your ideas in the comments below!

Love,

The Fat Chick

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Boy Scouts, BMI and Managing Risk

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Would the BSOA deem Russell “too fat” to go to camp?

Yesterday, I read Ragen Chastain’s amazing post on the new policies implemented by the Boy Scouts of America regarding participation in events and BMI. In order for any Boy Scout to participate in a “high adventure” activity which includes a duration of over 72 hours and being over 30 minutes drive from emergency medical services, his parents and doctors must fill out a group of forms including Part C which has a whole lot of questions about BMI. In fact questions about height and weight are the first things listed on the form before listing any pre-existing conditions or other information about disease or wellness. Any scout with a BMI over 40 will be forbidden from participating in these high adventure activities (including the Jamboree). And according to the site:

The Jamboree Medical Staff will review all applicants with a BMI of 32.0–39.9 and consider jamboree participation based on 1) health history, 2) submitted health data, and 3) recommendation of the applicant’s personal health care provider. For applicants with a BMI >31.9, a recommendation of “no contraindications for participation” by the applicant’s personal health care provider does not necessarily guarantee full jamboree participation. The jamboree medical staff will have final determination of full jamboree participation.

The Boy Scouts of America (BSOA) site, lists these reasons for the new restrictions:

“Anyone who is obese and has multiple risk factors for cardiovascular/cardiopulmonary disease would be at much greater risk of an acute cardiovascular/cardiopulmonary event imposed on them by the environmental stresses of the Summit. Our goal is to prevent any serious health-related event from occurring, and ensuring that all of our participants and staff are “physically strong.”

And frankly, all of this sent me scrambling for my manuals and training information about exercise in children. One question I had right away was, “Are they using data for all-cause mortality in adults and extrapolating that information for children?” Because, the data I’ve reviewed indicate that mortality among exercising children and teens comes from different sources that that of adults.

According to the Youth Sports Safety Alliance, the number one cause of death among exercising young athletes is Sudden Cardiac Arrest (SCA). During my fitness certification training, I learned that the number one cause for SCA is a heart defect called hypertrophic cardiomyopathy, a thickening of the heart muscle. Hypertrophic cardiomyopathy and other heart conditions likely to lead to SCA are often virtually undetectable from a standard physical exam. This is why many schools are starting to recommend and a few are beginning to require a EKG for participation in strenuous school sports. When SCA occurs, death often follows. Being close to a hospital only helps so much as mortality risk increases by 10 percent for every minute it takes to get to medical care. This is why there is a greater focus on CPR and Automatic External Defibrillators for helping to protect student athletes these days.

I am not aware of any research indicating that SCA is more frequent among overweight or obese young athletes. I am also unaware of any efforts on the part of the BSOA to ask that participants in high adventure activities be screened for hypertrophic cardiomyopathy or be given an EKG as part of the Part C form. Now, I understand that an EKG can be expensive to administer and read, but if the concern is really about the safety of the participants, it would seem that this is a more important test than BMI.

Another important risk for kids and strenuous exercise is heat stroke. And there is some research that indicates that heat illness is more frequent among overweight and obese football players than “normal weight” players. But many experts stress that exertional heat illness is 100 percent preventable. Most experts strongly recommend an acclimation process to help get student athletes ready for physical exertion. The super punishing, first day of practice workouts in full pads and gear is now frowned upon. I wonder if the Jamboree and other “high adventure” scouting activities really do enough to help scouts of all sizes acclimate to higher temperatures and altitudes or if they simply assume that as long as the kids are skinny, they will be safe.

Which makes me wonder. Where is the data? Show me the data that BMI has a serious impact on safety for children and youth who wish to participate in strenuous physical activity. Do not simply show me studies from adults and extrapolate down to kids. And if the health and safety of your scouts is of primary importance, why are you not requiring adequate screening for the leading cause of death among young exercisers? Are you building adequate acclimation days to make the camp safe for participants? Or again, are you assuming skinny = safe and healthy? And why are you making your most important event so strenuous that you have to worry so much about health and safety in the first place?

To borrow from a famous phrase from the film Jerry Maguire, “Show me the data!”

Love,

TFC

Like my posts? You’ll love my stuff!

Buy my book: The Fat Chick Works Out! (Fitness that is Fun and Feasible for Folks of All Ages, Shapes Sizes and Abilities)–available in softcover and e-book versions

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Why I am NOT Shopping at CVS

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Employees of “Gattica” surrender a drop of blood for analysis before starting work each day.

There’s been an awful lot of talk lately about CVS and their recent decisions regarding health care for their workers. It seems that CVS has implemented a policy that states that employees have a choice between submitting to a health screening or paying $600 more per year in health insurance premiums. The screening (paid for by CVS) will measure several “health metrics” including blood pressure, blood glucose levels, cholesterol, height, weight and BMI. Apparently this information will then be turned over to a third party. What we don’t know is what the third party plans to do with this information and how the third party and/or CVS will use this information to help their employees be any healthier. I submit that helping employees be healthier really has nothing to do with it.

Look, if you want to give your employees incentives to see their doctors twice a year–fine. Regular checkups with your doctor make sense. They help employees manage health and catch problems early. But I can think of no reason why handing this information over to anyone other than your own doctor will do anything to improve your health. Not one.

The only reason to hand this information over is so that a company–be it CVS or a mysterious “third party company” can start harassing you for being in a “higher risk” category. That harassment may come in the form of emails or phone calls. That harassment may come in the form of additional payments you need to make as long as you stay in a “higher risk” category. And believe me, the quotation marks are deliberate when I say “higher risk” category.

Every single one of these metrics has a strong, and I mean STRONG genetic component. They are not measures of behavior or lifestyle. They are statistics about bodies. Lifestyle may be a component of having diabetes in some people. Some people are simply born with a very high disposition to diabetes. So you may have two people, one diabetic and one not who engage in extremely similar lifestyles with very different outcomes. The same is true of cholesterol levels and blood pressure. So how is this not a Gattica style punishment of people who were born with less than perfect genes? How much longer before, like in the movie, we will be forced to leave a drop of blood in the scanner before starting work every morning?

And then there’s the question of collecting height, weight and BMI data. Despite the overwhelming evidence that BMI, height and weight do not serve as accurate measures of personal health, we are still collecting this data. Why? I’ll tell you why. Because fat people are discriminated against in this country. Fat people are blamed for everything in the US from rising health care costs to rising prices on airlines. If you have to look to a socially acceptable scapegoat on which to visit higher health insurance prices, you will choose the fatties. Don’t believe me? Just check out the comments section of any news story covering this decision by CVS. They are universally full of righteous thin people talking about how those fatties are driving everybody’s costs up and deserve to be punished “for their own good”.

Some argue that insurance companies already charge smokers more money. But let me be very clear about this. Smoking is a behavior. You can choose to smoke or not to smoke. You don’t need to smoke to survive. Weight and BMI are characteristics. You CAN NOT determine what a person eats, how much they exercise or how healthy they are by looking at their BMI. All you know is the proportion of their height to their weight, and the proportion of extra costs and stigma it is socially acceptable to heap upon that person.

Other risk behaviors are notoriously expensive and difficult to monitor. Behaviors like drinking, not sleeping enough, distracted driving, uncontrolled stress, not looking before you cross the street and skydiving cannot be measured with a 10 second test in a doctor’s office.

So to reiterate, why are we using weight and BMI to measure a persons health risk rather than behaviors?

1. Unless you actually watch a person or test a person all the time, it is difficult to know whether they are telling you the truth about stated behaviors.

2. BMI and weight, while poor proxies for real data about health require only extremely easy and inexpensive tests to determine.

3. It is socially acceptable in our country to blame fat people for anything and everything.

This is why I will no longer shop at CVS. They have chosen to pass insurance costs on to those who may or may not engage in higher risk behavior than their co-workers but are probably less genetically blessed than their co-workers. And they are already passing health care costs on to those of us who are already discriminated against when seeking a job and are already payed less than those of us who are thin. It’s not okay with me.

Love,

The Fat Chick

Body Intelligence or Body War?

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This week, I’ve come across two very different approaches to young bodies in the media. One is the announcement (and subsequent activism response by the amazing Golda Poretsky) that the television show “The Biggest Loser” will now include teenagers and the other is a new study about the effectiveness of “intuitive eating” among young adults.

It’s hard to imagine a stronger dichotomy than these two approaches. On the one hand, we have “The Biggest Loser” which teaches us that our body is the enemy. No punishment is too harsh. No humiliation is too great. We must deprive ourselves of delicious foods. We must exercise until we vomit or pass out. We must make our bodies thin at all costs.

The study outlines a different approach (at least to eating) by documenting the outcomes of young adults who practice intuitive eating. The study defines intuitive eating by the young people “trusting their bodies to tell them what to eat” and “stopping eating once they felt full”. Based on the Biggest Loser story, one would imagine that those who trust their bodies and allow hunger to guide their eating would be larger than those who focus on controlling body weight. However, the study seems to indicate the opposite. Those who trusted their bodies not only had fewer signs of disordered eating, but also had a lower average BMI.

Now, it’s important to remember that this is only one study. But we’ve yet to unearth a single study that indicates that deprivation and self hatred is an effective way to maintain a lower body weight or BMI over the long term (more than 5 years). So what should we be teaching our kids, to love their bodies or make war on them?

While it seems obvious to me that teaching kids to trust the innate intelligence of their bodies is the better choice, I think it’s important to recognize this is not the easier choice. I think peer pressure plays an enormous role both for children and their parents. I think many of us have faced discrimination and outright cruelty from others because of the size of our bodies. We don’t wish that pain on our worst enemies. So it’s not surprising that we don’t want it for our children. And the prevailing wisdom of the women at the beauty shop, Aunt Thelma and even our pediatricians often involves hushed side conversations about what the parent is going to “do” about a child’s weight. It seems clear to me that peer pressure bends us towards putting our kids on diets, obsessing over their BMIs, forcing them to exercise, sending them to fat camps and yes, even allowing them to be on “The Biggest Loser”, even though there is so, SO much evidence out there showing that this approach doesn’t work. But at some point, we have to ask ourselves, “Is peer pressure a smart way to decide what’s best for kids? Is bowing to peer pressure in this case going to make our kids happier or healthier in the long run?” I think we need to ask the proverbial question, “If our friends tell us to run off a cliff, will we do it?” Or will we put peer pressure aside, assure the ladies at the beauty shop and Aunt Thelma and even our pediatrician that we are doing what science indicates is best for our kids, and teach them that their bodies are wondrous and intelligent and trustworthy?

I’d love to hear what you think.

Love,

The Fat Chick

Obesity Panic: Now Available at Birth

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Counting baby’s fingers and toes and BMI

The Washington Post recently reported on a study that purports to predict which kids are most likely to become obese. This study claims that you can use a simple formula to predict which kids are more likely to get fat over the course of their lives. Apparently, worried parents can follow the formula (using a simple online tool) shortly after the baby’s birth to begin obsessing over the child’s potential chub before they have even brought their bundle of joy home from the hospital.

That’s just great, isn’t it?

The article goes on to suggest that doctors and parents will know shortly after birth, which kids can “benefit most” from interventions aimed at preventing them from becoming fat. The article admits that helping people lose weight once they are heavy “has yielded disappointing results”. So the article suggests, we might have better success in preventing kids from getting fat in the first place.

Hmmm. Based on what, I wonder? Is there any proof that these interventions work? Is there any evidence in the world to indicate that kids who receive these early interventions wind up thinner or more healthy than those who don’t? And what does it do to these kids to be singled out at such an early age?

Reading a little further in the article, I came across this little gem:

The authors note that such a formula if used in common practice could help physicians allocate health-care resources by steering those kids who most need help toward nutrition and psychological counseling. They further note, though, that their formula should not be used to stigmatize some families or to falsely reassure other families that their babies are not at risk of becoming overweight in the future.

Okay, so let me get this straight. The formula can help doctors figure out which kids to start badgering about not getting fat (starting at birth) but reassure us that those kids and families shouldn’t feel singled out (because we tell them not to). And God forbid you parents with kids at lower risk for obesity should relax your vigilance for even a minute. Your kid could wind up fat anyway. You just can’t be too careful.

GAAAAAAAAAAAAHHHHHHHHHH!

How long before we have Jenny Craig and Weight Watchers for babies? How long until health insurance becomes more expensive for families of “high-risk” kids? How long before parents are crunching potential BMI numbers before they even decide whether or not to have a kid?

I don’t know about you, but this sort of thing really, really scares the crud out of me. It’s not enough that we have five and six-year-old kids with eating disorders. Nope. Now we’re supposed to be obsessing over the gene size and the jeans size of children before they even start solid food.

Why don’t we just make healthy foods and a safe place to play available to all kids? How about we don’t start messing with kids innate and intuitive skills for playing and eating before they even begin to form their first words? How about we teach all kids about Health At Every Size and give them tools for healthy, happy, expansive, joyful lives instead of teaching them to fear and hate their own bodies before they are out of diapers?

Let’s, at least for a little while, let kids be kids.

Love,

The Fat Chick