report cards |

Forgive me for once again pointing out the blazingly obvious, but recent studies have not been able to find any actual benefits from sending “fat letters” home from school. What is a “fat letter” you ask? Many schools are now doing BMI testing on the entire student body. When a student’s BMI is considered to be too high (using some relatively arbitrary measure) a letter is sent home from school to the student’s parent that goes something like this:

Hi.

Your kid is fat. WE obviously don’t trust you to know your own kid is fat, because if you knew, you’d obviously have fixed it by now. We also believe that you don’t know how to keep your kid healthy (because FAT) so here’s some arbitrary weight loss advice that hasn’t been shown to work long-term on anybody, but we’re sending it anyways (because FAT). And obviously we know that you need help because your kid must be eating a whole cake and 4 liters of sugary soda every day and must need your assistance to run the remote as they watch TV because that is HOW kids get fat.

Also, clearly you aren’t showing the appropriate level of panic about this situation (because OMG Deathfat!) so here are some alarmist health statistics and nonsensical vague future health threats that indicate your kid won’t live as long as you (even though the statistics don’t bear this out because even though we’re in education EEK! MATH!). We don’t plan on doing anything to protect your kid from stigma because clearly if you were doing your job right there would be no stigma to protect against (and we don’t like the way your kid looks because OMG jiggly FAT!)

You’re welcome,

Signed Your Kid’s School

Wait, what? You mean parents don’t love these letters? You mean despite the fact there is nothing in medical science that indicates that there is a formula for long term weight loss, these kids don’t magically slim down like gazelles and become the most popular kids in the class after their parents receive the letter? Really?

Nope. In THIS very recent study and this earlier study, no link was found between sending home fat letters and BMI, weight, health behaviors or health outcomes. This doesn’t meant that the letters have no effect (for example we don’t know if it has an effect on self esteem or the price of broccoli in Boise.) It simply means that after all the hoopla and distractions from study and public money spent, there is no discernable benefit.

Let me say this again. State money is being spent on an educational program with no definable benefit. Which begs the question, do fat people cost our country money or does the knee jerk requirement to “do something about the fatties” whether it does any good or not cost our country money. Are we paying a premium to create a state-sanctioned forum for people to yell at parents of fat kids because we don’t like the way they look? (We could create a thread on Reddit.com for a whole lot less money. Look how much money I saved us!)

And let’s be clear. This is not just a few dollars at a few schools. According to the New York Times, nine states require that “fat letters” be sent home to parents. And today, 25 states weigh public school students to monitor population data on obesity rates.

Yet the results section of Gee’s study states:

BMI screening and parental notification during late adolescence, given prior screening and notification in early adolescence, was not significantly related to BMI-for-age z-scores, the probability of being in a lower weight classification or exercise and dietary intake behaviors.

So what “grade” do you give this exercise? After careful consideration, I’d have to give this project an “F”.

Love, Jeanette DePatie (AKA The Fat Chick)

P.S. Want me to come speak at your school? Check out my info here!

So very often these days we hear that the world has deemed to help the portly because they so desperately need help and the world is being nice–and stuff. Millions upon millions are invested in trying to prove that fat people are unhealthy, and if they would just eat a little less and move a little more, all their problems would be solved, everybody in the world would be healthy, and good, quality health insurance would cost everybody $1. The fact that despite the millions of dollars spent, nobody has been able to prove these or demonstrate any way to make this magical weight loss happen on all but a fleeting and temporary basis doesn’t seem to deter anybody from testing this hypothesis again and again.

And even when the proof is not available, or indeed the available evidence says that your “weight intervention” causes negative effects and makes people fatter current policy seems to involve simply ignoring those pesky little facts.

Take the current practice of weighing and measuring kids at school and then sending home “BMI report cards”. Despite showing again, and again and again that shame doesn’t make kids thinner or healthier, showing that shame causes kids to engage in more unhealthy behavior, that shame makes kids fatter, we still do this. Why? The National Eating Disorder Information Center issued the following statement regarding BMI testing in schools:

What the American Academy of Pediatrics (AAP) seems to be ignoring in its advocacy of weighing and measuring the height of schoolchildren is the risk it carries not just to increase body-based bullying from student’s teachers and peers, but the risk to children’s developing self-stigma and poor body image.

Body-based bullying continues to be the most common cause of bullying in youth. 29% of girls and 15% of boys are already teased about their weight at home. By grade seven, up to 30% of girls and 25% of boys are teased by other students. Poor body image has been found to stop youth from engaging in social, academic and physical opportunities. It limits willingness to express an opinion. In perpetuating focus on body shapes and sizes rather than on encouraging health providing attitudes and behaviours in children regardless of size, what are our schools (and public health) teaching?

However, it seems that plans to do BMI testing and BMI report cards in schools is continuing throughout North America.

This also reminds me of another recent situation I had recently reported. Blue Care of Michigan is still touting the positive results of their “enforced march” walking program for fatties despite the fact that there is no evidence at all that those who participated either lost weight, or had any positive health outcomes associated with the program. They apparently did nothing to track the original fitness level of the plus-sized participants and had no idea whether or not these folks were already active. They just told these people that unless they wanted to pay an additional $2,000/year they had to participate. They also forced those who participated to either be a member of Weight Watchers or wear a monitor which counted their steps during the day. Just like a prisoner, they were forced to wear a physical implement on their bodies that told their insurance overlords what they were doing throughout the day. Just because their BMI is over 30. They declared this project a success even though nearly 1/3 of the 12 percent of participants who bothered to respond to the survey said they hated the program and found it coercive. For more information, you may wish to read this article from my friend and colleague Jon Robison.

Throughout all this rhetoric about making fat people into “healthy thin people”. Throughout all this spending on proving that fat people can become thin people on more than a very temporary basis and that making fat people into thin people will make them healthy there is one thing continually missing and that thing is proof.

When the available evidence points to the opposite of the fat people can become thin people, or fat people can’t be healthy people or fat kids just have ignorant parents rhetoric, the powers that be either request more money to re-test the hypothesis or simply ignore the inconvenient facts.

You may have heard of iatrogenic effects in medicine. Dictionary.com defines them as: (of an illness or symptoms) induced in a patient as the result of a physician’s words or actions, esp as a consequence of taking a drug prescribed by the physician.

And good old Dictionary.com also defines iatrogenic as relates to social welfare: “(of a problem) induced by the means of treating a problem but ascribed to the continuing natural development of the problem being treated”.

Some experts have suggested that the “obesity crisis” is a textbook example of iatrogenic effects in both medicine and social welfare. But I wonder if the “obesity crisis” isn’t responsible for iatrogenic effects in the economy as well. If the response to the mounting pile of evidence that “diets don’t work” and “shame doesn’t work” and “fat people can be healthy” is always, “let’s pay for more tests” or “let’s do the weight loss junk but try harder this time” the obesity crisis will continue to be very, very expensive.

But I think the treatment for the economic effects of the hysteria surrounding the “obesity crisis” may be as simple as this. Demand proof. If your insurance company wants to put you on a walking program without doing an intake of any kind or presenting any data regarding the efficacy of the program, demand proof. If your kid’s school wants to measure their BMI along with everybody else’s and send home a BMI report card, demand proof that this makes kids happier or healthier. It’s not easy. It’s not fun. But the rights of fat people to enjoy life, liberty and the pursuit of happiness demands that we, the fierce fat folks, demand proof.

Love,

The Fat Chick

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