The Battle of the Bulge at Schools
DREXEL HILL, Pa., Feb. 20, 2007 — -- In the nurse's office at Hillcrest Elementary School in this Philadelphia suburb, nurse Kim Glielmi spends much of her day dealing not with cuts and bruises, but pounds and inches. On the day we visited, the entire kindergarten class was lined up for its mandatory march to the scales.
Welcome to the front lines in the nation's struggle against childhood obesity, a battlefield littered with emotional land mines. Like six other states -- Arkansas, Illinois, Maine, New York, Tennessee and West Virginia -- Pennsylvania now requires grade schools to record the height and weight of each student, measurements that are calculated into a body mass index, or BMI.
Children scoring above the 85th percentile for their age and sex are considered to be at risk by the Centers for Disease Control and Prevention. Children in the 90th percentile or above are deemed overweight. For example, a 5-year-old boy in kindergarten who stands 4 feet tall hits that upper range at about 57 pounds.
Failing Grades
Nurse Kim, as everybody calls her, calculates the BMI and corresponding percentile for each student. By state mandate, that information is then sent home to parents in notices that have been dubbed "obesity report cards." According to the CDC, 16 percent of American schoolchildren are obese, a figure that has tripled in the last three decades.
But the BMI report cards are getting mixed reviews from some parents and politicians who fear such information can backfire and hurt a child's self-esteem. Arkansas, the first state to mandate that schools send home BMI scores, is now considering whether to repeal its law.
At Hillcrest Elementary School, nurse Kim is careful to measure and weigh each student privately. She goes out of her way to pass on compliments instead of judgments about weight, constantly saying things like, "good job, honey, you've grown so tall!"
She believes the BMI testing is a valuable indicator for schools and parents alike.
"It's a tool and parents don't need to be afraid of it. It does not mean your child is overweight. It means that this is a flag that you should take to your physician. It could indicate that there is a weight issue, but not always."
At Hillcrest, only a few parents have complained about the BMI testing, but some take the score with a grain of salt.
An Imperfect System
Rose Shields, waiting to pick up her son from school, believes the BMI has its limitations. "I think it's a good indicator, but my son came back pretty high. And when I look at his body type, he's a pretty broad little guy. He's definitely not obese. I don't know if it's 100 percent true."
Indeed, experts say the BMI scores can easily be misinterpreted and misused.
Melinda Schwartz, director of research at Yale's Rudd Center for Food Policy and Obesity, says "one big problem with BMI is that it really doesn't distinguish between children who have a lot of muscle mass" and those who don't. "It's really designed to be a tool to look at large groups of children and to track changes over time. It's much less effective as an individual, medical, diagnostic tool," says Schwartz.
For schools such as Hillcrest, the BMI is only one small weapon in a comprehensive approach to better nutrition and exercise.
"That's one of our main focuses for this school year," says Hillcrest principal Daniel Horan. The cafeteria, for example, has undergone a radical transformation. Pizza is topped with low-fat mozzarella cheese.
Chicken fingers are baked, not fried. Club sandwiches are made with whole wheat bread and turkey bacon. Students in line for lunch are greeted with a dazzling display of freshly cut oranges and pears. Next to the rack of potato chips (baked) are tiny trays of carrots and broccoli. Soda pop is nowhere to be seen.
For their part, the students seem to have adjusted to the loss of French fries and sugary drinks. A random sampling of opinion in the lunchroom turned up few complaints about the food.
Diet and Exercise
Instead, the most common gripe was not enough gym time. Hillcrest students get gym class only once a week, although physical education teacher Russ Gutsche voluntarily opens the facility before school every Tuesday and Thursday.
A 35-year veteran, Gutsche laments that television and video games have largely replaced vigorous physical activity for many children. "The kids just don't go out and play as much."
To take up the slack, nurse Kim has started a walking club, inviting students, parents and teachers to walk a mile after school every day.
On the day we visited, more than a hundred of the school's 600 students showed up. Nurse Kim entices them by offering key-chain trinkets. Walking five miles earns one a tiny plastic foot.
But schools can only do so much. During the weigh-ins, the nurse casually asks the students what they had for breakfast. One 5-year-old boy replies, "I had sausage and a pop-tart with cinnamon icing!"
"It's a Family Thing"
Such a reply raises a larger question: In an era of increasing obesity among schoolchildren, who's ultimately responsible for how a child exercises and what he eats? Nurse Kim says, "these kids don't go to the food store. They have to sit at the table and eat what they're parents put there. So it's a family thing and parent education is a huge part of it."
At Hillcrest, parents are getting involved as well. Last year, a group of them started "The Biggest Loser" contest. Each parent contributed $20. Half of it was pooled to offer a cash reward to the parent who lost the greatest poundage; the other half contributed to a new rock-climbing wall for the school gymnasium. More parents are taking up the challenge this school year.
Johnna Healey, a parent along for a recent after-school walk, says she has already noticed a big difference with her 6-year-old son. "He has been willing to try a lot of new food lately, and I know that it's because of the walking club and the choices they have at lunch time. He even loves salad."
Already this school year, the walking club has logged nearly 3,000 miles. The club's goal is to walk the equivalent distance between Philadelphia and Hawaii. Says nurse Kim, "we're going to have a big luau in June when we get there." No French fries will be served.
Producers Ely Brown and Artis Waters contributed to this report.