Obesity letters spark controversy in childhood obesity debate

katyblack · 10-09-2013 7:26am #1

Parents receive all kinds of notifications from their children’s schools: grade reports, truancy and tardiness statistics, behavior accounts, etc. One letter you probably wouldn’t expect is what some have christened the “fat letter.” It is school’s most recent tool in the war they wage on childhood obesity.

Obesity as a serious threat

More than just a recurring nuisance, childhood obesity is a serious threat to the rising generation’s health. It is linked with a number of serious conditions in childhood and adulthood and, according to Michael Flaherty, pediatric resident physician in the department of pediatrics at Baystate Medical Center in Springfield, Mass., it threatens to reduce kids’ life expectancy. “Obesity is an epidemic in our country,” he said, “and one that is compromising the health and life expectancy of our children. We must embrace any way possible to raise awareness of these concerns and to bring down the stigmas associated with obesity so that our children may grow to lead healthy adult lives.”

The statistics are sobering. Today, the number of kids classified as obese is three times that of the number in 1980. As obesity numbers rise, other problems do as well, including heart disease, sleep apnea, joint issues, and asthma.

Schools collect health information

There are now 21 states that mandate weight screening. Schools are required to collect information on students’ height, weight, and/or BMI. Some, but not all of these states, also require parents be notified of the weight screening results. Some parents think the “fat letter” policy is taking legislation too far. They believe schools shouldn’t be allowed to intrude into such private matters. There are worries that should the information get out, kids will be bullied or develop eating disorders.

Dr. Flaherty, however, thinks a change in policy would be a mistake because, “The growing number of children and adolescents seen day in and day out in our clinics with hypertension, high cholesterol, diabetes, and musculoskeletal issues secondary to weight do not lie.”

Letters need to do more

Another doctor, Dr. David Dunkin, assistant professor of pediatric gastroenterology at the Icahn School of Medicine at Mount Sinai in New York City, believes the letters are a good idea, but one that is implemented ineffectually. He believes it would be better if the letter was accompanied with a recommendation for programs that would help the students make the necessary lifestyle changes.

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ted1 · 10-09-2013 10:01am

If done correctly I think its a good idea.

Parents can be blind to kids putting on weight, and if there informed that little tommy is actually big tommy they may do something about it.

Ideally schools should teach nutrition from primary school through to secondary. Many schools idea of P.E is a game of football. They seem to forget about the E part.

seamus · 10-09-2013 10:05am

School reports in primary school contain information on the child's development - how well they're getting on in groups, how well they interact in the class, whether they seem sociable or withdrawn, etc. If the child also appears to be suffering some difficulty, such as short-sightedness, then the teacher will also highlight that.

I don't see any reason why the school shouldn't raise concerns if the child has a health issue that appears to be going unaddressed. If the child was coming to school every day with a bad cough, or needing to go to the toilet ten times a day, and the parent wasn't mentioning it, then the school would get in touch with the parent. So why not do the same if the child is overweight?

mikemac1 · 10-09-2013 10:06am

There are plenty of primary schools that ban sweets and minerals for lón and sos

The only exception is Fridays

Seems to work well and has been going on for years

rubadub · 10-09-2013 10:09am

ted1 wrote: »

Many schools idea of P.E is a game of football.

And some consider it to be more like a treat, same as with art. I remember they would think nothing of not doing a PE lesson or art lesson, they would even treat it as a punishment forcing people to miss it.

In secondary school I didn't even do PE in the last 2 years as I was doing honours maths, dunno if that still goes on.

sillysmiles · 10-09-2013 10:11am

katyblack wrote: »

.... There are worries that should the information get out, kids will be bullied or develop eating disorders.

If they are obese then it will be fairly obvious to all without the actual numbers making a difference.

I think it would work if the letter was accompanied by an invitation for the family to enrol in a nutritional/exercise program and meet with specialists. Generally kids don't feed themselves and targeting the children alone will be ineffective, it is the entire family that will need to be assisted.

Cookie_Monster · 10-09-2013 10:13am

rubadub wrote: »

In secondary school I didn't even do PE in the last 2 years as I was doing honours maths, dunno if that still goes on.

same here

Alf Veedersane · 10-09-2013 10:14am

We never had P.E. It was 2 classes together called 'Games'. I **** you not. It consisted of an overcrowded game of football.

gymfreak · 10-09-2013 10:26am

I disagree with the idea of 'fat letters' for a number of reasons.

Firstly, the Irish Constitute states that the parents are the 'primary educators' of the child..if so why is more and more aspects of the child's development (be it social, emotional, physical, cognitive etc) left up to the teachers. If a child is having issues with their weight it's generally down to two causes-lack of exercise and very poor nutrition. Who is in control of the nutrition side of things....the parents. It is them who need to be educated on what to feed their child. This responsibilty shouldn't be turfed onto the schools.

A number of years ago, we introduced a healthy eating policy in the school. We supplied the lunches for the children and they got to pick what they'd like from a list. The parents fought against the healthy eating policy saying that their children wouldnt eat anything but rubbish and that if we enforced it the children would starve for the school day.....fast forward 8 or so years...the entire school eats their lunch without any complaints. I'm not saying that the lunches are perfect..but I am saying that it was the parents who caused more of a fuss than the children.

Secondly, is there really a need for schools to weigh the children and send home fat letters. The overweight child is probably very aware that they are overweight, the last thing that they need is their teacher telling them it too. One of my least favourite topics to teach in maths is Weight. I always bring in a variety of scales and let them guess and weigh anything in the classroom. It ALWAYS ends up in them wanting to find out what they weigh and no matter how discreetly I try to make the whole process, I can see the overweight children start to sink into their seats when they see other kids weigh themselves. They know that they are overweight they just don't have to skills or knowledge to fix the problem.

I will finish on saying that I DO think that it is extremely important that schools should teach children about nutrition. The only problem is that the school books are very much centred around the food pyramid..so hopefully in a few more years the curriculum setters and the book writers will have discovered that basing our nutrient requirements around the food pyramid is not ideal.

End rant:)

wolfpawnat · 10-09-2013 10:36am

sillysmiles wrote: »

Generally kids don't feed themselves and targeting the children alone will be ineffective, it is the entire family that will need to be assisted.

True, but now you have parents that are too busy trying to juggle work, school etc to just say no and sit the child down and explain why they can't have 2 snickers and a bottle of coke for sós, just placating the child with a yes instead, or you have parents that are more worried about their child liking them than raising them correctly.

gymfreak wrote: »

Firstly, the Irish Constitution states that the parents are the 'primary educators' of the child..if so why is more and more aspects of the child's development (be it social, emotional, physical, cognitive etc) left up to the teachers.

Because these days too many parents just cannot/do not give a damn. I think too much is being left to schools, and many parents expect the schools to rear their children for them.

I saw it at the school gates myself this morning, kids munching junk food in front of their parents because they didn't eat a proper breakfast. A lot of the kids are overweight and in many cases the parent with them was just as big if not bigger.

Thoie · 10-09-2013 10:53am

Thinking back to my childhood, the way I'd prefer to have it done:

Public health nurse/someone (not a teacher/school employee) comes in once a term. Everyone goes into a private room with the nurse and is measured/weighed. They could listen to chests etc at the same time. Children are not told their measurements.

A letter is then sent to each family saying "child was measured on x date, and here are the measurements - your child is under/over/right weight, here's a guide on healthy eating and exercise for children. Call this number to make an appointment if you need more info/guidance".

It shouldn't lead to any additional bullying in school, and will give parents the heads up.

Cookie_Monster · 10-09-2013 11:00am

where are the resources for that going to come from though. It's a good idea but with big cuts on the way as it is there is little or no hope of something like that being brought in, despite massive savings over the long term life of the kids.

seamus · 10-09-2013 11:08am

Cookie_Monster wrote: »

same here

And here afair. "PE" for senior students consisted of playing rugby or tennis after school, if you wanted to.

I think in 1st & 2nd year we got one double-class of PE (so just over an hour) plus 30 minutes of swimming. Which is something, but not nearly enough. In 3rd year the swimming was dropped. And in fourth year it was dropped again to just a single PE class which consisted of a 2km run around the grounds followed by a game of football until class was over.

I've said it a number of times, but the curriculum should require a minimum of 3 x 80-minute PE sessions a week, all the way through school.

Cut religion and Irish from the mandatory curriculum to facilitate it, you'd make savings too.

Oryx · 10-09-2013 11:23am

When I was 12 I had a teacher who weighed everyone individually in front of the class. Even at 12 I could see it was to embarass the 'heavy' girl of the class, who was substantially bigger than most of us. I still think of how she must have felt. That teacher was an utter cow, I still don't understand her doing it.

In secondary we were very active, in fairness. Two set classes a week, doing whatever sport was in season, and that teacher was great, got us all to do self defence classes and driving lessons, very proactive on diet too. More of that is needed, (I don't know what its like in schools now, but even with us we knew our teacher was an exception) but if it is not led from home, it wont do much. Parents do have to encourage kids not just to take up sport but to get out and active in small ways every day. The obesity problem is not caused within schools, it is a product of laziness: parents and kids too lazy and/or time constrained to eat proper food, or to take time to do active things.

seamus · 10-09-2013 11:33am

Oryx wrote: »

When I was 12 I had a teacher who weighed everyone individually in front of the class. Even at 12 I could see it was to embarass the 'heavy' girl of the class, who was substantially bigger than most of us. I still think of how she must have felt. That teacher was an utter cow, I still don't understand her doing it.

There are a substantial number of people who think that if you publically call people out on their weight, even make fun of them, then that will encourage them to do something about it.

Anyone who's actually been overweight understands that "fat shaming" will have exactly the opposite effect and will likely result in an overweight person becoming even more overweight as they become withdrawn and comfort-eat.

There may be validity in an intervention-style "outing" of someone's weight problem, but that's not the same thing as weighing kids in front of the rest of the class.

Tbh, I don't agree with schools physically screening children to check for weight problems. I would have no problem with a teacher raising a concern about the child's apparent weight problem, but collecting information will result in children keeping tabs themselves - running out of the screening and asking all of the other children what they weigh, what their BMI is, etc.

I have no problem with the health authority doing screenings in school (because that's the easiest way to get them together), provided that all results are kept private and sent only to the parents, not provided to the school or to the child themselves.

Thoie · 10-09-2013 11:35am

Cookie_Monster wrote: »

where are the resources for that going to come from though. It's a good idea but with big cuts on the way as it is there is little or no hope of something like that being brought in, despite massive savings over the long term life of the kids.

I live in a happy, magical world, where resources are freeeeee!

The admin side of things could be taken care of a number of different ways - the extra hours being put on civil servants, for example. Get someone in the HSE to prep the letters, enter the data, mail merge, and your uncle is Roberto. The public health nurse (or suitable equivalent) would be the hardest to find, as they're generally thin on the ground to start with.

Semi considered the notion of getting student nurses to do it as part of their training, but that would only work for height/weight - student nurses may not have enough experience to pick up on other things.

Another alternative is asking parents to enter the details every x months on a website, and withhold children's allowance until it's done, but there's too many holes in that plan. What if you don't have internet, what if you don't have a scales/tape measure, won't someone think of the children, etc. On the plus side, it could keep Joe Duffy going for months.

Thoie · 10-09-2013 11:39am

Thoie wrote: »

Public health nurse/someone (not a teacher/school employee) comes in once a term. Everyone goes into a private room with the nurse and is measured/weighed. They could listen to chests etc at the same time. Children are not told their measurements.

seamus wrote: »

I have no problem with the health authority doing screenings in school (because that's the easiest way to get them together), provided that all results are kept private and sent only to the parents, not provided to the school or to the child themselves.

My point exactly. Though I didn't specifically say that the school wouldn't get the data, I called out that it should be the health authority, not the school, for that reason.

Dravokivich · 10-09-2013 12:01pm

Cookie_Monster wrote: »

where are the resources for that going to come from though. It's a good idea but with big cuts on the way as it is there is little or no hope of something like that being brought in, despite massive savings over the long term life of the kids.

The text copied into the OP, appears as if it's lifted from an American article.

April O Neill · 11-09-2013 11:36am

seamus wrote: »

I've said it a number of times, but the curriculum should require a minimum of 3 x 80-minute PE sessions a week, all the way through school.

I hated PE (not gifted at sports, esp. teamsports), and would have ditched those classes if there was that much PE, tbh.

I wasn't an overweight teen, and have an active enough lifestyle, but loathed PE with a passion. Would be far from alone there.

Orla K · 11-09-2013 1:17pm

Dravokivich wrote: »

The text copied into the OP, appears as if it's lifted from an American article.

Thank f*** someone said it, I was starting to wonder did we become the 51st state or if Europe swapped us for Hawaii.

What's the big deal, some states which already collect that data are going to send a letter home to the parents, who probably already know anyway.

moc8827 · 12-09-2013 4:35pm

Surely the issue shouldn't be whether or not the child is overweight but instead whether they are participating in sports/ P.E. as these are the only things within the control of the school.

A child's weight is a difficult issue to try and address for a number of reasons:
1. A child might just be a bit overweight, it might have nothing to do with lack of exercise.
2. Weight is such a sensitive issue, it's never going to go down well with parents

I think it's good that schools are making this an issue. However, they're using completely the wrong tactic

Clearlier · 13-09-2013 12:53pm

wolfpawnat wrote: »

I saw it at the school gates myself this morning, kids munching junk food in front of their parents because they didn't eat a proper breakfast. A lot of the kids are overweight and in many cases the parent with them was just as big if not bigger.

In most cases the parents haven't been educated/don't know either. Not just with this topic but others as well we (the general public) seem to think that a magic wand is waved and people who weren't taught things as children suddenly know them as adults. I don't know anyone who enjoys being fat. If a fat adult has fat children there's a decent chance the parents don't know what to do which is not surprising given the food pyramid forms the basis of much public beliefs around nutrition (genetics could well be playing a role here too).

Thoie wrote: »

Thinking back to my childhood, the way I'd prefer to have it done:

Public health nurse/someone (not a teacher/school employee) comes in once a term. Everyone goes into a private room with the nurse and is measured/weighed. They could listen to chests etc at the same time. Children are not told their measurements.

A letter is then sent to each family saying "child was measured on x date, and here are the measurements - your child is under/over/right weight, here's a guide on healthy eating and exercise for children. Call this number to make an appointment if you need more info/guidance".

It shouldn't lead to any additional bullying in school, and will give parents the heads up.

Living in the UK for the past 4 years something like this is done annually at my child's school. A caravan comes for a few days and does some measuring of all the kids, provides some information about healthy eating and then (presumably) moves on to another school. Parents pay a small fee for the service (although it's not obligatory if you can't afford it). We get a letter at some point telling us where our son falls into national averages for height and BMI IIRC.

April O Neill wrote: »

I hated PE (not gifted at sports, esp. teamsports), and would have ditched those classes if there was that much PE, tbh.

I wasn't an overweight teen, and have an active enough lifestyle, but loathed PE with a passion. Would be far from alone there.

I've never seen a young child who didn't enjoy being active. It's as they get older and have bad experiences that they get turned off PE. While there probably are some outliers who will never ever enjoy and kind of exercise IMHO better teaching would lead to far more enjoyable experiences for children and much lower levels of desire to avoid PE.

wolfpawnat · 13-09-2013 12:59pm

Clearlier wrote: »

In most cases the parents haven't been educated/don't know either. Not just with this topic but others as well we (the general public) seem to think that a magic wand is waved and people who weren't taught things as children suddenly know them as adults. I don't know anyone who enjoys being fat. If a fat adult has fat children there's a decent chance the parents don't know what to do which is not surprising given the food pyramid forms the basis of much public beliefs around nutrition (genetics could well be playing a role here too).

Indeed. There are many reasons for overweight generations. Parents that don't care about good eating. Fast foods being cheaper than the ingredients for a homemade meal. Genetics and parents not having the time to cook. Another one a lot of people forget is we are not as active as previous generations. Our parents often feed us what their parents fed them, but we use cars and other means of transport these days as well as people having more jobs that require them to be seated more as opposed to more manual labour work as older generations would have done. So the food could be very good food, potatoes and the like, but without the right use of energy to burn the calories, people will gain weight.

LeinsterDub · 13-09-2013 2:45pm

All this focus on PE is misguided there are 824 calories is a 2 litre bottle of coke and I've seen kids down them . You could run a kid for a 1 hour 10 k and not burn this off .

LeinsterDub · 13-09-2013 2:58pm

wolfpawnat wrote: »

Fast foods being cheaper than the ingredients for a homemade meal

Is this actually true? I know Jamie Oliver for one would disagree and while I can think of one off items such as the McDonald's euro saver menu being cheaper by the time you've ordered enough to actually fill yourself I doubt you are saving much if at all.

https://www.facebook.com/McDonaldsIreland/app_128953167177144
Burger, chips, drink about €5 and i'd probably need to throw in the pie .

1kg of chips 1 euro http://www.tesco.ie/groceries/Product/Details/?id=274467293
Finest burger * 8 6 euro http://www.tesco.ie/groceries/Product/Details/?id=277598887

Buns * 6 1.29 http://www.tesco.ie/groceries/Product/Details/?id=250129932 total
8.29 for 6 to 8 meals and you could go cheaper and healthier for sure

Thoie · 13-09-2013 5:34pm

LeinsterDub wrote: »

Is this actually true? I know Jamie Oliver for one would disagree and while I can think of one off items such as the McDonald's euro saver menu being cheaper by the time you've ordered enough to actually fill yourself I doubt you are saving much if at all.

https://www.facebook.com/McDonaldsIreland/app_128953167177144
Burger, chips, drink about €5 and i'd probably need to throw in the pie .

1kg of chips 1 euro http://www.tesco.ie/groceries/Product/Details/?id=274467293
Finest burger * 8 6 euro http://www.tesco.ie/groceries/Product/Details/?id=277598887

Buns * 6 1.29 http://www.tesco.ie/groceries/Product/Details/?id=250129932 total
8.29 for 6 to 8 meals and you could go cheaper and healthier for sure

Burgers and chips from the frozen food cabinet aren't exactly healthy - in general premade burgers are made from the crappiest, fattest meat around, with whatever scrappings they pick up. For the "healthy" alternative, buy a bag of potatoes and make wedges/baked potatoes in the oven. To make a burger, buy some fresh mince (where you can see the quality), throw in some bread crumbs, seasoning, herbs etc and grill/dry fry it yourself.

rubadub · 13-09-2013 6:08pm

LeinsterDub wrote: »

Is this actually true? I know Jamie Oliver for one would disagree and while I can think of one off items such as the McDonald's euro saver menu being cheaper by the time you've ordered enough to actually fill yourself I doubt you are saving much if at all.

I am always amused at Jamie Olivers price claims, other chefs do it too. They do not factor in all the costs. Its very rare to hear them factor in electricity, and then they are always putting on extras as though they are free, like spices. There has never once been a time where I saw a TV chef price something where I thought "hmm that sounds a little high" -never.

I think the 1 euro burger is cheap. To make it at home you need, mince, buns, ketchup, mild mustard, onions, gherkins, salt, pepper. Electricity to cook & clean up after, and your time, which some may value highly. In mcdonalds they now have really nice seats and todays papers too!

Now stuff like the salt & pepper will last ages once bought so a "portion" is cheap. But I met a friend of mine in the supermarket getting stuff to do some Asian recipe (Jamie Olivers coincidentally), as we went around it was totting up really quickly and costing a lot more than a takeaway, some things were not going to be a bulk long term buy, the price of the fresh veg amazed him.

As for being filling, mcdonalds simply do not have massive portions, that's the main reason I believe you see this common complaint, they are comparing to other takeaways. I was in a chipper last week and weighed what I got as I was shocked at how heavy it was, doner kebab was 440g, chips were 460g, a big mac is ~205g and the chips would be a fraction of 460g, while admittedly more calorie dense per gram.

Look at the price of these, posted a month ago

eireannBEAR wrote: »

full sized doner kebab with chips and any free can of drink e4.95 including free delivery.

typical yummy italian chipper food have you seen a better deal?

LeinsterDub · 13-09-2013 8:51pm

Thoie wrote: »

Burgers and chips from the frozen food cabinet aren't exactly healthy - in general premade burgers are made from the crappiest, fattest meat around, with whatever scrappings they pick up. For the "healthy" alternative, buy a bag of potatoes and make wedges/baked potatoes in the oven. To make a burger, buy some fresh mince (where you can see the quality), throw in some bread crumbs, seasoning, herbs etc and grill/dry fry it yourself.

If you notice I didn't claim it was healthier I said cheaper. I'm aware of cheap healthy alternatives I was trying to compare like with like

Obesity letters spark controversy in childhood obesity debate

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