BMI report cards: Will they pass or fail in the right against pediatric obesity?
Division of Adolescent/Young Adult Medicine, Department of Medicine, Children's Hospital Boston, MA 02115, USA. Current opinion in pediatrics
(Impact Factor: 2.53).
06/2009; 21(4):431-6. DOI: 10.1097/MOP.0b013e32832ce04c
Pediatric obesity has reached epidemic proportions in the USA and Europe. The use of BMI report cards is one approach to addressing the epidemic that is gaining popularity across the USA and in the UK.
Recent findings suggest that parents of overweight children underestimate child weight status and the majority of pediatric overweight and obesity goes undiagnosed in primary care settings in the USA. Although there is no argument against the efficacy of tracking a child's BMI and informing parents of their child's weight status, there is considerable controversy surrounding whether schools should be involved in BMI screening. Research on the efficacy of BMI report cards suggests that parental awareness of weight status is not improved by BMI report cards. Findings are inconclusive on whether BMI report cards lead to changes in weight-related health behaviors, and there is no evidence to suggest that report cards ultimately impact weight status. Additionally, research indicates that BMI report cards may increase dieting, a risk factor for both increased weight and eating disorders in adolescents.
Research does not suggest that BMI report cards will be effective in reducing rates of pediatric overweight and obesity. Instead, recent findings show that the potential for harm may outweigh possible benefits. States and countries that mandate the use of BMI report cards should make evaluation of these policies a priority.
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ABSTRACT: It is recognized that public health intervention targeted toward changing lifestyle behaviors to reduce overweight status is a considerable challenge. It is important that individuals recognize their overweight status as a health risk in order for an effective change in lifestyle behaviors to occur, and growing evidence suggests that actual weight and perception of weight status often do not match, especially among adolescents. In this article, we explore the extent to which exposure to heavier peers and parents affects misperception of their own weight status by adolescents. Using data from a nationally representative sample of adolescents, we estimated instrumental variable models with school-level fixed effects to account for bidirectionality of peer influence and environmental confounders. Our results indicate that individuals who live in an environment that exposes them to overweight/obese parents and heavier peers tend to misperceive their weight status and think of themselves to be of lower weight than they actually are. Our analysis also revealed differential effects by gender and type of peers.
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