The prevalence of childhood obesity has reached an epidemic status especially in the United States. Agencies such as the Institute of Medicine, Surgeon General’s Office, and the American Academy of Pediatrics have called for action. Schools have been provided with guidelines to address obesity prevention. School-based body mass index screening and parent reporting programs have received a significant amount of attention in the literature. Intended to raise awareness for parents and provide a first step toward intervention for children who are overweight, there is to date limited outcomes of their success. However, one state, Arkansas, with mandated screening has reported success in that following screening in its schools, obesity rates were not increased. A significant concern with screening in schools is its potential harm to children around teasing, body image sensitivity, and possible unhealthy dieting. These controversial issues are explored, and recommendations are suggested for nursing’s role in obesity prevention especially in schools.
Chomitz, V., Collins, J., Kim, J., Kramer, E., & McGowan, R. ( 2003). Promoting health weight among elementary school children via a health report card approach. Archives of Pediatric and Adolescent Medicine, 157, 765-772.
2.
Cole, T., Bellizzi, M., Flegal, K., & Dietz, W. ( 2000). Establishing a standard definition for child overweight and obesity worldwide: International survey. British Medical Journal, 320, 1240-1243.
3.
Daniels, S., Arnett, D., Edkel, R., Gidding, S., Hayman, L., Kumanyika, S., . . . Williams, C. ( 2005). AHA scientific statement: Overweight in children and adolescents: Pathophysiology, consequences, prevention, and treatment. Circulation, 111, 1999-2012.
4.
Deitz, W.H., Story, M.T., & Leviton, L. ( 2009). Issues and implications of screening and reporting of children’s BMI. Pediatrics, 124, S98-S101.
5.
Dorsey, K.B., Mauldon, M., Magraw, R., Valka, J., Yu, S., & Krumholz, H.M. (2010). Applying practice recommendations for the prevention and treatment of obesity in children and adolescents. Clinical Pediatrics, 49, 137-145.
6.
Eating Disorder Coalition. (2010). Talking points for BMI screening. Retrieved from http://www.eatingdisordercoalition.org
7.
Fitzgibbon, M., & Beech, B. ( 2009). The role of culture in the context of BMI screening. Pediatrics, 125, S50-S62.
8.
Gallagher, M.R. ( 2010). Maternal perspectives of lifestyle habits that put children of Mexican descent at risk for obesity. Journal of Specialists in Pediatric Nursing, 15, 16-25.
9.
Gibbs, L.O.’Connor, T., Waters, E., Booth, M., Walsh, O., Gren, J., Bartlett, J. & Swinburn, B. ( 2008). Addressing the potential adverse effects of school-based BMI assessments on children’s well-being. International Journal of Pediatric Obesity, 3, 52-57.
10.
Grimmett, C., Croker, H., Carnell, S., Wardle, J. ( 2008). Telling parents their child’s weight status: Psychological impact of a weight-screening program. Pediatrics, 122, e682-e688.
11.
Haines, J., Neumark-Sztainer, D., & Thiel, L. ( 2007). Addressing the weight related issues in an elementary school: What do students, parents, and school staff recommend. Eating Disorders, 15, 5-21.
12.
Harbaugh, B., Jordan-Welsh, M., Bounds, W., Blom, L., & Fisher, W. ( 2007). Nurses and families rising to the challenge of overweight children. The Nurse Practitioner, 32, 31-35.
13.
Hendershot, C., Telljohan, S., Price, J., Dake, J., & Mosca, N. ( 2008). Elementary school nurses’ perceptions regarding body mass index measurement in school children. Journal of School Nursing, 24, 298-309.
14.
Himes. J.H. ( 2009) Challenges of Accurately Measuring and Using BMI and Other Indicators of Obesity in Children. Pediatrics, Supplement124 (S3-322).
15.
Ikeda, J., Crawford, P., & Woodward-Lopez, G. (2006). BMI screening in schools: Helpful or harmful. Health Education Research Theory and Practice , 21, 761-769.
16.
Institute of Medicine Committee on Prevention of Obesity in Children and Youth. (2005). Preventing childhood obesity: Health in the balance. Washington, DC: National Academies Press.
17.
Institute of Medicine (2006 ) Report: Progress in Preventing Childhood Obesity: How Do We Measure Up?Committee on Progress Report, Food and Nutrition Board.
18.
Isganaitis, E., & Levitsky, L. ( 2008). Preventing childhood obesity: Can we do it? Current Opinion in Endocrinology, Diabetes, and Obesity, 15, 1-8.
19.
Justus, M.B., Ryan, K.W., Rockenbach, J., Katterapalli, C., & Card-Higginson, P. (2007). Lessons learned while implementing a legislated school policy: Body mass index assessments among Arkansas’ public school students. Journal of School Health, 77, 706-713.
20.
Kubik, M., Fulkerson, J., Story, M., & Rieland, G. ( 2006). Parents of elementary school students weigh in on height, weight, and body mass index screening at school. Journal of School Health, 76, 496-501.
21.
Kubik, M., Story, M., & Rieland, G. ( 2007). Developing school-based BMI screening and parent notification programs: Findings from focus groups. Health Education and Behavior, 34, 622-633.
22.
Kuchler, F., & Variyam, J.M. ( 2003). Mistakes were made: Misperception as a barrier to reducing overweight. International Journal of Obesity and Metabolic Related Disorders, 27, 856-881.
23.
Nihiser, A.J., Lee, S.M., Wechsler, H., McKenna, M., Odom, E., Reinold, C., . . . Grummer-Strawn, L. (2007). Body mass index measurements in schools. Journal of School Health, 77, 651-671.
24.
Nihiser, A.J., Lee, S.M., Wechsler, H., McKenna, M., Odom, E., Reinold, C., . . . Grummer-Strawn, L. (2009). BMI measurement in schools. Pediatrics, 124, 89-97.
25.
Panjikkaran, S.T., & Kumari, K. S. (2009). Augmenting BMI and waist-height ratio for establishing more efficient obesity percentiles among school-going children. Journal of Community Health, 34, 135-139.
26.
Ricciardelli, L., & McCabe, L. (2001). Children’s body image concerns and eating disturbance: A review of the literature. Clinical Psychology Review, 21, 325-344.
27.
Robert Wood Johnson Foundation. (2010). Challenge. Fact Sheet. Retrieved from http://rwjf.org
28.
Ryan, K.W. ( 2009). Surveillance, screening and reporting children’s BMI in a school-based setting: A legal perspective. Pediatrics , 124, S83-S88.
29.
Story, M., Nanney, M., & Schwartz, M.B. (2009). Schools and obesity prevention: Creating school environments and policies to promote healthy eating and physical activity. Millbank Quarterly, 87, 71-100.
30.
Thompson, J.W., & Card-Higginson, C. (2009). Arkansas’ experience: Statewide surveillance and parental information on the child obesity epidemic . Pediatrics, 124, S73-S82.
31.
Trehearne, W.P., & Lobstein, J. ( 2009). BMI and screening: An international perspective. Pediatrics, 124, S42-S49.
32.
US Preventative Services Task Force.Recommendations for Screening : Obesity in Children and Adolescents, 2005, DC: Agency for Healthcare Research and Quality.
