A cautionary tale regarding the screening of ‘weight issues’ in children

Share This Post

The body mass index is a commonly used measure of body size. It’s calculated by dividing someone’s weight in kilograms by the square of their height in metres. It looks kinda ‘sciency’, but actually it’s a quite useless measurement, principally because it takes absolutely no account of the body’s composition nor the distribution of fat in the body.

I was reminded of the uselessness of this measurement this when a mother brought her 12-year-old daughter to see me in practice. In November, the mother had been sent a letter from her daughter’s school which informed her that she was too heavy, and at risk of health issues as a result.

Her parents thought this was quite mad, and just eye-balling the daughter led me to the same conclusion. Even the most cursory of glances told me there was nothing about this child that could remotely be described as overly fat.

Both the mother and daughter told me that the letters sent out by the school had caused many children at the school to become weight-focused. I wouldn’t be surprised if already some of those children are starting to have body image concerns. It was clear that the daughter had become somewhat insecure about her eating habits (she ate a generally very healthy diet, by the way) and the impact this might have on her weight.

I asked the daughter how she had felt before the letter. It was clear that up to this point, she did not perceive that there was a problem.

So, why did the mother bring her daughter to see me? Her mother thought the classification of her child as overweight was quite mad, but wanted this opinion supported by an independent health professional (me). Basically, her mother wanted to do what she could to put her daughter’s mind at rest. I do genuinely hope I managed to do that. He daughter did seem genuinely reassured after our chat.

After the consultation, I remember reading about similar stories in the press. Here’s one such story.

Screening programmes of this nature may look very worthy on the outside, but they clearly fail some people (like this girl and her parents). It reminds me of the limitations of screening generally. As we’ve seen with, say, mammography and prostate cancer screening, some people will benefit, but overall these interventions are simply not very effective. Plus, they massively increase the number of people who have a diagnosis and may then endure unnecessary, debilitating treatment, never mind the emotional distress that often comes as part of the process.

Has anyone actually assessed the impact of the screening for ‘obesity’ in children? I can’t find any relevant evidence. I wouldn’t be surprised that if it was studied formally, it would turn out to be, largely, a waste of time and resources. One thing I know for sure is that this initiative is causing unnecessary stress and worry in some children, and this can’t be a good thing.

More To Explore

Walking versus running

I recently read an interesting editorial in the Journal of American College of Cardiology about the relative benefits of walking and running [1]. The editorial

We uses cookies to improve your experience.