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Obesity tests could weigh down schools

State Senate measure requires body-mass index screenings

POSTED: March 17, 2008 5:00 a.m.
Tom Reed/The Times

Kevin Angula, right, and Courtney Watson run laps around the McEver Elementary gym during a Physical Education class Wednesday. Last week the state Senate passed a bill that would require elementary schools to measure every student's body-mass index to screen for obesity.

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Last week, the Georgia Senate passed a bill that would require elementary school students to be screened for obesity. School nurses say it would promote better health, but concerns have been raised about privacy and about how the mandate would be implemented.

Senate Bill 506 calls for testing students’ body-mass index twice a year, in fall and spring. The BMI is a combined measure of height and weight, and a higher-than-normal score could indicate the child is at risk for obesity.

The bill still needs to pass in the state House of Representatives before the end of the legislative session in order to become law.

Mamie Coker, health services coordinator, said a screening program is needed because childhood obesity has become "a public health threat that needs to be taken seriously."

Long before students reach high school, Coker said, many are already developing type 2 diabetes or high blood pressure because of poor diet and lack of exercise.

"The arteries start clogging in elementary school," she said.

Sen. Renee Unterman (R-Buford), a former nurse who serves on the Senate health committee, voted in favor of the bill, which passed 37-13. She said it’s much more cost-effective to prevent obesity than to try to reverse it.

"These kids are going to grow into obese adults, and they’ll have all the problems that come with that: diabetes, heart disease, strokes," she said. "We’re going to end up paying for that down the road, because many of these people will be Medicaid patients."

The Georgia bill is modeled after one that was enacted in Arkansas in 2003 under former Gov. Mike Huckabee, who has been a crusader for fitness and weight loss. Several other states have passed similar legislation.

"It’s truly embarrassing to see what other states are doing. They’re being proactive, and Georgia is doing nothing," said Unterman. "We’re on the bottom level with Louisiana and Mississippi in terms of our rate of obesity."

She said other bills that tried to address childhood obesity, such as a requirement for mandatory physical education in schools, have been repeatedly shot down by Georgia’s legislators.

"People just accept obesity as part of the computer age, and they say there’s nothing you can do about it," she said.

On the Senate floor last week, some legislators complained that the bill would create a "nanny state." They argued that families, not schools, should be responsible for monitoring children’s weight.

But Unterman said it’s obvious that some families aren’t up to the task. "I know it’s the parents’ responsibility, but at some point the state needs to step in and help out," she said. "The school didn’t make children overweight, but it can help them to not be overweight."

Under the proposed law, each child’s weight and height would be measured by the school nurse, or by a physical education teacher if the school doesn’t have a nurse. Individual BMI scores would be kept confidential and would be made available only to parents.

But the BMI scores of all the students at each school would also be combined into average score, which must be posted on the school’s Web site. The State Board of Education would compile all the data in order to gauge the health status of each school system in Georgia.

Schools with high aggregated BMIs may be asked to take measures such as increase the amount of physical education provided. But Unterman said the bill is not designed to be punitive.

"Hopefully, the (parent-teacher organizations) would step in and help out, offering parents education about diet and exercise," she said.

Catherine Rosa, principal of McEver Elementary School in Gainesville, said the bill sounds like it could be beneficial, at least in theory.

"With the growing problem of childhood obesity, it’s probably not a bad thing," she said.

But schools are already squeezed by so many state and federal mandates, and Rosa wonders whether this is the best use of limited time and resources.

"Why do the kids have to be weighed twice a year?" she said. "I only have 430 kids in my school. What about the ones that have 900?"

Rosa said Hall County is lucky enough to have a nurse at every elementary school, but some school systems in Georgia are not so fortunate.

McEver Elementary also has a medical scale on the premises, but not all schools do, and the bill does not include any funding to help schools purchase scales.

Coker said those logistical issues would have to be worked out. But she thinks the BMI can be an important health indicator.

And like it or not, schools are already involved in monitoring students’ medical status. In order to enroll, students have to provide proof that they’ve had their vaccinations and they’ve been screened for vision, dental and hearing problems.

Coker said parents don’t question those rules. But their child’s weight can be a touchy subject.

"There’s a lot of sensitivity about weight," she said. "Parents don’t want their child to be singled out or made fun of."

But that shouldn’t happen as a result of this law, if the BMI results are known only to the school nurse and the parents. Overweight children are already subject to teasing by other kids, simply because of their appearance. Having their BMI checked won’t change that, Coker said.

She said knowing the BMI score could be helpful for some parents, who may not realize that their child is at risk for health problems.

"A lot of families just don’t know the child is overweight," she said. "They think he’s just big-boned, or it’s just baby fat and he’ll grow out of it."

Coker said obese children almost always become obese adults, so early intervention is important. "Prevention is best done by about the second or third grade," she said.

If parents are not receptive and don’t want to acknowledge that the child may have a problem, Coker said schools can at least work on educating the student about proper diet and exercise.

Rosa said she prefers a group approach. "(At McEver) we do a lot already to promote health and fitness," she said. "We wouldn’t target any individual kid. We would offer the same education for everyone."

Coker said if it were up to her, she would delete the portion of SB 506 that requires each school to publicize its average BMI.

"I don’t agree with aggregating the data. What does that accomplish?" she said.

Coker pointed out that some schools have a higher percentage of obese students due to factors that are beyond the school’s control, such as cultural and ethnic differences. She doesn’t think it would be fair if those schools got a reputation as being "fatter" than others.

"I think that will hurt the chances of the bill passing (in the state House)," she said. "With No Child Left Behind, schools already don’t like being labeled."



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