BMI Screenings totally depress me

  1. So I just completed my BMI screening for first grade. 29% are "overweight" and 19% are obese. So roughly half the first grade is not normal weight. I had no "underweight" kids. It just makes me so sad. I have a 1st grader who weighs 200 pounds, her entire family is morbidly obese and there is nothing I can do, other than send home that referral paper. They know she is fat. They are fat. It is really sad.

    I do my health classes, they get healthy food at school, gym class, lots of wiggle breaks. Other than that, there is nothing else I can do. Just makes me sad for these kids and families.
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  2. 26 Comments

  3. by   Farawyn
    We don't do that. eschools just calibrates the height and weight into BMI
  4. by   OldDude
    It is very sad...I can't count the number of "referrals" for Acanthosis Nigricans I've sent home over the years (AN screening is mandatory in Texas public schools). There isn't one incidence I have ever seen where something was actually "done" about it. I see these guys around town, as they grow and graduate, and they just keep getting fatter and fatter. When I first started school nursing, We did AN screenings on 7th graders. Then it went to 5th and then it went to 3rd, and now we screen 1st graders too. Last year I referred six 1st graders for AN; these guys will start losing limbs, vision, and kidneys by the time they're 30...very sad.
  5. by   Farawyn
    We address on a case by case.

    More the other way- eating disorders. Very few obese students.
  6. by   ruby_jane
    Oy. In first grade... I hear you.

    We screen 9th grade newcomers and it is indeed my least favorite thing. Most parents are painfully aware by 9th grade.

    But in the decade I've been hear I had ONE kid come back from a nurse practitioner with a note saying that the kid was counseled on diet, exercise and family food planning...
  7. by   OyWithThePoodles
    I hate these BMI's. I have a kinder that is 46 lbs and our system flagged him as obese. Ugh. We no longer send home the BMI's to parents, just how to calculate them because of how many got upset that we were "calling their child fat".
  8. by   OldDude
    Quote from ruby_jane
    Oy. In first grade... I hear you.

    We screen 9th grade newcomers and it is indeed my least favorite thing. Most parents are painfully aware by 9th grade.

    But in the decade I've been hear I had ONE kid come back from a nurse practitioner with a note saying that the kid was counseled on diet, exercise and family food planning...
    I've received a few papers about the kids being evaluated and such but I've never seen any actual intervention or positive results.
  9. by   nmr79
    Quote from MHDNURSE
    So I just completed my BMI screening for first grade. 29% are "overweight" and 19% are obese. So roughly half the first grade is not normal weight. I had no "underweight" kids. It just makes me so sad. I have a 1st grader who weighs 200 pounds, her entire family is morbidly obese and there is nothing I can do, other than send home that referral paper. They know she is fat. They are fat. It is really sad.

    I do my health classes, they get healthy food at school, gym class, lots of wiggle breaks. Other than that, there is nothing else I can do. Just makes me sad for these kids and families.
    Wow, 200 lbs? That is really quite sad.
  10. by   nmr79
    Quote from Farawyn
    We address on a case by case.

    More the other way- eating disorders. Very few obese students.

    Same here. That's a whole other situation-- I have 7th and 8th graders, and they all have itty bitty moms who stay in workout clothes all day.
  11. by   kidzcare
    Quote from Farawyn
    We address on a case by case.

    More the other way- eating disorders. Very few obese students.
    Being severely obese comes from disordered eating too.

    Quote from nmr79
    Wow, 200 lbs? That is really quite sad.
    It really is.
  12. by   GaryRay
    I worked in a pediatric bariatric unit in houston... I feel your pain. We've started charging parent's with neglect and having CPS follow them to monitor their home diet when we get patients under 12. I've done gastric bypasses on 300 lb 9 year olds!

    The BMI just said my 4 year old niece is "overweight" and her doctor said we needed to change her diet. you can see all her vertebrae and her ribs. She is in Gymnastics and bounces off the walls! This kid has some thighs but other than that looks skinnier than all the other kids in her day care class. I'm a pedi nurse and really confused.

    While most of the time it is a cultural or family issue, it is also a problem with our school systems and a socioeconomic issue.

    My God daughter is in the "Obese" category and was never overweight until she started public schools. Her mom is on food stamps and cooks every night. She eats really healthy at home. But she is on free lunch at school. In 3rd grade her mom told me the PE teachers did a weight, BMI, and fat % study on the kids and sent the results home. She was obese. I asked to see the school's cafeteria menu. She can't afford to cook her breakfasts and lunches for school days, they scrape by on food stamps and she cooks her dinners and 3 meals on weekends. The cafeteria food made McDonald's look like salad. I ended up using the data for a case study in my public health class.
  13. by   djh123
    In some cases - such as myself (seriously) - I think BMI isn't quite right, or is skewed toward a certain body type. For example: my dad had skinny legs, and so did my oldest brother. My other brother and I have thicker legs - I'm not talking about being overweight or not, I'm talking about what we were given genetically. So even when I'm at what feels and looks like a really good weight, BMI will often still say I'm overweight.
  14. by   akulahawkRN
    Body Mass Index is flawed in a very particular way. For most people, that aren't particularly athletic, it is generally useful. That being said, people that are fairly athletic can be significantly heavier than a non-athletic person of the same physical dimensions. BMI only considers height and weight. It does not consider actual body composition. Someone that's 5' 8" tall who weighs 230 lbs will have a BMI of approximately 34. Age and sex do not factor in this. That person could easily be a couch potato and have a very high body fat content or could easily be an athlete with a body fat content of 15%. One person will truly look fat and start having health problems while the other will look very fit with few health problems, if any. It's possible for a person to have a high body fat content and yet look "ok" by BMI.

    BMI is a good screening tool but it does not replace clinical judgment.

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