Under proposed plans school children will have to face the scales on their return to schoolwww.uihere.com

Content Note: This article contains discussion of disordered eating.

Recently the National Obesity Forum has suggested that children should be weighed when they return to school in September, and again in the spring, to help them lose any weight that they may have gained over lockdown.

Obesity is a risk factor for a variety of health conditions, including coronary heart disease and type 2 diabetes. In the western world, obesity rates are increasing, a result of an increasingly inactive society addicted to junk food. It is currently estimated that 1 in 4 adults in the UK are obese. As these statistics highlight, this is not a trivial issue. It is important to encourage children to maintain a healthy weight from an early age, and to equip them with knowledge about what a balanced and healthy lifestyle looks like and how it can be achieved. One can only assume that this is what the National Obesity Forum aimed to achieve when they suggested weighing children in front of their peers. Unfortunately, taking such a narrow, reductionist approach to tackling a condition that is heavily socially influenced is unlikely to be successful, and may be actively harmful to the mental health of the children in question.

“Obesity does not exist in a social vacuum”

The first issue with weighing students comes from the process itself. Body mass index (BMI) is an equation that is commonly used to categorise individuals based on their weight, as either underweight, healthy weight, overweight, or obese. BMI is calculated using height and weight measurements, alongside age and gender in children. Nowhere in this equation is fat mentioned. In fact, a well-known limitation of the measurement is that it cannot tell the difference between excess fat, muscle, or bone. This limitation highlights a dangerous precedent that BMI sets: that weight, whether fat or muscle, is synonymous with health, and that too much of it is a bad thing. Because of this, it is important that BMI is used in conjunction with other assessments, as a “starting point for further discussion” as suggested by the NHS.

Obesity does not exist in a social vacuum, meaning that a narrow, weight-based approach to tackling it is likely to be ineffective. There is a correlation between childhood obesity and parental obesity, with parents who are overweight often thinking that their child is the correct weight, despite them being classified as overweight or obese. Additionally, in both reception and year six, obesity prevalence is over twice as high in the most deprived areas in comparison to the least deprived areas. This gap is only increasing.

Obesity is a social issue, and is linked to home conditions, whether that be parental obesity or levels of deprivation. Therefore, simply weighing children in school is unlikely to provide the motivation, information, and in some cases, the financial means to allow families to transition to a healthier lifestyle.

In addition to the potential inefficacy of the approach, it is important to consider the emotional consequences that being weighed in front of peers will have on some individuals. The knowledge that BMI calculations are being done with the aim of classifying individuals as healthy (or not), normal (or not), and thin enough (or not) is enough to make any child uncomfortable. However, for the 1 in 8 children who suffer from a mental health condition, the effects may be much more severe than 30 minutes of discomfort.

Eating disorders are the first worry that comes to mind. The NHS website states that being “criticised for your eating habits, body shape or weight” is one in a list of five factors which increase the risk of developing an eating disorder. In 2017 0.4% of 5-19 year olds were affected by eating disorders, with 1.6% of 17-19 year old girls being classified as having an eating disorder. This number will only increase as a focus on weight causes more children, even those who were never classified as overweight to begin with, to become paranoid about their size.

Eating disorders are not the only mental health condition that may be exacerbated by the National Obesity Forum’s weighing proposal. Emotional disorders, such as anxiety and depression, are also likely to be affected. Children who already have to deal with navigating their world through a lens of anxiety or depression will face the added pressure of an event that is likely to cause additional stress in the lead up to it and low self-esteem in the aftermath.

This potential effect on emotional disorders is especially concerning as these are the most prevalent type of mental health conditions seen in young people, and they are becoming more common. This increasing trend was recognised even before coronavirus, which will only have exacerbated the prevalence of such conditions, with people being more likely to experience risk factors such as loneliness and stressful life events.

We live in a society that continually rams down our throats the importance of being thin. Schools should protect children from this. They should teach them to love their bodies, teach them that it is okay to have stretch marks on their legs or on their hips, that it is okay if they are a size 14 not a size 8, that all bodies are different and will react in different ways to the food they eat and the exercise they do, and that while they should aim to be healthy, this does not mean that they have to aim to be thin.

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