A groundbreaking statewide study released last week evaluating the body weights of nearly all public school students in Arkansas has found that 38 percent of them are overweight or are at risk of becoming overweight.
“The Arkansas Assessment of Childhood and Adolescent Obesity” is available online from the Arkansas Center for Health Improvement. (Requires Adobe’s Acrobat Reader.)
The study results, which are drawing national attention, have led researchers in Arkansas to suggest that the problem of childhood obesity may be even more common than federal figures show. The government estimates that 31 percent of U.S. children are overweight or at risk of becoming so.
“No area of the state has been spared from the epidemic of childhood obesity,” said Dr. Joseph W. Thompson, the director of the Arkansas Center for Health Improvement, the independent health-care-policy research center in Little Rock that conducted the study. “This study clearly indicates that children of every age, gender, economic status, and ethnic group across the state are vulnerable.”
|View the accompanying chart, “Arkansas Weigh-In.”|
Researchers in Arkansas analyzed “body-mass index” data for more than 345,000 students at all grade levels in 93 percent of the state’s public schools during the 2003-04 school year. National experts said it was the most comprehensive statewide survey of the body-mass index of public school students ever conducted.
Based on the data, the researchers calculated that 21 percent of students were overweight and that 17 percent were at risk of being overweight.
The study used the federal government’s definition for body-mass index, which is calculated by comparing a person’s weight in relation to height. For example, a child who was 4 feet tall and weighed 100 pounds would have a BMI of 30.5 and be considered overweight. But a child of the same height who weighed 80 pounds would have a BMI of 24.4, which is considered normal.
Statewide, the study found, 39 percent of boys and 37 percent of girls were considered overweight or at risk for being overweight.
It also found that African-American girls and Hispanic boys had the highest risk of being overweight. Forty-four percent of African-American girls were found to be overweight or at risk of weight problems, and 49 percent of Hispanic boys were in those categories.
Even though the trends are consistent with national estimates, officials at the federal Centers for Disease Control and Prevention in Atlanta cautioned that a statewide study is probably not representative of the nation.
Deb Galuska, the associate director for science in the division of nutrition and physical activity at the CDC, said state studies generally do not represent the whole country because they may have concentrations of subgroups that are prone to weight problems.
Even so, experts in Arkansas hope that their study will serve as a model for other states.
Last year, Arkansas became the first state to enact legislation requiring an annual BMI screening assessment for all students in public schools starting in prekindergarten classes. Act 1220, which requires schools to screen students and issue reports to parents, has been promoted as a step forward in the fight against childhood obesity.
But the initiative has raised concerns among some health experts and parents, who argue that such screening methods go beyond the role of schools.
“It’s a problem weighing kids like this,” said Frances Berg, the author of Underage and Overweight, a book about childhood obesity in the United States.
Ms. Berg said in an interview that focusing on a child’s weight at school is an inappropriate means of dealing with obesity. Screening in schools, if done in open areas such as gyms, she said, can humiliate heavier children, hurt self- esteem, and potentially increase eating disorders.
In addition, she pointed out, the body-mass index can inaccurately cite athletic students as overweight. Athletes may naturally have a higher BMI, because muscle weighs more than fat.
The study has elicited worries among Arkansas parents and caused some local controversy, said Rosemary Rodibaugh, a food and nutrition specialist with the University of Arkansas’ Division of Agriculture- Cooperative Extension Service who is not connected with the study.
“It’s very controversial because of the anecdotal evidence presented by parents” of perceived problems with the program, she said.
Parents are fearful of the labeling or rating of their children as overweight, or may be confused over what the BMI means and wonder why schools are notifying them about their children’s weight.
Some parents, according to Ms. Rodibaugh, have questioned the results for children described as overweight because the parents consider them to be thin or their doctors say the children are fine. Letters with individual results were mailed to parents this summer.
‘Seeing Heavier Kids’
Officials at the Arkansas Center for Health Improvement acknowledge that the BMI screening is merely a tool, and they encourage parents to seek confirmation from their family doctors. But they argue that weight problems can often sneak up on people, and they say that many parents don’t recognize when their children are at risk.
“It’s very hard for some people to tell if their child is overweight because we’re getting used to seeing heavier kids,” Ms. Rodibaugh said.
Dr. Peter LePort, a bariatric, or obesity, surgeon at Orange Coast Memorial Medical Center in Fountain Valley, Calif., said that the Arkansas study provides parents with important facts and confirms that weight problems are on the rise.
However, he argued, the steps center officials are suggesting to help solve the problem— cutting down on junk food, exercising more, watching less television— oversimplify the situation.
“It’s a big leap at something that’s not proven,” he said of the emphasis on such causes.
The underlying problem, he contended, is that many children and adolescents are bored, lack values, and have no sense that they need to achieve. To fill the resulting void, he said, they eat too much or find some other addiction.
Diet and exercise alone, he emphasized, will not cure the problem.
Despite concerns and skepticism, the Arkansas study has garnered support for the mandates of Act 1220. In addition to sending parents letters on the screening results, the law’s provisions require schools to disclose the details of food and beverage contracts and to remove vending machines from elementary schools.
Gov. Mike Huckabee, a Republican, has announced that the state will continue its efforts to combat childhood obesity by adding six additional community health education specialists to help schools and communities.
Individual schools are also making changes, according to officials of the health-improvement center, and recommendations were presented to the state board of education in June on how to help schools combat obesity. Possible steps include limiting student access to food of low nutritional value, offering staff members professional development on nutrition and physical activities, and restricting beverage contracts so that schools can sell only 12-ounce sodas.
“This is not just an educational challenge,” the center’s Dr. Thompson said. “And it’s not just a challenge for parents. It’s a community challenge.”
A version of this article appeared in the September 15, 2004 edition of Education Week as Arkansas Pupils’ Body Weights Add Up