Hooray! Massachusetts To Stop Sending "Fat Letters" Home To The Parents Of Fat Kids

Let me get this straight: a student can die of an asthma attack in a public school because there’s no nurse on duty, but schools have the time, and funds, apparently, to harass their fat students.
Publish date:
October 21, 2013
fat, being fat all over the internet, fat acceptance, fatty fatty two by four

If there’s one thing fat kids, and their parents, probably already know, it’s that they’re fat.

Fatness is kind of inescapable, seeing as how it’s an integral part of your body, and you don’t really need anyone to inform you, though people often feel the need to do just that, including in 19 states, where parents receive so-called “fat letters” informing them that their fatty mcfatty fat children are about to keel over from The Fats.

Make that 18, actually, because Massachusetts just backed down on the whole fat letter thing in recognition of the fact that it is an absolutely terrible idea. The state is rethinking its stance to the health of children in the schools, and I can only hope that other schools will follow suit.

The way the whole fat letter system works is that schools conduct routine health screenings (sometimes as early as preschool) to check for scoliosis and other heath problems that can benefit from early intervention (this is a good thing). With a quick forced weigh-in and measure, nurses and dieticians can calculate a student’s Body Mass Index (let Lesley tell you about how it’s a horribly flawed measure for assessing health risks), and hey presto, if a child’s considered overweight, a letter goes out to the family (this is a bad thing).

Size acceptance advocates have obviously argued against this practice, as have anti-bullying groups concerned about how fat letters might put targets on children’s backs. Likewise, eating disorder organizations are concerned about the potential consequences of making young children in particular anxious about their weight, particularly given that such a flawed measure is being used to determine “health.” The American Academy of Pediatrics supports fat letters, because apparently it thinks informing children and their parents about the obvious is really going to help with childhood illnesses or...something.

Seriously though, despite the mounting evidence indicating that there isn’t a direct connection between health and size, the AAP, like many medical organizations, is still fixated on the idea that being fat means you’re unhealthy, and that fat in and of itself is a health problem. In a “let’s think of the children” mode arguing that fat children don’t have a say in many lifestyle factors (like what they eat, where they live, their activity levels, oh, and their genetics), fat letter proponents say that these measures are necessary to promote childhood health and wellbeing.

Because telling parents their kids are fat will magically cure their kids of any health problems.

Let me get this straight: a student can die of an asthma attack in a public school because there’s no nurse on duty, but schools have the time, and funds, apparently, to harass their fat students.

Fat children are much more prone to bullying, and they’re also common victims of bullycide, choosing to commit suicide rather than continuing to deal with harassment because of their weight. As Marilyn Wann has elegantly pointed out, telling children and parents not to be fat is a hateful message, encouraging people to continue thinking of fat as bad and creating an incentive to keep bullying fat children. When it’s adults doing the bullying along with other children, that only legitimizes feelings of shame and low self-worth.

When you’re fat, you spend your days navigating the world as a fat person; from the subtlety of a woman hesitating and then not sitting next to you on a plane with open seating to someone mooing at you while you’re walking down the street. It’s not like you’re unaware that you’re fat, or that you need to be reminded that society thinks you’re really gross and it’s rather appalled that you would dare to set foot outside your door.

For fat children, weight can be especially fraught. Many children, as discussed above, don’t have any control over their lives, and yet, they’re surrounded by people who judge them for something they can’t control. They can also be anxious to please the people around them, and to avoid bullying and abuse from their peers -- getting a menacing warning letter doesn’t do anything other than underscoring the obvious, though. Like, great, I'm fat, tell me something I don't know, dude.

Fat letters are also, of course, not the way to promote health in children, which is actually an issue I care a lot about. Especially right now, where many children are living in poverty due to the economy, which makes them extremely vulnerable to health disparities -- including food insecurity, which can actually be a direct contributor to weight changes and serious health problems. (Note that it’s not necessarily that the weight changes cause the health problems, but that the two can go together; for example, poor nutrition can cause weight gain and also lead to problems with brain development.)

Some schools in low-income areas are providing the primary source of nutrition to their students. How about instead of wasting resources on fat letters, they evaluate what they are serving and how to determine if maybe there’s something they could be doing to directly help kids living in households with food insecurity? Some schools, for example, have pilot programs that provide take-home meals to children so they have something to eat after school, with such programs offering nutritious, healthy options to kids who would otherwise be struggling for the calories they need.

For that matter, if we’re truly concerned about childhood health issues, those routine screenings should include not just the standard scoliosis, hearing, and vision testing (which aren’t even standard in all schools) but also evaluations for cognitive and intellectual disabilities that might be interfering with a student’s ability to learn and take in information. (My dyscalculia, for example, wasn’t identified until long after school, far too late to make up for years of math classes in which I struggled desperately in the face of teachers and other students telling me I was stupid.)

Furthermore, school screening should consider specific environmental health factors that could be an issue; Oakland students, for example, are more prone to asthma due to industrial pollution, and might not realize that their difficulty breathing is actually a sign of a potentially fatal medical problem. Likewise, students in areas where Lyme is present need to be screened to determine if frequent infections, fatigue, and behavioral changes are actually caused by Lyme disease.

Does all this sound expensive and time-consuming? It should, because it is. But if we genuinely care about children, it’s the best way to quickly identify early childhood illnesses and get children into recommended treatment. BMI testing tells us nothing about a child’s overall health, but schools are apparently willing to pay for that in some sort of mistaken belief that it’s a good health indicator, and that sending parents fat letters will somehow lead to a productive change for a child deemed unhealthy (AKA FAAAAAAAAAT).

Massachusetts is making a decision to focus on health, not arbitrary indicators. The question is: will other states do the same?