Arkansas Led the Nation Sending Letters Home from School About Obesity. Did It Help?

The following article, by Kavitha Cardoza, was published in KFF Health News on April 9, 2024.

LITTLE ROCK, Ark. — Sixth-grade boys were lining up to be measured in the Mann Arts and Science Magnet Middle School library. As they took off their shoes and emptied their pockets, they joked about being the tallest.

"It's an advantage," said one. "You can play basketball," said another. "A taller dude can get more girls!" a third student offered.

Everyone laughed. What they didn't joke about was their weight.

Anndrea Veasley, the school's registered nurse, had them stand one by one. One boy, Christopher, slumped as she measured his height. "Chin up slightly," she said. Then Veasley asked him to stand backward on a scale so he didn't see the numbers. She silently noted his height as just shy of 4 feet, 7 inches, and his weight as 115.6 pounds.

His parents later would be among thousands to receive a letter beginning, "Many children in Arkansas have health problems caused by their weight." The letter includes each student's measurements as well as their calculated body mass index. The BMI number categorizes each child as "underweight," "normal," "overweight," or "obese." Christopher's BMI of 25.1 put him in the obese range.

In 2003, Arkansas became the first state to send home BMI reports about all students as part of a broader anti-obesity initiative. But in the 20 years since, the state's childhood obesity rates have risen to nearly 24% from 21%, reflecting a similar, albeit higher, trajectory than national rates. During the pandemic, the state obesity rate hit a high of more than 26%.

Still, at least 23 states followed Arkansas' lead and required height and weight assessments of students. Some have since scaled back their efforts after parents raised concerns.

One school district in Wyoming used to include a child's BMI score in report cards, a practice it has since stopped. Ohio allows districts to opt in, and last year just two of 611 school districts reported BMI information to the state. And Massachusetts stopped sending letters home. Even Arkansas changed its rules to allow parents to opt out.

04/29/2024