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Are Healthy Eating Programs at Schools to Blame for Eating Disorders?

An early look at a Pacific Standard story that's currently only available to subscribers.
Healthy-living programs in American schools may be anything but healthy. (Photo: Joe Toreno; Model: Nadia Warner)

Healthy-living programs in American schools may be anything but healthy. (Photo: Joe Toreno; Model: Nadia Warner)

School-based nutrition and BMI screenings are meant to improve the health of students, but emerging evidence shows that, not only aren't they helping, they also appear to be triggering deadly eating disorders in children. Carrie Arnold examines how a small group of activists is now taking on the system—and making a difference.

Arnold's Pacific Standard feature story is currently available on newsstands and to subscribers and will be posted online on Monday, March 14. Until then, an excerpt:

By the time she graduated high school, Jane had been hospitalized three times for her eating disorder and attended three separate eating disorder programs, sometimes thousands of miles away from her family.

The causes of any eating disorder are complex, but to Leslie, one thing is certain: The public BMI test is where things went wrong for Jane.

"I don't believe that the public school weigh-in and BMI screening caused her eating disorder, but rather they were significant factors, among others, which triggered her illness," she says.

The Rosens' experience isn’t an anomaly. Around the country, many psychologists and families are noticing an increasing number of children and teenagers with eating disorders that appear to be triggered by school-based obesity-prevention programs, ranging from discussions of healthy food in class to so-called "BMI report cards" that report a child's body mass index in a letter to parents.

Proponents of such programs say that something must be done, given that one-third of American children are overweight or obese and likely to face a panoply of health issues like high blood pressure and diabetes as a result.

The goals of these programs may be well-intentioned, says University of Minnesota epidemiologist Dianne Neumark-Sztainer, but the results have been mixed at best.

"There have been reports from health-care providers on kids coming to see them after having this report card go home, after having been put on a diet, after having been teased about their weight by other kids and having that be one of the early steps along the long and complicated road to an eating disorder," Neumark-Sztainer says.

To a small but committed group of eating disorder advocates, BMI report cards and similar efforts aren't just harmful: There's also a startling lack of evidence that they even work. Given this dismal track record, Rosen and other parents and people affected by eating disorders have taken to Capitol Hill to lobby for changes to these school health programs. Their work is beginning to gain traction, even at the Centers for Disease Control and Prevention (CDC), the federal agency most vocal in raising the alarm about childhood obesity. The result of this lobbying could be the development of initiatives like New Moves, which focus on nutrition and physical activity as goals in and of themselves—a shift that could help prevent obesity without risking eating disorders among young people like Jane.


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