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Body mass index screening in schools – does this cause harm?

Excessive weight gain; some would argue that this is one of the biggest challenges of the 21st century. In many paediatric clinics, the body mass index (BMI) is calculated and discussed with the family and child. In the USA there is a screening process in schools and the BMI is reported to the family. Is there any evidence that this makes any difference or indeed could this cause harm? Madsen AK et al. [JAMA Pediatr 2021;175(3):251–259. doi:10.1001/jamapediatrics.2020.4768] have examined the impact of school-based BMI reporting on weight status and adverse outcomes. These adverse outcomes could have importance consequences: increasing psychological morbidity, weight stigmatisation and weight-related perceptions and behaviours and weight dissatisfaction. ‘The Fit Study’ was established by this team and using a cluster randomised study design in 79 schools, they allotted three groups of schools; those that screened and reported BMI only, those that screened BMI only and a control group of schools with no BMI screening. A total of 28 641 students (14 645 [51.1%] male) in grades 3 to 7 at baseline participated in the study for up to 3 years. Changes in BMI z score and in adverse outcomes (based on surveys conducted each autumn among students in grades 4 to 8) …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Provenance and peer review Commissioned; internally peer reviewed.

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