Bills in Congress to Enable BMI Surveillance

Two bills in Congress have been introduced that would provide grants through the Department of Health and Human Services to help states develop and expand their immunization registries.

Some studies estimate that the epidemic costs the nation $1,000 per person, per year in health care costs - about $150 billion or 10 percent of overall health care expenditures.

“And the end is not in sight,” said Longjohn. “We are developing a generation of kids with adult risks before they leave adolescence.”

About 30 states have implemented or considered BMI surveillance programs, most of them school-based, like the one in Arkansas that was launched in 2003.

“In an ideal world, the doctor has a list of who is coming in that day and the immunization registry tells him they need this shot, this lead test follow-up and height and weight assessed and the BMI checked to see if they are overweight and if they are, kick in with other screening tests,” said co-author and senior policy analyst Amy Sheon.

With the registry-based model, personally identifiable information never leaves the doctor’s office and the only data shared is aggregate information on rates of obesity.

But some parents object to surveillance as an “intrusion by well-meaning adults.”

“I have no problems with government publishing information regarding the effects of obesity and educating the public on this issue,” said Scott Hipsak of Anchorage, Alaska.

“Further rules and regulations will not address this issue,” he said. “People will eat what they want when they want it and you cannot change that.”

He insists advertising, like anti-smoking campaigns would be more effective.

Dawn Friedman, a Columbus, Ohio, mother who writes the blog, ThisWomansWork, said the BMI tool is misleading.

“I have one skinny to medium child and one child who has always, always been off-the-charts for weight since she entered the world at 9 1/2 pounds,” she said of her adopted 5-year-old. “It’s how she’s built. It’s how her family’s built.”

“She is also very active, eats a wide variety of healthy foods and is sick the least of us so to take her weight as a measure of her entire health would be a huge mistake,” said Friedman, 40.

She is also frustrated by efforts to “shame” children and parents, rather than providing healthier school lunches, and making good food more affordable in neighborhoods where shopping is a challenge.

The contentious issue of obesity has already created a cultural divide, even splitting one family.

Laurie Harper, a saleswoman from New York City, is in the middle of a legal battle that sprang from an argument over weight.

“I am being sued by my ex-husband for custody of my 16-year-old daughter who no longer wants to live with me or talk to me because I am very concerned about her weight, food binging and unhealthy lifestyle,” she said.

Harper urged her daughter, who is 40 to 50 pounds overweight, to join an exercise program, but she refused.

“My ex-husband is also someone who has a history of weight and made me out to be the bad guy,” said Harper, 56. “His side of the family has High cholesterol and heart attacks.”

“The judge was obese herself and very angry with me because she doesn’t believe parents should be involved in kids’ weight,” she said. “It’s incredible because [my daughter] is going to have a heart attack by the time she is 20.”