Gwendolyn Williams is 9 years old and finishing up third grade at PS 29 in Staten Island, New York. She enjoys playing softball and riding her scooter. She is a ball of energy and, according the New York Department of Education, overweight.
In November, as part of the city’s fitness and health assessment program, Gwendolyn was one of the more than 870,000 New York City K-12 students who received an annual health assessment. The Fitnessgram looks at the students’ aerobic capacity, muscle strength, muscular endurance, flexibility and body composition. As part of the body composition, they look at the height and weight of the student, as well as measure their body mass index (BMI) on a scale that is based on their age and gender.
As originally reported by the New York Post, Gwendolyn’s BMI percentage was 19, which put her squarely into the overweight category for nine year old girls. At 4 feet, 1 inch tall she is one pound over the “healthy” weight. She tips the scales at a whopping 66 pounds.
As anyone can see, Gwendolyn is not overweight.
The assessment was sent home with the kids shortly before the Memorial Day weekend. While her mother was tucking her in, Gwendolyn said, “Hey, Mom. The school told me I’m overweight. Is this what they mean?” she asked as she jiggled her thighs.
Her mother, Lisa Bruiji Williams, was heartbroken.
According to the Centers for Disease Control’s BMI percentile calculator, Gwendolyn is clearly within the healthy weight. While it is unknown what calculator the school used (there are many), there is one thing many health officials agree on: BMI is not an accurate assessment of an individual’s health. So why do we use it?
The body mass index is a simple equation of dividing weight by the height. It was created in 1832 by Adolphe Quetelet in his quest to find the average, normal man. It had nothing to do with weight or obesity, but was more an attempt to understand the standard human build. While doctors had suspicions that obesity had ill effects on the human body, it would be nearly a century later that large scale studies would be conducted. These studies showed a correlation between being overweight and certain diseases. Many were conducted by insurance companies which looked at data showing overweight policyholders died earlier than those of a “normal” weight. They used this information to create actuarial tables.
It wouldn’t be until 1972, however, that physiology and obesity research Ancel Keys published “Indices of Relative Weight and Obesity,” which reported the results of his study of 7,400 men in five countries that showed a mathematical formula to determine body-fat percentage. It was the same formula created more than a century earlier by Quetelet, except now there was more data. Keys renamed the formula the body mass index.
Over the next decade, researchers and medical professionals would use the formula to determine the body fat of individuals because it was simple and inexpensive. In 1985, the National Institutes of Health (NIH) started defining obesity using the BMI and created the percentage table, with obesity being defined in the 85th percentile for each gender. In 1998, the threshold was adjusted down. What was the 85th percentile in 1986 is the 50th percentile today.
Meaning, it’s much easier to be considered overweight today than it was in 1986.
The irony of all of this is that neither Quetelet or Keys meant the formula to be used in such a manner. Keys stated in his landmark 1972 paper that the BMI should not be used for individual diagnosis as, at the time, the formula ignored age and gender, as well has an individual’s overall health. It also ignored body type and muscle mass. The BMI was meant as a way to estimate the body fat of a large group with diverse body types – not label an individual.
It should definitely not be used to label a 9-year-old girl.
The NY Department of Education says that the Fitnessgram is just one indicator in the health assessment. Gwendolyn’s mother, however, believes that sending these kinds or reports home with the kids can affect their self-esteem. When Lisa Bruiji Williams spoke with the principal, she was sympathetic. The principal pointed out that the kids were not supposed to look at the easy-to-open assessment (because telling a nine year old to not do something always works). In the end, the school agreed to look into the matter – by sending home the assessments in sealed envelopes with report cards next year.
Fortunately, Gwendolyn is a very self confident girl who already sees the flaws in the assessment. As she points out, “I just don’t think that it’s fair to be called overweight when you’re not really overweight! I know that I’m not overweight, so why should I believe the New York Department of Education?”