Some families are pushing back when it comes to a new measure of scholastic success: annual weigh-ins that test for body mass index (BMI). Schools in 19 states have begun to participate and also send reports, which note whether or not a child can be considered healthy, home to parents. According to ABC News, the kids call these reports “fat letters.”

The National Institutes of Health explains how BMI is calculated for children and teens, two to 20 years old, by using their weight and height and then comparing these figures to growth charts, which add age and gender to the equation. A child or teen whose BMI is between the 85th and 95th percentile is considered overweight, while those in the 95th percentile or above are considered obese.

BMI readings are “the best means we have to determine whether a child’s weight is healthy or unhealthy,” Dr. Lanre Omojokun Falusi, a spokesperson for the American Academy of Pediatrics told ABC News.

Many pediatricians agree, stating the BMI readings are not only helpful in preventing childhood obesity but the annual weigh-ins may generally encourage more nutritious eating habits. (Prior to BMI measurements, physical education programs in many schools have routinely, if more discreetly, weighed children for years.) Some people, including parents, oppose the BMI initiative. “For those who are already insecure about their weight, these tests can … potentially trigger an eating disorder,” Claire Mysko of the National Eating Disorders Association told ABC News.

Meanwhile, the Centers for Disease Control and Prevention (CDC) reports that obesity affects 17 percent of all children and teens, which is triple the rate from just one generation ago.

Childhood Obesity

Overweight and obese children and teens are at risk for various health problems, including breathing problems (such as asthma and sleep apnea) as well as skin infections and joint pain. Much more serious health risks, such as high blood pressure and high cholesterol, are also associated with childhood obesity; in one study, the CDC reports, 70 percent of obese children had at least one cardiovascular disease risk factor, while 39 percent had two or more. Obese children and teens also commonly develop impaired glucose tolerance, insulin resistance, and type 2 diabetes.

Some of these problems continue into adulthood while other issues permeate their daily experience. Not only are obese children and teens more likely to become obese adults, but they also report social and psychological problems, including discrimination by their peers and poor self-esteem. In one retrospective study, Swedish researchers found that overweight children had increased odds of being bullied in school.

Source: Bejerot S, Plenty S, Humble A, Humble MB. Poor Motor Skills: A Risk Marker for Bully Victimization. Aggressive Behavior. 2013.