Middle school girl disciplined for refusing weigh-in in front of her class

© The Des Moines Register

Iowa middle school student Ireland Hobert-Hochtold

During a check-up in her physical education class, Ireland Hobert-Hochtold told her teacher that she didn't want to take part in the FitnessGram program, a fitness measurement tool her school has used for at least four years.

Ireland's decision landed her in the principal's office.

"I don't feel like it's [the school's] business," Ireland told the Des Moines Register. "I feel like it's my doctor and my mom and my own business - or maybe not even my own, because I don't need to know that right now."

The FitnessGram program, which has been in existence since 1982, assesses six areas of health-related fitness - including body composition, flexibility, muscular strength and endurance, and aerobic capacity. Once physical education teachers conduct tests, they measure scores using the Healthy Fitness Zone standards. School administrators use the reports in letters addressed to parents that explain the importance of physical activity and outline "areas for improvement."

Right now, 21 states require schools to hold obesity screenings and send letters home in cases when students' BMI exceeds a certain level. BMI, however, often doesn't provide a holistic picture of fitness level. That's why the Centers for Disease Control and Prevention recommends supplementing BMI tests with assessments like skinfold thickness measurements.

While school officials tout the FitnessGram program as a tool in combating the nation's childhood obesity problem, the process has been likened to fat shaming. Critics point out that it may bring on body image problems in youngsters, compelling them to develop eating disorders.

Earlier this year, a third grader expressed her displeasure to the after receiving a letter from the New York City Department of Education that placed her in the "overweight" category. A mother in Florida also spoke out against the state's department of public health after receiving a letter that placed her physically fit daughter "at risk" for obesity. Upon visiting FitnessGram's website, the mother found out that "at-risk" actually meant "overweight."

Clinical psychologist Michael Feldman says that the BMI tests and letters could reinforce these negative feelings among youngsters, especially girls.

"[Fat letters] insinuate that children are to blame for their condition and that they lack awareness or willpower. And because "fat letters" are a collaboration between the child's school, parents and doctor, kids are likely to feel that school officials, health care professionals and possibly their own parents are ganging up on them over their weight," Feldman argued in a article last year. "This will simply validate their fears that they are somehow bad or subpar because their body is unacceptable."

According to the National Eating Disorders Association (NESA), many elementary and middle school-aged girls report concerns about their weight and body shape. More than 40 percent of girls in the first through third grade say they want to be thinner. Among 10-year-olds, more than 80 percent express wishes to be thinner. NESA has repeatedly warned against using the FitnessGram assessments, saying that could influence young students to skip meals, vomit, or take laxatives.

In Pleasant Hill, Iowa, Ireland's act of defiance against the FitnessGram program has compelled a couple of her classmates to take a similar position and refuse to participate. It also may prompt a policy change, as the school board will discuss whether to stop weighing kids in the school system. Last year, Massachusetts' school board voted 10 to 1 to stop sending "fat letters" after five years of doing the practice, citing parents' privacy concerns and the inadequacy of the BMI as an indicator of obesity.

Ireland's mother, Heather Hobert-Hoch, told the Des Moines Register that she fully support's her daughter's decision. "She doesn't want her weight taken anywhere," Hobert-Hoch said. "The family stopped using a scale years ago and Ireland has been very happy since then. It's very common among young girls, and even women, to become obsessed with the number on the scale."

Parent and eating disorder awareness groups have railed against similar well-meaning but insensitive efforts to combat childhood obesity - like a public health campaign in California that circulated an altered photo of an overweight girl on the web and a series of television ads in Georgia that said "Being fat takes the fun out of being a kid."