I’m hopeful that this works as planned, but I’m hesitant to fully endorse it because BMI, especially for APIs is not a good measurement tool.
By KATHY BARKS HOFFMAN , 09.14.11, 08:39 AM EDT
LANSING, Mich. — Gov. Rick Snyder plans to direct doctors in Michigan to begin monitoring the body weight of their young patients and provide the data to a state registry in one of the most extensive government efforts to address the growing problem of pediatric obesity, the Associated Press has learned.
The move would help track the state’s growing obesity problem while opening the way for doctors to be more proactive in offering advice, Snyder spokeswoman Sara Wurfel told The Associated Press on Tuesday. The Republican governor will announce the initiative Wednesday as part of his proposal for improving Michigan residents’ health.
The body mass index statistics for patients under 18 would be reported to the Michigan Care Improvement Registry but the children’s identity would remain anonymous. The state already requires doctors to report how many children are immunized.
Arkansas came under fire when it passed a law in 2003 requiring that schools send parents annual measurements of students’ BMI, which takes a person’s height and weight into account when estimating body fat. The law was modified in 2007 to require fewer years of testing and to give parents more ability to keep their children out of the program.
Michigan’s new monitoring system could raise similar concerns.
University of Michigan pediatrician Julie Lumeng, who’s involved in a research project looking at how obese children as young as 3 can be helped, said Michigan may be the first state to require that children’s BMI ratings be included in a state registry.
The governor’s office didn’t know if other states have taken this step.
Lumeng said the advantage to having physicians measure BMI and report the results to the state registry rather than have schools send the results to parents is that the physician, “who has some training in how to talk to families about these health issues in a sensitive way, can really talk to the family in that moment behind a closed door privately.”
“A lot of families don’t even recognize their children are obese,” she said.
The American Academy of Pediatrics, which is working with First Lady Michelle Obama’s efforts to reduce childhood obesity, is urging physicians to measure children’s BMI and to talk to their patients and parents about steps they can do to address weight problems. The National Institutes of Health is funding research programs to see if pediatricians, in the 20 minutes they generally have with a patient in their office, can make a difference in patients’ behavior by offering advice on better eating and exercise habits.
“The jury is still out on that,” Lumeng said.
As the state’s top health official, Olga Dazzo takes seriously the need to address Michigan’s growing number of obese and overweight residents and the effect that’s having on health care costs and quality of life. The 61-year-old community health director has lost 32 pounds in the past year and makes sure she gets in at least a 30-minute walk every day. Always pressed for time, she’s been known to have “walk meetings” with as many as eight of her staff members at a time.
Dazzo’s agency handles the registry and will take on the added job of making sure children’s BMI results are entered.
The agency also is convening a Sept. 21 obesity summit at the Lansing Center to gather health care professionals, policy experts and others to come up with ways to get Michigan residents to do more about their weight problems, which can lead to or worsen chronic diseases such as heart disease and cause medical costs to soar.
“It’s moving in the wrong direction,” Dazzo said of the state’s obesity percentage. “If we don’t do something about this, it’s only going to get worse.”
The new reporting requirement Snyder’s proposing will make weight screening more likely to be a part of every child’s medical care. About 800,000 Michigan children are considered overweight or obese based on height and weight, 12 percent of the total. Rates for adults are much higher, with around 30 percent of Michigan adults considered obese and 35 percent considered overweight, one reason Michigan ranks as the eighth fattest state.
By having discussions in a doctor’s office when children are overweight or obese, “it would help improve quality of care . . . by potentially catching it earlier and having a conversation about it,” Wurfel said. “It would be an important step in managing pediatric obesity.”
A spokeswoman for the Michigan State Medical Society was reluctant to comment without hearing more details from Snyder.
“We’re anxious to hear what he has to say. We’re glad that he’s focusing on nutrition and fitness. It’s a good first step,” Sheri Greenhoe said.
Associated Press writer Andrew DeMillo contributed to this report from Little Rock, Ark.
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