A Smart Incentive or Obesity Persecution?

French diet guru Pierre Dukan is urging his government to give extra marks in school for a healthy BMI. The Telegraph reports:

“Obesity is a real public health problem that is rarely – if at all – taken into account by politicians,” Mr Dukan told newspaper Le Parisien ahead of the book’s launch.

Mr Dukan said his education plan would be “a good way to sensitise teenagers to the need for a balanced diet.”

He denied it would punish overweight children, saying: “There is nothing wrong with educating children about nutrition. This will not change anything for those who do not need to lose weight. For the others, it will motivate them.”

This reminds me of the fitness test the University of Chicago administers to all incoming undergraduates, and the rampant cheating it inspires. The “punishment” for failing the fitness test was P.E. classes through your first year. So on the one hand, you had those who would try to trick the fitness test (these tips are traded on message boards before school starts, one being holding the heart rate meter at varying intensities to trick it) in order to place out of gym classes. On the other hand, you had students who wanted to take the P.E. classes, trying to game their way into them, since those who fail the fitness test have priority status into all gym classes.

Erik Jensen

BMI might be good for epidemiology, but it says little about an individual. Arnold Schwarzenegger in his physical prime was probably "morbidly obese" by this measure. The University of Chicago has the right idea with a variety of fitness measures.


Most people are not Arnold Schwarzenegger. Chances are, you know if you're very muscular, and would be aware that your exaggerated BMI score is not reflective of your health. For the rest of us, BMI gives a pretty good indication of whether we need to lose weight or not.

Enter your name...

You don't have to be an "Arnold" to have a problem with using the BMI as a sole measurement. Talk to anybody in the military, where being overweight is a career-destroying move: everyone knows people who have failed the BMI test but passed easily when they got "taped out" (physically measured to calculate their body fat).


The gym classes at my university were actually a lot of fun. I regret not having taken more of them


Yeah, if only there was some way to make teenagers self-conscious about their weight. If only we could make high school more of a living hell for fat kids, we could shame them into loosing weight! If only we'd thought of it sooner.


This proposal would reinforce a rewards system that the science increasingly repudiates. I'm not saying the argument is settled, but at the very least, offering rewards for activities that would otherwise be undertaken willingly decreases motivation and performance. (Lepper, Greene, & Nisbett, 1973) Rewards have negative effects mainly when they are clearly contingent on doing another activity, when they are expected, and when they are tangible, such as money or prizes or grades (Lepper & Henderlong, 2000, p. 261).

Lillard, Angeline Stoll (2008-08-12). Montessori : The Science Behind the Genius (p. 157). Oxford University Press. Kindle Edition.

Lillard, Angeline Stoll (2008-08-12). Montessori : The Science Behind the Genius (p. 155). Oxford University Press. Kindle Edition.


Why not have a separate "health" grade? It doesn't even have to mean anything. The sheer fact that kids are getting graded on it will have some impact. Though it could be upsetting to people who have known chronic health issues that can't be improved...


This is unfair on the children of parent's that don't care about grades. These kids are still living with their parents and have little to no control of their diet. If your parents provide you with nothing but pizza and hot pockets then how are you supposed to lose weight?


combining two horrible things: "weight shaming" and "arbitrary grading" can't lead to anything productive or good.

I'm all for addressing the obesity epidemic pretty much anywhere, but this is definitely the wrong way to do it. Particularly when relying on the archaic BMI...


So this character thinks that a) losing weight is about motivation and b) fat kids have no motivation? (Oh and c) fat people are stupid and illiterate. Does he really think anyone over the age of 3 knows nothing about "healthy" foods?)

He's not been looking at the research in either area has he.

I'm not sure I go for UC's idea either. They are just using a different proxy for health and one that isn't that useful anyway. I know diabetics who have good results on heart rate monitors after running, I am not that fit but my bloodwork says I'm very healthy indeed: low blood sugar, low blood pressure, low cholesterol. Why should I be forced to take classes?

It's well known that if you want to measure something you have to measure that thing, not proxies for it, and that most things are measured because they can be, not because the result is useful.


Grade them on their number of sick days. Even better, and a much more direct measure of their health!

Rrose Selavy

Most of us who are overweight are pretty well aware of it. This does nothing to help people achieve a more desirable, healthy weight.


Why not bring back daily gym class?

Back in the day I had gym class every day at school and we were graded on it. The gym teacher didn't fail all the fat kids, but you failed if you didn't try or make progress. There were fitness tests of strength and endurance. I got exposure to tons of different sports and status was associated with fitness and athleticism and not merely who could be the most sarcastic in the cafeteria.

Is it any wonder that fitness has declined since then?


I have got to say, weight shaming is big in Japan and there are hardly any overweight people there. They have the longest life expectancy of any nation in the world.

My Japanese wife has born me three kids and she remains in terrific shape. She is happy to make fun of my weight, cutting a sharp insult and then soothing it over with warm words. Its been good for my health I think.

When did we get so thin skinned? Overweight will shorten y0ur life, reduce your odds of being able to have kids and give you lots of health problems. It's not cool.


Weight norms have a huge effect on how much you weigh, so if people around you are causing you to feel pressure toward thinness, they are a friend.



According to the CDC:

1) Chronic conditions are responsible for 75 % of all healthcare costs in the U.S.
2) Chronic conditions are behavioral in nature and are entirely preventable.

Actions have consequences.

But today those who are doing themselves harm are not paying the cost of that harm. According to a report on NPR last week, the least healthy 50% of the population are responsible for 97% of healthcare costs. The healthiest 50% (the ones who produce only 3% of the costs) are enablers. They pay the bills for those who make themselves sick.

To fix our healthcare system we must reconnect actions with consequences. We must stop enabling willful healthfulness.

Each and every one of us has every right to eat exactly what we want. We should also pay the costs of our choices.

While BMI may not be perfect, there are some very good measures to determine health. Start grading kids in school. More importantly, continue to grade adults by charging them health insurance premiums commensurate with their unhealthy behaviors. Charge them what they cost the system.... just like car insurance.

That's when we'll see a rush to health.



Just make gym class mandatory for all freshmen. Measure the weights of all incoming freshmen and then through their years (including 5th year seniors). This should give some trends on at least weight, which my not neatly correlate with health (one reason BMI is not the best measure). Schools could give a wealth for health credit (i.e,. slight tuition reduction), but they're making too much money off of the pop/candy machines to care.


It seems to me there's a difference between health awareness/education and 'lol u r so fat go 2 da gym fatty.'

Also isn't BMI just a collection of average height/weight ratios anyway? Sounds like a meaningless metric, but I could be wrong.


Some sense to this, only it's probably not wise to embark on any argument with something the CDC posits. They are the very organisation that is responsible for ensuring - in the name of preventative medicine - that thousands of people have become chronically ill.
Here's how you do it.
Encourage everyone to go to their doctor even when they are well and have no symptoms. Have the doctor perform a barrage of tests. Regularly alter the desirable outcomes (on Big Pharma based studies) so that more and more people - with no symptoms mind you - are considered 'at risk'. Ensure those people are prescribed medicines (which, uh, have those funny incidentals called 'side effects' which are likely to bring them back to the MD's office) Hey presto, you've got a chronically ill person.
But, yes, I'd love to have an insurance policy and premium that reflect my beliefs and health spending instead of being lumped in with this sort of lemming.



I work with obese youth on a regular basis. They know that they are obese/overweight. They are aware of what a healthy lifestyle entails. The problem lies in the lack of healthy options in school lunches, lack of parental cooperation, and limited access to exercise equipment. Heavier kids don't want to try out for sports because it can be intimidating. Many kids skip breakfast, go to school, eat lunch there, and go home after school to take-away dinners their working parent(s) bring home or have to make themselves. If we are going to grade someone, it should be the parents.