Should I consent to my child being weighed at school?

By nutritionist Jennifer Nash and Body Happy Org’s founder and Executive Director Molly Forbes

Firstly, why are kids being weighed in school?

The National Childhood Measurement Programme (NCMP) was set up in 2006 by Public Health England. Once a year, all state-maintained schools in England measure the weight and height of children in reception (ages 4-5) and Year 6 (ages 10-11) to collect BMI data, which can monitor trends in children’s weight to inform policies on body size in children.

Parents typically receive a letter following the NCMP with the ‘results’ of the programme, where they are informed of their child’s BMI category. Some local authorities might offer a referral to weight management services or a general follow-up with parents. Not all local authorities share feedback as part of programme delivery - if you live in the Sandwell Council area, for example, you need to opt in for the feedback letter to find out your child’s weight and height results.

Things to consider: why should we care about the NCMP? What has this got to do with body image?

The NCMP can, and does, cause harm for many children. This might be in the form of encouraging calorie-controlled dieting and disordered eating behaviours amongst children as a result of NCMP feedback, either by parents, health professionals or peers. Or it could be that following the NCMP, children experience increased dissatisfaction with body and weight, and therefore develop poor body image. There is much research into the negative experiences and consequences of weighing children in schools (more on this later).

 Another thing to consider is that the programme itself takes a weight-normative approach to healthcare, which states that weight is the sole measure of health and is a personal choice or responsibility. This in turn perpetuates anti-fat bias and weight stigma in children, which can have detrimental effects for those in higher weight bodies.

Whilst some may perceive the NCMP as a simple ‘health check’ for children, it does not take into consideration an individual child’s development, rate of growth, social circumstances or current health needs. It determines a child’s health based on their BMI, which itself has been widely criticised as an incomplete and inappropriate (especially for children) tool to measure health, and one which inaccurately categorises children who are Black or of South heritage [1],[2].

Contrary to what some may believe, the NCMP does not lead to better health for children. Evidence shows that following the NCMP there is limited change in health-promoting behaviours, and it does not lead to reduced BMI for those identified as higher weight categories[3] (note: weight loss does not categorically equal health, and certainly not for children, who can be significantly negatively affected by under-nutrition).

What does the research say?

 There is much research out there on the topic of the NCMP. Relating to body image, in 2021 the Women’s and Equalities Committee produced a parliamentary inquiry into body image, in which they condemned the NCMP, stating that it should be urgently reviewed by government, and that the programme was likely to cause harm to children’s mental health and disrupt the development of positive body esteem[4]. Research shows that identifying and labelling children as “overweight” is associated with negative health outcomes, including mental health issues[5].

 A recent paper which reviewed a wealth of research on household perceptions of the NCMP summarised experiences of the programme by concluding that despite the fact that it is a fleeting event in the school calendar, the NCMP is experienced by children as an emotionally significant event, which affects their mental health (notably anxiety) and perception of self, and leads to weight-related bullying and an increased focus on weight and diet, particularly for those identified as of a higher weight[6].

 What should I do about this?

 We urge you to consider this programme carefully and make an informed decision about whether you wish your child to be included or not. Please check out our free resource, produced with the charity Anybody UK, which covers the NCMP in detail and provides expert opinions on the issues raised here, alongside links to much scientific literature on the topic: Making An Informed Decision: Your guide to the National Child Measurement Programme. Please also direct other parents towards this information – many parents know very little about the programme and are therefore not equipped to make an informed decision on whether they wish for their child to be included or not.

Extract from the NCMP Information Pack created by The Body Happy Organisation and the charity AnyBody UK

At some point in the school year, parents and caregivers will receive a letter notifying them of the upcoming NCMP. School nursing teams do not need consent to carry out the height and weight measurements, so if you do not wish for your child to be measured, you need to opt them out.

This is usually done by informing the school nursing team that you would like to opt your child out via a consent form on a letter sent out by the school on behalf of the local authority’s school nursing team. The process is not consistent across the country, so it may be that you have to ring up to opt up - this information should be on the letter you receive around a fortnight before the weight and height data is collected at the school. We also recommend letting your school know that you have opted out. Although they are not the ones collecting the data (they are a separate entity to the school nursing team), they will be responsible for lining your child up on the day. Letting your school know that you have opted out will reduce the chance of a mistake happening on the day and your child being weighed in error.

If the NCMP is accompanying another health screening check, such as a hearing or vision test, you may be able to opt your child out of just the height/weight measurements, and not the hearing/vision screening. Speak to your local authority about how they conduct the programme to find out if this is possible.

Considering whether you wish to opt your child out of the NCMP is a great opportunity to have an age-appropriate conversation with your child about health, body size, consent, body autonomy and body image. Our free info pack has more guidance on how to have these conversations with your child and with your child’s school, as well as our guidance for schools on how best to support students and minimise the potential harms of the programme on the day.

[1] Nuttall FQ. Body Mass Index: Obesity, BMI, and Health – A Critical Review. Nutrition Today. 2015; 50(3), pp.117-128.

[2] Caleyachetty R. et al. Ethnicity-specific BMI cut-offs for obesity based on Type 2 Diabetes risk in England: a population-based cohort study. The Lancet Diabetes & Endocrinology. 2021; 9(7), pp.419-426.

[3] Falconer CL. et al. The benefits and harms of providing parents with weight feedback as part of the National Child Measurement Programme: a prospective cohort study. BMC Public Health. 2014; 14(549).

[4] Women and Equalities Committee. Sixth Report: Changing the perfect picture: An inquiry into body image. 2021.

[5] Robinson, E. et al. Telling people they are overweight: helpful, harmful, or beside the point? International journal of obesity. 2017. 41(8), pp.1160-1161.

[6] Hawking, M.K.D. et al. Weighing up the future: a meta-ethnography of household perceptions of the National Child Measurement Programme in England. Critical Public Health. 2023; 33(4), pp.395-408.