Wednesday, June 24, 2009

Planetarium Pitfalls

N went to our local planetarium last night along with his peers and leaders in his scout/church group. He arrived home, holding back tears, telling me about a "giant scale." All of the boys weighed themselves and then pressured N to get onto the scale. What could he do? He stepped onto the scale and was, unfortunately, the heaviest of the bunch. I think he is also the tallest, but that detail didn't reassure him at all. He said that he was the heaviest by "like 15 pounds." When I pressed him, it turns out that one boy weighed two pounds less and another 10 pounds less. But to N the difference was monumental.

My first question was, where were the leaders? My second thought was that there was no way I could expect them to anticipate everything. They probably didn't even think twice about the boys climbing onto the scale.

The devastation to N's spirits has been huge. He stood back while the other boys loaded up one of the vans to come home. He rode home, instead, with two other leaders and no boys. Thankfully, they threw in a stop to McDonald's which helped N's spirits a bit. He came home afterwards instead of playing street hockey with the boys. Today, he begged me to not let him ride bikes with the boys who had come to our front door asking.

He seems to be eating fine, but he is very anxious and sad. I'll need to watch carefully and hug him a lot.

Friday, June 19, 2009

A Genetic Link Between Anorexia and Autism?

Interesting article: A Genetic Link Between Anorexia and Autism?,8599,1904999,00.html?xid=rss-topstories

I was actually more interested in the end of the article. They discuss Maudsley as being the only treatment with evidence-based success. The article also addresses problems that parents are encountering with traditional therapy that are similar to hurdles faced with autism 20 years ago.

It's good that the media is finally catching up with the reality of anorexia as a biologically based illness. Now, I just wish these things would sink in with the public (and all of their preconceived, but erroneous notions), and more importantly, the doctors, therapists and psychologists that treat anorexia.

Thursday, June 11, 2009

Boy Scouts of America

We are members of The Church of Jesus Christ of Latter-day Saints. Currently, our church uses boy scouts as the activity arm for the boys' youth activities each week. That is why N is doing so much with scouting right now.

Just recently the Boy Scouts of America released their new health form which is required to be filled out annually by both boys and leaders participating in any activities. Anytime that they participate in "any event that exceeds 72 consecutive hours, a resident camp setting, or when the nature of the activity is strenuous and demanding, such as service projects, work weekends, or high-adventure treks," they are required to fill out "form b." What concerns me is that "form b" is an extended health form with a heavy emphasis on BMI.

Here are two quotes from the form:

"It is important to note that the height/weight chart must be strictly adhered to if the event will take the unit beyond a radius wherein emergency evacuation is more than 30 minutes by ground transportation, such as backpacking trips, high-adventure activities, and conservation projects in remote areas."

"Individuals desiring to participate in any high-adventure activity or events in which emergency evacuation would take longer than 30 minutes by ground transportation will not be permitted to do so if they exceed the weight limit as documented at the bottom of this page. Enforcing the height/weight limit is strongly encouraged for all other events, but it is not mandatory."

There is a doctor's allowance (that basically transfers liability to the doctor) that can override the BMI requirements up to a point. But the basic guidelines suggest that anyone with a BMI in the "overweight" category (BMI of 25 or higher) should not be allowed to participate in the activities listed above. Interestingly, they don't restrict anyone who falls into the "underweight" category.

I have several HUGE concerns with this. BMI is NOT a good indicator of health or fitness levels. It's not even a good indicator of fatness. In fact, the most physically fit tend to fall above the "normal" weight category because of additional muscle mass. My Brother-In-Law who regularly rides his bike 25 miles, is considered border-line "obese" (which is basically where the doctor can't even make a medical exception) based on the BMI scales.

Also, my boys tend to gain weight, grow tall, gain weight, grow tall, etc. If you weigh them right before a growth spurt, you are almost guaranteed that they will not be allowed to participate in the youth BSA activities because of these new BMI guidelines.

My biggest concern is for N. His BMI has traditionally fallen at around the 75% percentile. So that is where we've aimed for his weight gain as he has recovered from anorexia. He is currently above the 75th percentile for height and right about the 75th percentile for weight. In other words, he is right where we want him. However, if we utilize the BMI charts, he is just a few pounds away from being considered "overweight."

It would be completely devastating for him to be assessed using this new BSA "form B" and consequently restricted from participation in many of these youth activities because of being "overweight." In fact, I won't let that happen. I don't think our local leaders will let that happen either. I suspect that they will change activities from being BSA activities to simply "church activities" in order to protect N in particular. They will probably have to do that anyway because I think that 95% of the men in our congregation (potential youth leaders) will fall outside of those BMI guidelines anyway.

Here is a link to the new BSA health form.