Thursday, July 18, 2013

One Little Pound: Boy Scouts and Arbitrary Weight Limits



My oldest son is at Scout Camp this week.

This is not just any Scout Camp, mind, but one of THE ultimate Scouting experiences you can have.  It's a huge national gathering of Scouts called "Jamboree."  Thousands of Scouts attend, mostly from the U.S., but also some from all over the world.

Jamboree only happens every few years and it incorporates all kinds of "High Adventure" opportunities.  This year's Jamboree is being held for the first time in a brand-new facility in West Virginia. They expect over 50,000 participants, staff, and visitors. This is a VERY BIG DEAL in the Scouting world.

My son's Jamboree troop flew into Washington D.C. and spent some time sight-seeing, visiting Gettysburg and other spots of historic interest, and then traveled on to the area around Beckley, West Virginia and the brand-new Summit Bechtel Family National Scout Reserve facility near the New River Gorge area.

This is especially meaningful for me, because part of the extended family that had been unknown to me until just recently grew up right in this area.  My son will be tramping through family stomping grounds, just by coincidence.  How cool is that?

This National Jamboree is the Scouting experience of a lifetime, and my son is the Senior Patrol Leader (SPL) of his Jamboree troop, which is basically the student leader of his entire troop. This is a huge honor and great leadership opportunity for him. He is very close to becoming an Eagle Scout, the ultimate Scout achievement (attained by only 2% of Scouts), and I'm sure this will be one of his most memorable Scouting experiences of all time.

But he almost didn't get to do it.  You know why?

Yup. His weight.

According to the published BSA High Adventure guidelines, my son weighed exactly the maximum allowed for his height.  If he had weighed even one pound more, he might not have been allowed to go. (*See update below)

I find these weight limits to be outrageous and egregiously unfair. I understand the impulse from which they come, but the way they are applied is short-sighted and wrong.

Boy Scout Weight Limits - Details

A couple of years ago, the Boy Scouts put into effect strict weight limits that prevent people who don't meet these limits from participating in High Adventure programs. This applies to both Scouts and their adult chaperones.

This doesn't mean that the Scouts are preventing fat kids and adults from participating in Boy Scouts. Not at all. Fat folks are still welcome to Scouts...but they can't participate in every activity or outing. And disturbingly, there is now an underlying message of judgment and condemnation around body size being pushed by Scout leadership.

The bottom line is that people of size can participate in most Scout activities and outings, but can't participate in High Adventure programs.

High Adventure programs are ones where participants are more than 30 minutes away from access to medical attention and where activities tend to be more strenuous, like long backpacking trips, whitewater rafting, rope courses, zip lines, mountain biking, rock climbing, etc. In other words, some of the most fun stuff Scouts can do.

Looking at the height/weight limit chart and calculating BMIs from the chart, the cutoffs fall pretty universally at a BMI between 32 and 33.

So they are letting those in the "overweight" (BMI 25-29) or just barely into the "obese" category (BMI 30-32) participate in High Adventure programs.  How very magnanimous of them.  But how did someone determine what level of "obesity" is too much for High Adventure program?  What research proves that a BMI of 33 is too heavy to safely participate?

According to the Scouting website:
The Annual Health and Medical Record is based on several evidence-based sources, including the revised Dietary Guideline for Americans from the U.S. Department of Agriculture and the Department of Health and Human Services, and has been successfully deployed by our high-adventure bases.
Well, frankly, that doesn't say much. Notice the Scouts don't cite specific evidence, just general "evidence-based sources." That's not enough. I'd like to see the evidence that these cut-offs for participation are justified. Likely all these sources say is that a person with an obese BMI is at greater risk for blood pressure and blood sugar etc. issues, not that they all automatically have these things or that there is a sudden spike of risk starting at a BMI of 33.

The guidelines do make room for an end-run around them if you can meet body-fat percentages instead.  In other words, if you are one of the many athletes that fall into the "obese" category based solely on BMI, then you can bypass the weight guidelines if your body fat falls below 15% for males, 20% for females.  But of course, to do that, you have to pay for an expensive specialized body fat test instead, which few people are going to do. Not to mention the fact that many fit folk and even some athletes don't meet those particular body-fat cutoffs, let alone most regular folk. The body-fat requirements would eliminate most people from participation, not just fat ones.

So basically, this escape clause around the weight limits is a dead end. They've created the appearance of flexibility while not being flexible at all.

Here's my gripe:

These weight/height guidelines are extremely arbitrary and they don't take actual fitness into account, just weight and body fat. 

What's really important here is the question of FITNESS. Is the individual in question fit enough to participate safely in these activities?

The problem here is that Scout officials are assuming that weight, BMI, and/or body fat percentages are an adequate surrogate for fitness, BUT THEY ARE NOT.

Plenty of kids with a BMI of 33 or more are quite fit, and plenty of kids with a BMI less than that are not fit. Allowing participation in High Adventure activities based only on BMI will arbitrarily restrict a lot of kids from participating in the very coolest Scout activities, even though many of them are perfectly fit enough to do these activities safely. And that's just wrong.

Jamboree vs. High Adventure Weight Cut-Offs
UpdateIt's important to note that I learned yesterday (after I had written this post) from recent stories that there are actually two different sets of cut-offs, one for High Adventure trips (no one with a BMI greater than 33), and a slightly more liberal one for Jamboree (no one with a BMI greater than 40). 
[They justified the "morbidly obese" cut-off at Jamboree because the brand-new Jamboree site in West Virginia is very hilly and there is a lot of walking involved.  As if kids with a BMI over 40 are not able to walk several miles a day or go up and down hills!]
Here's the crucial point: Scouts with BMIs between 32 and 40 were allowed to attend Jamboree if they provided additional information to Jamboree medical staff that proved they were healthy enough for the activities. That means my son would have been able to go to Jamboree after all, even if he'd weighed a bit more. 
However, that's news to our family. The official medical form we were given for Jamboree cited weight limits that aligned with the stricter High Adventure standards. And the wording on the Scouting "Medical Forms FAQ" lists the Summit Bechtel Reserve as one of the "High Adventure Bases." So we thought he had to meet the strict standards.
Somehow we got wrong information about this. The point is moot because my son made the cut on the lower High Adventure limits─barely─by being the exact weight specified on the medical form as the "maximum allowable weight."  But we sure sweated it. 
Whether or not the more liberal Jamboree cutoffs would have allowed my son to go, the bottom line is that there are still Scouting activities and camps he would not be allowed to attend if he were one pound heavier, which I find ridiculous because he is a very active and fit kid.  And that is why I'm going to go ahead and publish this post, despite yesterday's discovery of slightly more flexible Jamboree cut-offs.

I want my son to be able to do the High Adventure trips in the future, and as the High Adventure cut-offs stand, he may or may not be able to do them. That's the real point here.
More on the Weight Limits

Here's a little more background on the High Adventure weight limits and why they were put into effect. According to an article on the new restrictions from a Scouters magazine:
The Annual Health and Medical Record, which takes effect in January 2010, restricts participation in high-adventure activities based on standardized height/weight ratios. For wilderness outings where health care is 30 minutes or more away, Scouts deemed too overweight won’t be allowed to participate....
[Ruth T. Reynolds RN, BSN, and medical coordinator for the Boy Scouts of America] doesn't apologize for that. She says the BSA intends the new forms to be in line with the Scout Oath: “I will keep myself physically strong, mentally awake, and morally straight.” She argues that, “We as Scouters are not taking responsibility for who we are. The Scout Law says a Scout has 12 important characteristics, but it doesn't say a Scout is sedentary, fat, or unhealthy.”
Leaders say Scouting must confront the issue of obesity, the biggest health threat facing children today, as part of its commitment to child advocacy. 
“Our role is clear,” [Chief Scout Executive Robert J. Mazzuca] says, “We must continue to aggressively create and promote programs that help build healthier lifestyles for our Scouts. As leaders, we must do all we can to set the example for encouraging these healthy choices, not only for our Scouts, but for their parents and peers as well. Their future is Scouting’s future.”
I am so disappointed in these Scout leaders, perpetuating this kind of stereotyping and prejudice about fatness to our Scouts. What kind of example are they setting for our youth with this kind of bigoted talk?

Yes, the Scout Oath says they will keep themselves physically strong, but many fat kids are physically strong. (My "obese" son is physically much stronger than a number of his thinner troop-mates.) Many Scouts with a BMI over 32 can absolutely meet the rigorous physical standards needed for High Adventure activities.  I know my son can and does.

Furthermore, being fat doesn't always mean you are sedentary or unhealthy.  It really ticks me off to see a Scout leader in the national organization conflating these things. Sadly, these leaders have been brainwashed by the public health obesity campaigns that assume that fat people can't possibly be healthy, fit, strong, or active. The truth is that these things are separate issues, but they are not being treated as such.

I was also disappointed to see that some of the articles in Scouts publications recycle the old myth, "This generation will be the first not to outlive its parents" because of obesity.  Folks, there is absolutely no statistical evidence to back up that claim and its time people stopped making it, but it still gets passed around as if it's truth. To see it in a Scouting article is especially frustrating.

Many Scout leaders also decry too much time in front of screens (TV or computer) and the lack of exposure to the outdoors, what some people call "Nature Deficit Disorder." They link it to obesity. (As if a fat person only ever sits in front of the TV or computer and never gets outside, and as if no thin person ever spent much time in front of a screen.) They cite Scouting as the answer:
Jason Barlow, area commissioner for the Northeast Region, uses public service announcements aired on local radio stations as an answer to obesity: “Our kids are spending too much time indoors, online, and logged on to the computer. At Scout camp ‘logged on’ means putting more wood on the campfire and ‘online’ means catching a great trout for dinner. Scouting will get your son unplugged from screen time and plugged into the great outdoors, where he will develop character and leadership skills.”
While I completely agree that this generation spends too much time in front of screens, I reject the common assumption that this is the main factor that drives childhood obesity. It can be a factor for some, but just unplugging the screens won't make fat kids thin, and plenty of thin kids get far too much screen time without becoming obese.  Using BMI as a cutoff to make assumptions about who gets enough outdoor time and who gets too much screen time is wrong.

Weight Limits for Adult vs. Kids

In many articles, the media attention to this issue has focused on the limits this puts on adult volunteers who must chaperone Scout trips. But to me, the issue is much more about weight limits for kids.

To be fair to the BSA, there are some reasonable concerns driving these weight limits. High Adventure excursions go out into the wilderness and are far from medical help.  The BSA was presumably seeing out-of-shape adults going on these trips as chaperones and then encountering medical issues far in the wilderness, where it was a struggle to help them. They were concerned about liability of having middle-aged, Weekend Warrior parents who over-estimated their fitness having a heart attack in the middle of nowhere on a Scouting Trip.  As a Scouting FAQ notes:
Standards are put in place to protect the health and well-being of all participants. The participant that is not healthy enough to participate in a given activity puts himself/herself and others at risk. No one wants a Scout or Scouter to be placed in a situation that is risky or could lead to permanent disability or death.
So while I'm not a fan of the arbitrary nature of adult weight limits, I understand the impulse they come from.  Middle-aged adults are more at risk for heart attacks and other problems, and there are some who are probably not fit enough to safely participate in some of these activities.  What a terrible thing it would be for a boy to go with his dad on a wilderness backpacking trip, only to see him die of a heart attack on the trail because they couldn't get him to medical help in time.

So I get where the BSA is coming from on this concern.  They want to minimize the risk of something awful like this happening.

The problem I have with these weight limits, though, is that they judge a person's fitness solely by weight.  And that's just not a very accurate or reliable method of judging fitness.

The BSA simply doesn't buy into the possibility that a fat person can be fit enough to do these High Adventure activities.  They've totally bought into the myth that fat automatically equals unhealthy, unfit, and someone who never exercises. This ignores the fact that fat people can be fat and fit.

It also conveniently ignores the fact that many thinner people are very unfit and at strong risk for heart attacks too.  I can think of several men I've known over the years who would have met the BSA adult weight requirements to go on High Adventure outings, and yet who had heart attacks or strokes in their 30s or early 40s just doing normal activities. They weren't fat, but they weren't fit. They certainly were fortunate that their medical crises didn't take place in the woods─but under the Scout guidelines they would have been eligible to go.

Yes, I'm sure there are plenty of fat parents who aren't fit enough to go on some of these High Adventure treks. But I'm also sure that there are some fat parents who are (and who did it many times before this new guideline was put into place). And I'm also sure that there are plenty of adults with a "normal" BMI who really aren't fit enough to participate safely.

To me, it should be about proving fitness, not assuming fitness based only on arbitrary cut-offs.

And really, is a 16 year-old fat kid at the same risk for a heart attack as a middle-aged fat adult? Are teens really dropping like flies from heart attacks on wilderness treks?  I don't think so.  And to me this is why these arbitrary limits are even more ridiculous for kids.  Fat kids are not at the same kind of risk for the kind of disastrous scenarios they are most concerned about.

OK, fatness is a mild risk factor for lower-extremity injuries in kids. This may be because of an increased mass causing more force in a fall, but it may also be because supportive equipment is not designed for larger bodies or because coaches don't know how to help larger bodies safely. Still, the absolute risk is still quite low, and very few kids will experience such an injury, fat or not.  It's certainly not worth banning a kid from an activity across the board.

So while I understand the impulse behind weight limits, to me the reasoning is even more ridiculous for kids.  Again, you can't tell someone's fitness from their BMI.  As NAAFA's recent press release on the issue noted:
One mother reported to NAAFA in 2009 that her son was having issues attending Philmont High Adventure Boy Scout Camp in Cimmaron, NM. "Philmont has a weight standard and anyone over this standard is labeled unhealthy and cannot participate. I tried to explain to them that my son plays football, wrestles and runs relays, shot put, discus thrower, in track & field and [is] a weight lifter. During the summer he swims, weightlifts and conditions for football. He has been conditioning for Philmont by hiking for 2-3 hours with a 50 pound pack on his back for the last 2 months. He weighs 261 lbs. and has been eating a 1200 - 1400 calorie diet trying to lose weight. Unfortunately he only lost 3 pounds... According to Philmont medical staff if he doesn't weigh below 246, he will be sent home. It didn't matter to them if he is active, only his weight number. I have watched my son condition for football and he can run circles around other players that are what society deems healthy."
Frankly, neither kids nor adults should be banned from High Adventure activities based only on their BMI. Standards should be fitness-based instead.

My Own Kids

My son throwing discus at a Track and Field meet
Let me clarify my son's situation.  We're not talking about a kid here who has mobility or fitness concerns.  My son is an extremely healthy 16 year-old who is very active and in great shape.

Interestingly, he would never be identified as obese by most people.  He really doesn't look "fat." I have more familiarity with Body Mass Index guidelines than most, but even I was deeply surprised at his last check-up to find out that he is considered to have an "obese" BMI.

He is a very solidly-built kid, like his dad and paternal grandfather. Not "big-boned" in the way that people use to make excuses, but truly big-boned in that he has a very substantial frame and is built solidly and muscularly. He doesn't have six-pack abs, mind, but he's plenty fit.

In years past, he played soccer, swam on a swim team, skied, and did track and field. He regularly does long hikes with the Scouts, he got his Kayaking merit badge last year in Alaska, and he just earned the BSA Lifeguard Merit Badge, a demanding achievement that few Scouts attain.

This is not an out-of-shape kid. He truly is plenty fit enough to do demanding programs, and there are a lot of skinnier kids in his troop that are a lot less fit than he is. Yet he is the one who wouldn't get to attend a High Adventure trek if he weighed one more pound.

Given his build, he will probably always be close to the edge of the limits allowed for any High Adventure trips he might want to do in the future.  He's an ambitious and adventurous kid, and I want him to be able to have these adventures while he can.  But I worry that any little fluctuation will bar him from participating.

In addition, I worry about him trying to manipulate his weight to meet these stupid guidelines, like the Scout in the NAAFA press release.  Boys are less at-risk for eating disorders than girls, but they do still get them.  Wrestlers and jockeys are notorious for them because of the strict weight limits enforced by those sports.  I don't think my son will go down that path, but I do worry about it if the Scouts keep being so uptight about these cut-offs.

But I'm not just worried about my older son.

I'm even more worried and sad for my younger son (who is just hitting puberty) because he likely won't meet the height-weight guidelines unless his upcoming growth spurt changes something drastically. He was always an average-sized kid until shortly before puberty, when his weight suddenly increased drastically. You can see that he has very strong insulin resistance because he has acanthosis nigricans (darkened skin around his neck and armpits) and lots of skin tags. I think he has the male version of my PCOS. If he's like me, that means it will impact his weight and make it very difficult to lose to "normal" levels.

Once he hits his growth spurt, I'm sure he'll outgrow some of the weight (as many kids do), but I doubt if he'll ever lose enough to meet these Scout weight cutoffs. That means he likely won't be allowed to go on High Adventure activities. And I'm outraged at that on his behalf.

He is not quite as fit as his older brother, mind, but he's worked hard at improving his fitness, whatever his weight. He works out every morning on our treadmill, and he goes for hikes with the local Scouts (he's out on Wilderness Survival this week). He played soccer for many years, swam, skied, and also participated in Track and Field. But he's still heavier than his brother and definitely heavier than the High Adventure cut-offs.

I will continue to encourage him to work on his fitness, just for the sake of his insulin resistance and general health, but I doubt he'll ever be a "normal" size.  And I'm concerned he'll get discouraged and stop when he realizes he may never meet the weight cutoffs for High Adventure programs.

I want him to get the concept that exercise and fitness are not for the purpose of losing weight or meeting arbitrary weight standards, but rather for the purpose of health and feeling good in his body.  But these Scout guidelines make getting that across more difficult.

And that's another reason that I dislike these Scouting weight cut-offs so much.

Final thoughts

I'm not without sympathy for the BSA here. I don't envy the Scout leadership some of the tough risk-management decisions they have to make. I agree there is room for concern about out-of-shape folks taking part in activities that they aren't ready for. I don't think it's unreasonable for the Scouts to put some limits on participation in strenuous, back-country activities that take place far from medical help.

But these height-weight guidelines just seem too arbitrary. They don't take into account fitness, which is the real question here, but instead use BMI as a surrogate for fitness. That's wrong.

Too many BSA leaders have bought into the notion that weight = fitness level. This is the caustic result of public health campaigns about obesity, that leaders can't even consider the possibility that fatness and fitness are two different things.

But they are two different things.  Conflating them means that many people who could safely participate in High Adventure activities will automatically be denied access to them, while others who may not be fit enough get to take part in them, endangering themselves and the people around them.

To me, the rhetoric we've heard from Scout leaders on these guidelines represents holier-than-thou attitudes about obesity from naturally skinny leaders who don't have a clue about how someone could possible have a BMI greater than 30.  Their bodies don't work that way, so they assume everyone's bodies should work similarly. They believe that if we all just ate better, turned off the screens, and got outside, we'd all have a BMI of 22. But it just doesn't work that way for many of us.

My oldest son was lucky that he just managed to squeeeeak past the fascist weight cut-offs, but we were sweating it for a while, not knowing that there was a bit more flexibility for Jamboree. But the guidelines allow NO wiggle room whatsoever for the High Adventure activities. You either make the weight cutoff or you don't go, period.

What a loss that would be for him.....but even more, what a loss for the Scouts. They are all about training leaders for a new generation, and he is an outstanding leader, if I do say so myself (not that I'm biased!). Yes, he can continue as a leader in non-High Adventure outings, but that's not the same.

And even non-High Adventure outings are starting to lean towards weight restrictions.  As the Annual Health and Medical Record Form notes:
Enforcing the height/weight limit is strongly encouraged for all other events, but it is not mandatory.
This is apparently meant to encourage anyone exceeding the High Adventure standards to lose weight, but the way the statement is phrased fills me with dread. How long till these draconian limits are enforced in non-High Adventure activities?  How many local troops are going to start enforcing these limits for regular scout outings, not just High Adventure ones?

The Scouts just don't seem to see that they are shooting themselves in the foot here. They already have a problem with kids dropping out before they finish the program; if fat kids aren't allowed to do the most fun activities, that will only increase drop-outs from the program. In addition, these limits will lead to fewer adults being available to chaperone Scout outings. They have trouble already getting enough adult chaperones to meet requirements. This will only increase that problem.

Furthermore, the publicity surrounding these weight limits may backfire. Instead of helping Scouts lose weight, it may discourage many families with fat kids never to join Scouts in the first place. Why would they join something where they couldn't participate in everything, and where this kind of fat-phobic rhetoric gets modeled by leaders?  How can they trust that their child will be treated respectfully and not be subjected to yet more weight-loss pressure and fat-hate propaganda?

Scouts are against bullying, but the kind of fat-hate language and stereotyping being used by Scout leaders in some of the articles about the weight limits certainly has more than a whiff of weight bullying and prejudice in them. What a poor example they are setting for the kids. I can't emphasize how disappointed I am in the Scout leadership about that.

If we weren't already part of Scouts and my husband an Eagle Scout himself, frankly I'd be thinking twice about having them in Scouts at all. In fact, I almost decided not to publish this blog post because I'm concerned that just writing about this issue may discourage some of my fat readers to avoid Scouts completely. (Many want to now; see the comments in this blog post here.)

And that would be a tragedy, because whatever you think of some of their policies, Scouts is an excellent organization that offers OUTSTANDING programs. I can't say enough good things about that part of Scouts. No, I don't agree with all their policies, but we have chosen to give our sons the benefits of Scouts and work from the inside to change things about Scouts with which we don't agree. Scouting just has too many positive things about it to abandon.

Scouting helps children develop responsibility, self-reliance, first-aid skills, fitness, wilderness knowledge, community service, and other important life skills. Most importantly, it helps develop character and excellent leadership skills. It has been a TREMENDOUSLY positive influence on both of my sons, especially in their leadership abilities. I can't say enough about the benefits they have experienced.

I don't come from a Scouting family or a camping background; my boys are only in Scouts because my husband was a Scout and wanted to pass that on. Having seen what it's done for my sons, I'm a big believer in Scouts now, despite having disagreements with some Scout policies. But these weight limits are pushing me near the breaking point.

The Scout fitness-fascist leaders hope that these weight limits will motivate fat folks to get off their butts and lose weight, and that the end result will be a more fit society.  They think it will motivate fat people to lose weight if they are not allowed to participate in some activities.

I think they're wrong. I think fat kids in Scouts will only feel more isolated and stigmatized, opt out of the more challenging outings, drop out at earlier ages, or worse yet, won't join Scouts at all. And that will hardly promote Scouting's goal of improving society's fitness levels, getting more kids out into nature, and developing future leaders.

I don't think the answer is more restrictive weight limits, but rather more inclusiveness and emphasis on fitness as the goal, instead of on arbitrary weight limits.

The goal of increasing fitness in Scouts is a valid one.  But this is not the way to encourage it.

3 comments:

Hannah, Horn, and Hannabert said...

Would you think that a fitness test would be more reasonable to judge activity participation?

bit said...

I think it's interesting to see how weight bias is often focused on one end of the spectrum while ignoring the other. For example, my DD is in the low percentiles on the growth charts and it comes up every well child appointment, yet I don't hear about that type of consistent focus from the moms of kids at the same percentile mark on the high end of the chart. The BSA chart seems more biased once you notice there is no absolute minimum weight, merely a recommended low in the range. Assuming children still take the same president's fitness tests I remember every year from fourth grade on, it would make much more sense to use something like that as well as any weight considerations that the equipment requires.

Well-Rounded Mama said...

My last child is on the low end of the growth percentiles, unlike my other children, who are on the high side. I've heard about both at exams, trust me.

However, my pedi is much more about focusing on consistency of a growth curve than the actual number, which is why she is our pedi. She's not perfect but she's much better than most.

So if a child who was in the 25th percentile suddenly fell to the 5th percentile (or 75th and suddenly jumped to 95%), that would get more attention than someone who was consistently at the 10th or the 90th percentile. At least from her, anyhow.