Parents in England will for the first time be routinely informed if a child is clinically overweight under controversial plans to tackle an epidemic of obesity that were announced yesterday by the Department of Health.
Ministers have ruled that letters to parents should not use the words "fat" or "obese" for fear they might stigmatise overweight children and cause families to ignore the results.
But the government has decided that parents ought to know if a child's weight is well above the healthy norm, carrying a greater risk of heart disease, diabetes and cancer in later life, so that they can change the child's diet or lifestyle.
The move was welcomed by public health campaigners, but it attracted criticism from the National Obesity Forum, which said the government's decision to avoid using the word obese was "prissy and namby-pamby".
The height and weight of most children in England is already measured by school nurses in the first and last year of primary education, but parents have a right to exempt their children.
The results are converted into a body mass index (BMI) for each child to inform NHS commissioners about the extent of obesity in each area. Parents have been entitled to ask if a child is overweight, but few have done so.
From next month, results for about 1.2 million children a year will be sent automatically to parents, with advice on what to do if the child is overweight. To avoid stigma, school nurses and GPs will not be told the individual scores.
Figures for 2006-07, published earlier this year, showed 22.9% of children aged four to five in primary school reception classes were overweight or obese. Among those aged 10-11, the proportion rose to 31.6%.
The government may start measuring the height and weight of children at the age of two if statistical difficulties in calculating the desirable BMI can be resolved.
Ivan Lewis, the health minister, said: "Research shows that most parents of overweight or obese children think their child is a healthy weight." As the number of overweight children increased, it became harder for parents to identify the problem.
He added: "This important move isn't about pointing the finger and telling parents that their children are overweight. Instead it's about equipping parents with the information they need to help their children live healthier lives."
Legislation that came on to the statute book last month will allow NHS primary care trusts to tell parents if a child's body mass index is above or below the healthy norm. The scheme is likely to be adopted by about 80% of trusts this year and may later become obligatory.
Will Cavendish, the department's director of health and wellbeing, said: "We have to get the balance right between being a nanny state and a neglectful state."
Parents will be told if a child is underweight, a healthy weight, overweight or "very overweight" - a category that coincides with clinical obesity.
Cavendish added: "Use of the word obese shuts people down. They associate it with 10-tonne mums and half-tonne kids ... We have not banned it, but we have chosen not to use it. There's no point giving them a letter that does not have any impact on their behaviour."
But Tam Fry, a board member of the National Obesity Forum, said: "I find this particular line from the government [to be] tiptoeing through the daffodils."
Experts in the US had also suggested banning the word obese, but had changed their minds.
"The Americans have gone back to using the term because it's the kind of shock word that makes parents sit up and take notice. It's a nasty word, but by God it should sound alarm bells in parents' minds.
"I find this whole approach from the Department of Health a bit prissy and namby-pamby."
Andrew Lansley, the shadow health secretary, said: "School nurses can make a real difference in helping children develop healthy habits, [but the government has] failed to address the chronic shortage of school nurses."
The Liberal Democrat health spokeswoman, Sandra Gidley, said: "If ministers are serious about their plans to tackle child obesity, then they should use this opportunity to really highlight the health risks it causes.
"Unless these letters are accompanied by practical help, then they will be a waste of time and resources."
Height and weight
From September, primary school staff will measure the height and weight of children in the reception class (aged four to five) and in year 6 (aged 10-11). The NHS primary care trust will work out each child's body mass index (the weight in kilograms divided by height in metres squared). The PCT will send a letter to parents saying whether the child is underweight, a healthy weight, overweight or very overweight. The "very overweight" category will correspond with the clinical definition of obese. The letter will be accompanied by leaflets on healthy eating, physical activity and the risks of being overweight. It will be left to parents to decide what to do. School nurses and GPs will not be told any individual results.
