Saturday, May 17, 2008

First negative report on Wii Fit?

5-16-08: Wow, the Wii Fit hasn't gone on sale yet here in the States, but already a potential storm is brewing, based on when you configure your Mii when you first set it up. Having just sets up my Mii today for the first time, I went through all the assessments and one of the assessments was my BMI (body mass index) and where I was at, healthwise (normal weight, etc.).

Turns out that an article reports of a story in the UK, a 10-year old girl's BMI was high enough that the Wii Fit said she was "Fat". This upset her and her dad, and now obesity experts are calling for Nintendo to change this or at least warn parents that their kids could be "harmed" by this game.

This is actually also of debate in the medical community--especially among pediatricians on how they should talk to their little patients. Some say they need to call it what it is, while others say it could damage their self-esteem, especially girls, leading them to eating disorders and distorted body image.

Having worked with overweight kids and adults for the last 15 years, I'm usually the one telling them that they are "fat", though I do it in a "nice way". But at the same time, we don't sugar coat it either, because it's a serious situation and will only get worse unless we take steps now to reverse it (unlike what many parents like to think, they don't "grow out of it" by elementary age).

I can count on one hand how many kids in the past 15 years I've measured who had a "high" BMI but were not fat--they were truly all muscle and bone. The vast majority of kids that have a high BMI ARE overweight due to too much fat on their body.

More precisely than BMI, for kids, we actually use BMI%-tile and if they are at or above the 85%tile BMI, then they are considered "at risk for overweight" and if they're at the 95%-tile BMI or higher, they are considered "overweight".

Finally, BMI is NOT a diagnostic tool, but a screening tool. If a child is at or above the 85%-tile, then other methods should be used to determine if they truly are heavy due to too much fat or lean mass. That's why we use a body fat machine along with BMI%-tile at the clinic and the XRtainment Zone.

For more on BMI and kids, go the CDC's site on this.

What do you think? Should Nintendo warn parents that this game might call their kids "fat"? If Nintendo changed the terminology to something less blunt, like "pudgy" or "jiggly", would that be better? Should they use the CDC's terminology of "risk of overweight" and "overweight"? Or should they build in sensors to measure body fat and really reveal the truth??? Leave your comments below.

ps. BTW, we did the math for the girl in the article, and depending on if her dad rounded down to "6 stones" (a stone = 14 lbs) and she was actually closer to 7 stones, her BMI%-tile would've been at 84%-tile, which is just under the "at risk for overweight".

In the article, he stated that his daughter "dances and swims", so therefore, can't be fat. Our daughter also dances (4 days a week--ballet, jazz, and hip hop) and swims 90 mins. 5 days a week, and I can tell you that we see girls at both who are "overweight" (too high body fat) doing these activities doesn't mean you can't have too much body fat.

For the record, Summer comes out with a BMI of 15.4, which puts her at the 17th%-tile BMI. ;-) When you pinch near her belly button, you only pinch skin. (I wish I had that!) This is what she looks like on the block:

One last thought--I don't think this will hurt exergaming, for this has been an "issue" for some time now, given the pediatric obesity epidemic. If anything, this will bring this discussion more to the forefront, which is good, because the sooner we get past this, the sooner we can deal with this problem head on. Hurray for exergaming to do this! ;-) (Hey, they don't call me the exergaming evangelist for nothing! LOL!)


gamercize @ said...

Brilliant post Ernie, well said!

At Gamercize we use BMI, Body Fat %age calculation, Waist/Hip ratio and Resting Heart Rate for our personal trainer software.

Rather than use words such as obese or overweight, we keep it simple with emoticons. Here is a link to my stats on my blog that shows these indicators; not brilliant stuff but it was last year!

All of these are, as you point out, just an indication for screening to expert medical referral.

What would be a great follow up is to see the father take his daughter for a proper assement. It is a shame there are no XRtainment sites in the UK!

Richard Coshott -
Founder and CEO of Gamercize UK.

Dr. Ernie "Exertainment Evangelist" Medina, Jr. said...

Thanks for your post, Richard. We'll have to do something about getting XRTZ into the UK! ;-)