Sunday, November 22, 2009

Lincoln University in Pennsylvania to mandate students with high BMI to pass physical-fitness test

From The Chronicle of Higher Ed:

At Lincoln University, in Pennsylvania, students who are deemed too heavy must pass a physical-fitness course.

As part of the university's core curriculum, campus health educators weigh and measure all freshmen during the fall semester, and later calculate each student's body-mass index, or BMI. Those with a BMI above 30, which suggests obesity, must enroll in a one-credit course called "Fitness for Life" before they graduate. Students can satisfy that requirement if they "test out"—by subsequently earning a BMI below 30—or by passing a sports course.

As first reported on Nov. 18 by the university's student newspaper, The Lincolnian, some students and faculty members at the historically black institution have recently complained about the requirement. The newspaper quoted a sophomore who said, "It's not up to Lincoln to tell me how much my BMI should be." In the same article, a freshman asked: "What's the point of this?"

The point is to keep students healthy, says James L. DeBoy, chair of Lincoln's department of health, physical education, and recreation. All Lincoln students have long been required to pass a two-credit course called "Dimensions of Wellness," which covers array of subjects, such as alcohol, drugs, nutrition, and sexual health.

While revising the department's curriculum in 2006, however, Mr. DeBoy and his colleagues concluded that the university should do more to help students become more physically fit. The result was a course designed for students who are overweight. It includes walking, Pilates exercises, and fitness games.

"There's an obesity epidemic," Mr. DeBoy says. "The data are clear that many young people are on this very, very dangerous collision course with heart disease, diabetes, and stroke—health problems that are particularly bothersome for the African-American community."

Lincoln adopted the fitness course for freshmen who enrolled in 2006, but its existence did not cause much of a stir until this fall, when the university sent e-mail messages to some 80 seniors—16 percent of the class—who had yet to fulfill the requirement. In a faculty meeting on November 3, officials agreed that they "must make every effort to directly notify the remaining undergraduate students who have not made an effort to meet this graduation requirement," according to minutes posted on the university's Web site. The minutes also state: "We should have the university attorney look at this requirement to determine if it is legal."

Several experts on higher-education law were not quite sure what to make of the policy. "I can understand that the university's trying to help its students, but it's a weird idea," said Susan L. Wheeler, a policy and legal affairs adviser at James Madison University. Nonetheless, she suggested that physical-fitness requirements, which were once ubiquitous at colleges, may become legally problematic only if an institution failed to exempt a student who was physically incapable of exercising. "If they accommodate, it may be a non-issue," she said.

Military academies can demonstrate that minimum requirements for physical fitness are essential to their missions. But can a traditional university say the same? The question intrigued Laura Rothstein, a law professor at Louisville University and a leading expert on disability discrimination. She speculated that a student could challenge Lincoln's requirement under the federal Americans With Disabilities Act. "But I can't tell you how that would turn out—it would be breaking new ground," Ms. Rothstein said. "The key would be whether the obesity and size of a particular student is a disability."

John F. Banzhaf III thinks such a finding would be unlikely. A professor of public-interest law at George Washington University, he has been dubbed "The Man Who Is Taking Fat to Court" for his use of legal action to fight obesity. He describes Lincoln's requirement as reasonable.

"The law here is not completely settled, but it seems to apply only in cases of extreme obesity," Mr. Banzhaf said of disability protections. "In order to be considered disabled, it must be to the point where someone suffers severe limitations in performing everyday activities. Among college students, it would be hard to find a kid who is that obese."

Peter F. Lake was not so sure about the requirement, however. Mr. Lake, director of the Center for Excellence in Higher Education Law and Policy at Stetson University, wrote in an e-mail message that the BMI could be construed as legally protected medical information: "Being put in a class with other 'at-risk' BMI's walks a little close to disclosure."

Legal issues aside, Mr. Lake questioned the educational value of a mandatory course for some, but not all, students. After all, to encourage physical fitness is one thing; to require it is another. "Is it really good to brand people?" Mr. Lake wrote. "Will enforced wellness like this work?"

Similar questions inspired Tiana Y. Lawson, a student at Lincoln, to offer her personal take on the requirement. This week the Lincolnian published an opinion column she wrote called "Too Fat to Graduate," in which she describes her objection to the mandatory fitness course.

Ms. Lawson described how it had taken years for her to accept that she would never be a size 2. "I didn't come to Lincoln to be told that my weight is not in an acceptable range," she wrote. "I came here to get an education which, as a three-time honor student, is something I have been doing quite well, despite the fact that I have a slightly high Body Mass Index."

Mr. DeBoy has heard those concerns from other students before. Since 2006, roughly 15 percent of each incoming class has been found to have a BMI over 30. Some students have come to his office to complain about having to take the course. Hearing that you're overweight is not easy, he concedes.

Yet Mr. DeBoy believes the university is doing its students a service. He describes the fitness course's instructors as caring and encouraging. He recalls watching students who at the beginning of the semester could not walk for 15 minutes without getting winded; by the end, they were jogging with ease. Soon he hopes to start collecting hard data on the students who complete the course, to determine what, if any, effects the program may have.

"We as health educators are responsible for students' total well-being, not just academic and cognitive, but physical and social," Mr. DeBoy said. "If a student is being wheeled out on a stretcher at age 35 or 40, they will never be able to say, 'I wish someone had told me that this would happen.'"

Mr. DeBoy has faith in the BMI as a measure of health. Within the medical community, however, the index has its doubters. Some experts have argued that the formula, which depends solely on height and weight, is too simplistic. Because it measures proportionate body weight—and not body fat—it may overestimate obesity, especially among athletes and those who are particularly muscular.

J. Eric Oliver, a political-science professor at the University of Chicago, has argued that the BMI reveals far too little about how people live, how they get sick, and why they die. In Fat Politics: The Real Story Behind America's Obesity Epidemic (Oxford University Press, 2006), Mr. Oliver wrote: "BMI is not only a poor measure of health, it is actually a lousy measure of obesity."

Whatever the case, Lincoln University appears to be the first university to make weight testing mandatory. James C. Turner, president of the American College Health Association and executive director of the University of Virginia's department of student health, said in an e-mail message that he had never heard of this kind of requirement. "I don't know if there is any evidence," he wrote, "that such a policy would result in weight loss."