As America’s struggle with obesity continues, an increased pressure has been placed on schools to serve healthier foods and ramp up physical education programs.

Many Los Angeles are taking these initiatives one step further, and have begun sending letters to the parents of obese children. Students refer to these messages as “fat letters.”

“We look at growth charts and percentiles. And when a child is at 95 percent of their…we can look at weight for age or weight for height…that child would be considered obese,” said Laura Schmitt, a dietician who performs health screens on preschoolers in San Fernano Valley, California.

“We let the parents know in a gentle fashion, but we also send out a ton of handouts to try to help that family,” she added.

“It shouldn’t be a stigma. It’s not a way to categorize someone. It’s just showing that this child has increased risk to be obese as an adult, which then could lead to quite a few chronic diseases.”

Schmitt says out of the 900 preschoolers she screens, around 200 of them are clinically obese.

Los Angeles schools aren’t the only ones in the country sending out the letters. Schools in North Andover, Massachusetts send similar messages to parents. In Massachusetts, as well as Los Angeles, there are a handful of parents who do not like the letters.

“Every year there are a few phone calls from parents who are upset,” said Schmitt.

“No one wants get letter saying they’re obese,” said Matt Watson, the father of a North Andover student who received a letter. “That’s a very strong, uncomfortable word, and we didn’t see if fitting with our son who is very active, he’s very strong.”

Other California schools have decided against sending a letter home with students. They mail a Body Mass Index report home instead.

Sources: CBS-LA, WHDH