Coronavirus Chronicles — Unclear on the Concept

As previously mentioned, COVID and obesity are locked into an ever-broadening spiral of mutual aid. For some reason, the disease finds fat very attractive. To the virus, an overweight or obese person looks like a luxury cruise with all the trimmings, and it cannot wait to jump on board.

For the privilege, the virus pays a generous fare. In some patients, it creates the perfect conditions for the cultivation of even more obesity: chronic fatigue, physical pain, inadequate diet, brain fog, exercise intolerance, shortness of breath, and a general trend toward staying in one place. The cherry on top of this sundae is, because “long COVID” is a new thing, nobody knows how many years it might last.

Mass delusion

Last month, in the middle of June, less than halfway through 2021, it was announced that the global COVID-19 death toll was already higher than the entire preceding year of 2020. And yet, speakers and writers use such phrases as “As society reopens…” — which turns out to be an undertaking more hazardous and complicated than it sounds. People say, “America is back,” but they are deceiving themselves. The virus is back. It never went away. We may be done with COVID, but it is not done with us.

Skeptics tell people not to worry about catching it, because the survival rate is almost 100%. The John Hopkins University of Medicine puts it at 98.2% in the USA. (In Peru it is more like 91%, not so good.)

Two things about that

Case totals and death tolls vary from day to day. Of course, this is not an exact analogy, but the ancient fable of the chessboard gives a rough idea of what we are dealing with here. A chessboard has 64 squares. On the first square, one grain of rice is no big deal. Likewise, in the adjoining square, two rice grains. But by the time you get to the next row of squares, we’re talking about a serious number of rice grains.

Now pretend each rice grain is a single SARS-CoV-2 organism, capable of constantly reproducing by doubling. By the time we are at the last chessboard square, imagine 9,223,372,036,854,775,808 copies of that one tiny life form occupying the square, or your respiratory tract. Of course, this is not exact coronavirus behavior, but it is a useful visualization exercise.

Alternately, imagine the first grain of rice as a patient who passes along the disease to one other person. On the second chessboard square, there are two sick people, and each one of them transmits it to one other person, so then there are 4, then 8, then 16… By the same kind of relentless progression, today’s low number of cases, or of fatalities, can quickly become a very large multiple of that number.

And another thing

Survival only means not dying; it says nothing about the quality of life. No one knows how many people have “long COVID,” because generally they are not tested for it unless they are sick enough to be hospitalized, or suddenly expire. Folks are living with greatly reduced capabilities that are sometimes mistakenly attributed to some other cause. Michaela Brown wrote about three young, formerly vibrant and active people whose lives were drastically changed. They are adults, so we won’t dwell on them, but they are three people she knows personally, and their stories are very sobering:

Do symptoms like hair loss or joint pain scare you?… Can you afford to be so tired you can barely get through a work day? Or if you do give all you have to your job, there’s nothing left in your tank for your family? Do you want to risk the chance of leaving your partner a widow? Do you want to risk the chance of not watching your kids grow up?

Your responses and feedback are welcome!

Source: “Mortality Analyses,” JHU.edu, undated
Source: “The most powerful force in the universe,” Medium.com, 05/30/17
Source: “When You Say ‘Covid Has A 99% Survival Rate!’ You Sound Ignorant And Uncaring,” ScaryMommy.com, 05/14/21
Image by McGeddon/CC BY-SA 4.0 via Wikimedia Commons

Obesity, Schools and Personnel, Continued

It is not that easy to find definitive reports of what actually goes on in schools, rather than guidelines and other literature of the aspirational type. Of course, the past year and a half have been a circus, and not the fun kind. There seems to be a great deal of uncertainty about what to expect in the coming school term. It looks like COVID-19 will be the major medical issue for the foreseeable future, overshadowing other health-related concerns like spotting dangerous tendencies toward obesity and its co-morbidities.

News about anti-discrimination laws, as they relate to obesity, is generally about adults in the context of employment. Late in 2020, for instance, it was reported that…

[…] the Washington State Supreme Court has ruled that obese individuals are members of a protected class under Washington’s Law Against Discrimination.

The piece included no mention of children or schools. A contemporaneous article published by the Minnesota Journal of Law & Inequality bore the promising title, “A Disability Studies Perspective on the Legal Boundaries of Fat and Disability,” but again, revealed nothing about young people or the K-12 school system.

In June of 2021, just to throw a monkey wrench into an already complicated situation, there was a newly re-aroused conflict over these issues. In the United Kingdom, Fiona Simpson reported on the possibility of psychological damage from the now widely accepted practice of weighing kids at school.

The country’s National Child Measurement Programme (NCMP) had been on hold during the COVID months, but is being reinstated. A child is weighed twice in her or his grade-school career, and alerts the parents of signs of encroaching childhood obesity. Simpson quotes charity director Tom Quinn:

Many eating disorder clinicians working in children and young people’s eating disorder services have told us how the programme has triggered restricted eating patterns, which has then developed into an eating disorder requiring specialist care. At a time when we know that the pandemic has had a devastating impact on people with eating disorders, with children and young people seeking treatment at record highs and with waiting times longer than ever, this is absolutely the wrong move.

The Women and Equalities Committee has objections, and wants the government to take a second look before re-implementing the program which could prevent a child from developing a positive body image. Their report said,

Academics stated that clinicians consider being weighed in front of people or making a child’s family aware they need to lose weight or have a high body mass index (BMI) as a trigger for eating disorders.

Parental interest, opinion, and activism have been mobilized.

Your responses and feedback are welcome!

Source: “Is Obesity a Protected Status Under Washington’s Law Against Discrimination?,” Sapphire-Law.com, 12/09/20
Source: “A Disability Studies Perspective on the Legal Boundaries of Fat and Disability,” LawAndInequality.org, February 2021
Source: “Weighing Children at School Increases Eating Disorder Risk, Charities Warn,” Cypnow.com, 06/25/21
Image by U.S. Dept. of Agriculture/CC BY 2.0

Obesity, Schools and Personnel

For the bureaucrats in charge of deciding who should be considered disabled for Social Security purposes, the task is not easy. In 2019 a document was issued to provide “guidance on how we establish that a person has a medically determinable impairment (MDI) of obesity and how we evaluate obesity in disability claims.” Apparently, a lot depends on variables leading to case-by-case decisions. The clearest part says,

When deciding whether a person has an MDI of obesity, we consider the person’s weight over time. We consider the person to have an MDI of obesity as long as his or her weight, measured waist size, or BMI shows a consistent pattern of obesity.

In 2019, the Centers for Disease Control said,

Care coordination in schools involves school nurses organizing the care of students by sharing information and maintaining communication among those concerned with the needs and care of students with chronic health conditions (e.g., asthma, diabetes, epilepsy).

Since type 2 diabetes and obesity are very closely related, this would seem to make weight checks necessary, even if not specifically for the purpose of identifying obesity. The 2010 document issued by another governmental department suggested accommodations that might be made for students who could not deal with school without help, and Childhood Obesity News discussed a few of these.

Some of the more obvious adjustments that can be made for a morbidly obese child or teen include suitable seating and usable restrooms. Other suggestions include counseling for the affected child, and for the rest, education about medical conditions. A really ambitious program might include peer counseling, and there are many other ways in which schools can help kids with this particular problem — including the traditional routes of nutrition and exercise.

In 2019, the American Academy of Pediatrics recommended that every school, of any size, should have at least one registered nurse on duty when school is in session. At the time, only about 39% percent of schools employed a full-time nurse. In only about 10% of schools was a staff physician available. Furthermore,

According to a 2018 study in the Journal of School Nursing, more than half of school nurses cover more than one school building, and about 38 percent cover three or more schools.

All that was, of course, pre-pandemic. If and when conditions return to normal, it is uncertain how this will shake out. As before, each state will be different. In many places, absent a nurse, a teacher or administrative assistant is designated as the person who dispenses medications, provides first aid, or decides whether emergency services should be called in. In some places, teachers and staff need to be certified for cardiopulmonary resuscitation and/or other life-saving procedures. With all the time and energy that will be needed to deal with COVID-related matters, it appears that working in schools in any capacity will be stressful for adults.

Your responses and feedback are welcome!

Source: “Policy Interpretation Ruling — SSR 19-2p: Titles II and XVI: Evaluating Cases Involving Obesity,” SSA.gov, 05/20/19
Source: “Care Coordination,” CDC.gov, 05/29/19
Source: “Guidelines for Educators and Administrators for Implementing Section 504 of the Rehabilitation Act of 1973 — Subpart D,” MemberClicks.net, 2010
Source: “What You Should Know About School Nurses,” ConsumerReports.org, 08/13/19
Image by Wil Pharma/CC BY 2.0

Schools Trying Their Best

Information gathered in the early 1990s about the education system was included in a report called “A Closer Look,” which concentrated on the services that school districts nationwide were willing and able to provide. Almost every jurisdiction did First Aid, and administration of prescription meds to students. In the obesity area, “Other commonly provided services include such health screenings as height, weight, vision, and hearing…” Also related to obesity, just slightly more than half of the school districts concerned themselves about nutrition counseling.

In 1997, via the National Academy Press, the Institute of Medicine published Schools and Health: Our Nation’s Investment. The Committee on Comprehensive School Health Programs in grades K-12 had worked three years on this massive book. The object was to create a set of programs that would serve, in a systematic way, the needs of “health education, health promotion and disease prevention, and access to health and social services at the school site.”

The ideal

Returning to what the experts decided in 1997 to recommend with regard to obesity in schools, they began with screening. It was felt that all teens should have their blood pressure checked annually, and if the numbers look dangerous, they should be tested again twice within the same month, to get an idea of what is going on. At least once, their total blood cholesterol level should be determined.

Other tests would be desirable for kids whose parents or grandparents suffered from certain obesity-related conditions, and there are some very specific recommendations about which tests should be done, and when. The issue of unknown family history presents another set of problems. This is one of the many burdens carried by adopted and foster children. When someone asks whether there is heart disease in the family, they don’t know.

Other advice concerns checking adolescents for eating disorders, including via interviews about body image perceptions, dieting patterns, self-induced vomiting, use of diuretics or laxatives, and so on. Now, what about teens with a body mass index at or above the 95th percentile? They definitely need an in-depth assessment. Meanwhile:

Adolescents with a BMI between the 85th and 94th percentiles are at risk for becoming overweight. A dietary and health assessment to determine psychosocial morbidity and risk for future cardiovascular disease should be performed on these youth…

The authors go on to list the various red flags that indicate a need for watchfulness. One introductory paragraph of the book contained unintentional and unforeseeable irony:

Whereas earlier generations of school health programs were predominantly concerned with stemming the threat of infectious disease, these problems have now to a large extent been ameliorated and replaced with the “new social morbidities” — injuries, violence, substance abuse, risky sexual behaviors, psychological and emotional disorders, and problems due to poverty — and many students’ lack of access to reliable health information and health care.

Of course, all these other problems exist, and it is too true that many students suffer from shortages of both health care and information. But the disturbing part is that today, because of COVID-19, we are back to a predominant concern with infectious disease. Even in places where the physical school has been in session, routines have been disrupted and priorities have shifted. Everybody is just doing the best they can with what they have.

Your responses and feedback are welcome!

Source: “Schools & Health: Our Nation’s Investment,” NIH.gov, 1997
Source: “Schools and Health: Our Nation’s Investment,” NAP.edu, 1997
Image by Fotos_PDX/CC BY 2.0

Obesity and Establishments — Whose Opinion Counts?

There is always controversy around schools and what they ought to be doing about various problems. Obesity prevention is a prime example. Many Americans have the sincere and worthy desire to give each child every possible advantage in life. Others are like, “Hey! Teacher! Leave them kids alone!

The existence of Section 504 of 1973’s Rehabilitation Act inspired a mass of commentary, such as “Guidelines for Educators and Administrators,” published in 2010. This very comprehensive manual identified 18 major life activities which, if impaired, could define a child as having a disability. This, in turn, would signal the need for the institution to offer a service or accommodation to help put the child on equal footing with peers. It does not explicitly say so here, but several of the difficulties could apply in the case of obesity: caring for one’s self, walking, breathing, sleeping, standing, working, helping, eating, bending, and the operation of a bodily function.

Down to specifics

Page 31 offers a list of red flags that might indicate the need for action. If the child does not qualify for special education services under the IDEA, they might through Section 504. There are many other possible reasons for the school to take an interest and intervene, like persistent parental concern, or if the child is being expelled from school, or is in a substance use rehab program. One item says the school should be concerned “when a disability of any kind is known or suspected,” which covers a lot of ground.

This would include, it is to be hoped, the circumstance where a young person might need extra help because of obesity. The authorities are even reminded to take disabilities into consideration when a school is being built or remodeled.

What are accommodations?

The possibilities are many. The strategies come in batches: environmental, organizational. behavioral, presentation, methodology, curriculum. There is an exhaustive list of the kinds of small adjustments that good teachers delight in using and in originating. They would doubtless do a lot more of this sort of thing if they had fewer students and more support.

In an ideal learning environment, each child gets as much attention as the scion of a royal family, from a teacher who loves both the job and the child. Of course, nowadays, there are COVID-related issues in schools, and many different opinions on what should be done, and when, and how, and by whom. Even though obesity and COVID are bosom buddies, it must be admitted that since COVID came along, obesity has lost a large share of the attention it had been accustomed to.

Privacy can be a stumbling block

One of the ongoing problems is that, in order to give the appropriate care, schools need information. A treatment action plan is especially vital if the child has asthma, epilepsy, or diabetes. When accommodations need to be made, parents are expected to do things like fill out a form that asks a lot of nosey questions, and maybe to have a doctor fill out a form, too. With some folks, this just doesn’t sit right. Idealism and the urge to do good run up against other barriers in real life. A parent may deeply resent having a child go on record as “disabled” because the secretary in the principal’s office thinks the kid breathes funny.

Or, just to take an extreme example, say your kid is a serial bully who finally got thoroughly trounced by another child, and in your heart you know she deserved it. The last thing you need is the school calling you in on suspicion of abuse, to explain why your kid has bruises. It is, after all, possible to see why people don’t necessarily want the education system prying into every last detail of their business. The friction between parental rights and society’s demands will always make the handling of matters like obesity fraught with problems.

Your responses and feedback are welcome!

Source: “Guidelines for Educators and Administrators for Implementing Section 504 of the Rehabilitation Act of 1973,” MemberClicks.net, 2010
Image by Steven Depolo/CC BY 2.0

Obesity and Schools — Who’s In Charge?

Carrot and Stick is Not Love

There are around 100,000 public schools in the USA and, says Brendan Pelsue:

[…] individual municipalities, are, in most cases, the legal entities responsible for running schools and for providing the large majority of funding through local tax dollars.

Still, the states have ample authority over how their educational institutions are run.

The Constitution’s 10th Amendment says that powers not delegated to the government in Washington, D.C., belong to the states. Some say this means the federal government should stay out of education, but no.

There is also the 14th Amendment, according to which every state must provide “any person within its jurisdiction the equal protection of the laws.” To exert its influence, the federal government uses the proverbial “carrot and stick,” a combination of rewards and disincentives. Money may be involved:

Public school employees like occupational and physical therapists bill much of their work through Medicaid, which also provides dental, vision, hearing, and mental health services.

Parents often find reasons to object to policies that seem helpful, or at least harmless. This is when some kind of professional might become involved. When a child’s issue is a dangerous tendency toward obesity, a school social worker might try to intervene. They deal with such pupil services as counseling, support groups, home visits, parent training and education, crisis prevention and intervention, and referrals to appropriate experts. An Institute of Medicine publication says:

As with other pupil services personnel, school social work is often threatened by budget cuts during a time of financial constraints.

Another issue is the challenge of interpreting to educators how social work services can contribute to improving the educational performance of students.

The American Medical Association issued a clutch of recommendations that provides a framework for the organization and content of preventive health services. Guidelines for Adolescent Preventive Services is a comprehensive set of ideals. Schools should promote healthy eating habits, and work to prevent eating disorders, including obesity. Also:

Adolescents with baseline BP values greater than the 95th percentile for gender and age should have a complete biomedical evaluation to establish treatment options. Adolescents with BP values between the 90th and 95th percentiles should be assessed for obesity and their blood pressure monitored every six months.

Selected adolescents should be screened to determine their risk of developing hyperlipidemia and adult coronary heart disease, following the protocol developed by the Expert Panel on Blood Cholesterol Levels in Children and Adolescents.

According to these precepts, schools should also take an interest in an adolescent with “unknown family history,” especially if they have risk factors like “smoking, hypertension, obesity, diabetes mellitus, excessive consumption of dietary saturated fats and cholesterol.” It is suggested that such teens be tested at least once for a (nonfasting) total serum cholesterol level.

Your responses and feedback are welcome!

Source: “When it Comes to Education, the Federal Government is in Charge of… Um, What?,” Harvard.edu, Fall 2017
Source: “Common Elements of School Health Services,” NAP.edu, undated
Source: “Guidelines for Adolescent Preventive Services,” NAP.edu, undated
Image by opensource.com/CC BY-SA 2.0

Obesity and Establishments

This is by no means comprehensive coverage of the law as it pertains to obesity. The object is to look at a few selected moments in history because they are typical, or atypical; and the other object is to grasp the big picture.

A publication from the Social Security Administration in 2019 explained “how we establish that a person has a medically determinable impairment (MDI) of obesity and how we evaluate obesity in disability claims”:

[W]e consider the person’s weight over time. We consider the person to have an MDI of obesity as long as his or her weight, measured waist size, or BMI shows a consistent pattern of obesity.

This seems rather vague, but apparently, variables are very important, and the question of who is legitimately disabled needs to be evaluated case by case. Which is only fair, because all applicants are individuals with their own histories and problems. Returning to the rights and obligations of the education system, in 2019, the Centers for Disease Control said,

Care coordination in schools involves school nurses organizing the care of students by sharing information and maintaining communication among those concerned with the needs and care of students with chronic health conditions (e.g., asthma, diabetes, epilepsy).

Since type 2 diabetes and obesity are very closely related, this would seem to make weight checks necessary, even if not specifically for the purpose of identifying obesity.

Information gathered in the early 1990s was included in a report called “A Closer Look,” which concentrated on the services that school districts nationwide were willing and able to provide. Almost every jurisdiction did First Aid, and administration of prescription meds to students. In the obesity area, “Other commonly provided services include such health screenings as height, weight, vision, and hearing…” Also related to obesity, just slightly more than half of the school districts concerned themselves about nutrition counseling.

Population-based approach versus selective high-risk approach

There are a couple of basic problems. Due to limited resources, school districts often feel they must face the choice between A) offering to everyone services that are so minimal they are almost insignificant; and B) providing more meaningful services to the neediest. As a real-life example…

[…] the National Cholesterol Education program recommends a population-based approach for implementing dietary guidelines for children, combined with a high-risk approach to blood lipid screening targeted only at children considered at risk based on family history.

Another factor is that, because mandatory attendance just makes corralling kids at their schools so easy, administrators sometimes object to being coerced into filling roles they don’t particularly feel it is their job to fill.

(To be continued…)

Your responses and feedback are welcome!

Source: “Policy Interpretation Ruling SSR 19-2p: Titles II and XVI: Evaluating Cases Involving Obesity,” SSA.gov, 05/20/19
Source: “Care Coordination,” CDC.gov, 05/29/19
Source: “Schools & Health: Our Nation’s Investment,” NIH.gov, 1997
Image by Maryland GovPics/CC BY 2.0

Defining Obesity Under the Law

After the Americans with Disabilities Act (ADA) had been in effect for a while, it was amended in 2008, but still some members of Congress believed that various judicial decisions had “improperly narrowed the broad scope of protection” because of incidents like this:

[T]he first federal circuit court to address this issue, the Eighth Circuit Court of Appeals […] rejected the plaintiff employee’s argument that his obesity constituted a disability, and affirmed summary judgment in favor of the employer.

This was in line with the Equal Employment Opportunity Commission’s opinion that physical traits are not disabilities unless they are outside the normal range, and result from a physiological disorder. That applied to severe obesity, too, and in 2016 the Eighth Circuit court confirmed it.

On the other hand, according to a website for Human Resources professionals…

[…] in several instances, the Equal Employment Opportunity Commission (EEOC) has successfully obtained settlements on behalf of employees alleging that the discrimination they faced due to their obesity violated the ADA.

The 2008 ADA amendments, rather than clarifying matters, had seemed to inspire even more confusion about whether obesity, in and of itself, should qualify as a disability. Such a determination has far-reaching consequences, including a fear that people living on taxpayers’ bounty would just sit around gaining even more weight. In 2012 the American Medical Association said that obesity constitutes a disease, so that had some influence.

Then, along came the U.S. District Court for the Eastern District of Louisiana, to say that under the ADA, severe obesity can be a disability even if there is no evidence of an underlying physiological condition. A National Law Review article by Melissa Legault says,

[W]hether obesity qualifies as a disability under the ADA is largely dependent on jurisdictional and situational factors, but most jurisdictions that have considered the issue have held that obesity alone, without an underlying physiological disorder, does not constitute a protected physical impairment.

Soon, the Seventh U.S. Circuit Court of Appeals was heard from. It agreed with the Second, Sixth and Eighths circuits. Unless caused by an underlying condition, extreme obesity is not a physical impairment. Michael D. Malone elaborated on the complications:

However, the First Circuit has reached the opposite conclusion, holding, based on expert testimony presented at trial, that morbid obesity, independent of an underlying physiological disease or disorder, can be a physical impairment under the ADA, and taking the position that a jury should decide the issue.

At any rate, all of that was about workplace discrimination and had very little to do with young people, especially in their roles as students. But we will get back to that.

Your responses and feedback are welcome!

Source: “Is Obesity a Disability Under the ADA?,” HRSource.org, 04/19/16
Source: “Eighth Circuit: Obesity Itself Not a Disability,” 04/14/16
Source: “Does Obesity Qualify as a Disability Under the ADA? — It Depends on Who You Ask (US),” NatLawReview.com, 04/11/19
Source: “Obesity Alone Is Not a Disability Under the ADA,” SHRM.org, 09/10/19
Image by Alan Levine/CC BY 2.0

Hey Uncle Sam, Mind Your Own Business

Among schools that measure Body Mass Index, it is common to send the child’s parents a letter that states the findings, along with any recommendations for further evaluation and treatment. The previously mentioned “Colorado Healthy Weight Toolkit” includes an example of the opt-out form that parents can sign if they want no part of this. It explains the purpose of the Growth Screening Program and how the screenings take place in privacy, supervised by the school nurse; and why the school wants any additional information it seeks from the family.

Today we look at the kinds of questions that schools have been asking parents. A 2010 publication from the U.S. Department of Education Office for Civil Rights offers a sample questionnaire that includes sensible queries about who is legally responsible for the child, and pre-existing health problems, and medications, known allergies, and so forth. It also asks such questions as…

What does your child do when not in school?
Please describe your child’s behavior at home?
Have there been any important changes within the family during the last 3 years?
What time does your child go to bed at night?
What methods of discipline are used with your child at home?
What is your child’s reaction to discipline?

The aforementioned “Colorado Healthy Weight Toolkit” sample intake form contains places to enter the child’s height, weight, BMI, and blood pressure. Then, a number of boxes are to be checked if there is a history of bullying, low self-esteem, school avoidance, depression, suicidal ideation, or inadequate family resources caused by poverty, homelessness, or crisis.

For girls, there is a checkbox pertinent to heavy or irregular menstrual cycles. Also inquired about is orthopedic pain — strangely, only if it is located below the waist. Back, neck, shoulder and rib pain seems to have no claim on the school’s attention. Parents and educators are also expected to make note of inappropriate sleep patterns, odor complaints, bowel or bladder accidents, skin or wound problems, severe psychological issues, emotional crisis, and acanthosis nigricans. This last item is a skin condition that can indicate diabetes, but which might be difficult to check for, because it tends to show up in the armpits, navel, groin, or under the breasts.

Privacy standards

That some parents regard all this as intrusive, and even abusive, behavior on the part of the authorities, does not come as a total surprise. Meanwhile, one problem that school staff members are supposed to be on the alert for is abusive parents, and reporting suspicious details to law enforcement entities is an official duty.

Certain parents, no matter what their reason — and indeed, one of their talking points is that they do not, as free Americans and taxpayers, need to proffer a reason — do not want the school to give any attention to some of these issues. Even less, do they want the sensitive information entered into any sort of permanent record.

This tension is one of the many factors complicating the effort to lower childhood obesity rates.

Your responses and feedback are welcome!

Source: “Childhood Obesity Legislation — 2013 Update of Policy Options,” NCSL.org, 03/01/14
Source: “Guidelines for Educators and Administrators for Implementing Section 504 of the Rehabilitation Act of 1973,” MemberClicks.net, 2010
Source: “Colorado Healthy Weight Toolkit,” CDE.state.co.us, 12/01/14
Image by Michael B. Smith/CC BY 2.0

Different Strokes for Different States

This blog has been looking at some complications that can stand in the way of the concept of growth measurement, sometimes known as student fitness screening, which is mainly concerned with tracking obesity in school children. We looked extensively at the Body Mass Index measurement process, which establishes the person’s weight in proportion to their height. According to “Childhood Obesity Legislation — 2013 Update of Policy Options,” published by the National Conference of State Legislators, the technique is “widely accepted as a reliable indicator of body fat content.”

Some states mandate the reporting of individual student BMI measurement, while others require the reporting of aggregate BMI data, for various reasons, like identifying which states have the best and worst records of helping children who are headed for obesity or already there.

A few selected states

In 2013, legislators in Massachusetts, New York and Oklahoma left the debate over BMI measurement to wait for their 2014 sessions. Massachusetts carried over a bill that would require BMI measurement in first, fourth, seventh, and 10th grades; and another that would prohibit the health department from collecting height, weight, or BMI data at all. New York had several different bills, all aiming for the collection of the same information.

Oklahoma’s proposed law seemed determined to please everyone, by providing students with the opportunity to attend health and wellness-centered school assemblies, where they could also receive informational material from the Centers for Disease Control and Prevention. Those who wanted their BMI calculated could have that done, and their parents would receive a letter explaining the results.

In that year, Mississippi, Montana and New Jersey looked at legislation that would address BMI measurement but did not pass anything. South Carolina gave schools the authority to do the measurements and collect the data, while Arkansas considered, then rejected, a proposed law that would have ended its BMI measurement program.

Other matters

But obtaining, recording, and reporting BMI stats was not the only thing on the minds of school administrators nationwide. The federal government wanted them to be interested in quite a few health-related areas, including:

  • Diabetes Screening and Management at School
  • Insurance Coverage for Obesity Prevention and Treatment
  • Joint or Cooperative Use Agreements for School Facilities
  • Physical Activity or Physical Education in Schools and School Recess Legislation
  • Raising Awareness
  • School Nutrition Legislation
  • School Wellness Policies
  • Task Forces, Commissions, Studies, Grants and Other Special Programs
  • Taxes, Tax Credits, Tax Exemptions and Other Fiscal Incentives

(To be continued…)

Your responses and feedback are welcome!

Source: “Childhood Obesity Legislation – 2013 Update of Policy Options,” NCSL.org, 03/01/14
Image by Joshua Tree National Park/Public Domain

FAQs and Media Requests: Click here…

Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources