Rankled by Rankings

Whenever some person or institution presumes to judge the best of anything there are bound to be some unhappy losers. So far, no town has threatened to sue or boycott Money magazine for its decrees about the healthiest American cities. The best were chosen “based on a range of factors, including access to medical care, rates of common diseases, and the residents’ own assessments of their personal health.”

The editors note that the focus this year was on small cities, so no metropolis should have hurt feelings. Among those small cities, Provo, Utah, earned the #8 spot, because it has the lowest rate of childhood obesity in the nation. First place went to Highlands Ranch, Colorado, mainly because it has the country’s lowest adult obesity rate.

Provo, Utah, is just a city, but apparently, Oregon is the entire state with the lowest childhood obesity rate. (The page this information came from also boasts an extensive and eye-opening infographic.)

The global picture

The United Nations established a list of Sustainable Development Goals, or SDGs, a list so capacious that all the goals can’t be evaluated at once. Journalist Tamara Rosin explains:

For the latest study, researchers estimated the performance of 33 health-related SDG indicators for 188 countries from 1990 to 2015. The SDGs, which include the Millennium Development Goals and the Global Burden of Diseases, Injuries and Risk Factors Study of 2015, measure things like poverty, clean water and education, as well as societal inequality and industry innovation.

The Bill & Melinda Gates Foundation financed the work of the 1,870 researchers who arrived at the answers. Overall, America ranks 28th, slightly better than Estonia. In the child obesity category, the U.S. placed 69th. Admittedly, this is a worsening problem worldwide, and there seems to be little correlation between a country’s economic health and its childhood obesity status. Still, the fact that the situation is better in 68 other countries is a cause for serious concern.

Research and its limitations

Earlier this year, the Clinical Research Institute (Duke University) published the results of data analysis derived from the National Health and Nutritional Examination Survey (NHANES), which collects data in two-year increments. The team, headed by Dr. Asheley Skinner, asserted that NHANES is the most accurate source of information, concluded that no decline in obesity had taken place in any age group.

In June, the Journal of the American Medical Association published the report from a multi-author “Original Investigation” carried out by researchers from the Centers for Disease Control and Prevention and the U.S. Public Health Service. It added little to the overall understanding of the problem, but Howell Wechsler, of Alliance for a Healthier Generation, attempted a clarification:

In simplest terms, here is what we learned from the latest report from the Centers for Disease Control and Prevention (CDC) on children and adolescent obesity: there has been modest progress with the youngest age group, flattening levels of obesity with kids and a slight increase in obesity rates among adolescents.

For the study authors themselves, the grand finale was the anticlimactic pronouncement that more research is needed. Meanwhile, Duke University has calculated that each obese child will incur nearly $20,000 worth of lifetime costs for health problems related to obesity.

Your responses and feedback are welcome!

Source: “The 10 Healthiest Places to Live in America,” Health.com, 09/19/16
Source: “Child Obesity in the United States and How to Fight It,” Visual.ly, 06/31/16
Source: “US ranked No. 28 in world for health, living standards,” BeckersHospitalReview.com, 09/26/16
Source: “Childhood obesity rates continue to climb, study finds,” ConsumerAffairs.com, 04/26/16
Source: “Trends in Obesity Prevalence Among Children and Adolescents in the United States, 1988-1994 Through 2013-2014,” HealthierGeneration.org, 06/08/16
Source: “Medical cost of childhood obesity is $19,000, researchers say,” LATimes.com, 04/07/16
Image by Christopher Dombres

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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:


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.

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