Act 1220 From Arkansas — the Rest of the List


Recently, Childhood Obesity News summarized some of the 10 things learned from a very major and important study. The state of Arkansas had an inspiration, and the Robert Wood Johnson Foundation saw an opportunity to document and guide a major project from its inception.

One result of the mutually beneficial association was the 40-page report, “Evaluation of Act 1220 of 2003: Lessons Learned, 2004-2012.” (The numbered Lesson headings are verbatim from the report.)

Lesson 7: Changing school environments was associated with only specific and modest changes in family behavior.

We left off with how changes in public school policies affected the home lives of children. The report goes on to discuss how the new school procedures impacted the customary ways and habits of teenagers. Subject to the same caveats as all self-reported data, the older kids seem to have bought less from the school’s snack and soda vending machines.

During the times when they were not at school, the adolescent subjects cut back on their fast-food intake. However, increased consumption of fruits and vegetables among this age group seems to be a mirage that may be glimpsed but never reached.

In the physical activity realm, the teens actually became less active over time, but the study authors take into account a series of severely hot summers in the geographical area. This underscores yet again the difficulties faced by scientists. To say the roots of the obesity epidemic are “multi-factorial” is an understatement.

Lesson 8: Changing school environments, practices, and policies is not sufficient to change student BMI at the population level.

To put it more bluntly, all the measures the school system took to address obesity pretty much failed.

Lesson 9: Focusing attention on childhood obesity and weight overall did not lead to increases in unhealthy student behavior.

The good news, on the other hand, is that nobody got hurt. The report says:

Since the early days of the implementation of Act 1220 and throughout the 9-year period of the evaluation, concern has been expressed by policy makers, school personnel, mental health professionals, and parents about the possibility that the BMI measurement, in particular, and the attention being focused on weight status, more broadly, would result in adverse consequences, such as eating disorders, unhealthy weight loss behaviors, and weight-based teasing.

But that concern was needless, because as the text goes on to assure the public, no “unintended adverse consequences” were found.

Lesson 10: It takes changes in both nutrition and physical activity to make changes in BMI at the school level.

This section goes into detail about some of the variable factors the researchers had to take into account. Not all schools adopted all the suggested measures, and different schools put things into place at different times and with dissimilar levels of enthusiasm.

The study authors also describe their criteria for declaring a school successful, and report on their findings on “Case Studies of Successful Schools”:

Rather than a single key policy or practice, a combination of activities focused on wellness contributes to the success. The combination of nutrition and physical activity changes on campus made the difference over the years.

Your responses and feedback are welcome!

Source: “Evaluation of Act 1220 of 2003: Lessons Learned, 2004-2012,”, Feb 2014
Image source: highwaystarz/123RF Stock Photo

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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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