The Exemplary State of Colorado

Admittedly, the coronavirus pandemic has disrupted procedures and practices for more than a year. When this is all over, every institution, business, and family will need to get back on track in numerous ways. Nobody wants to think of the conditions we currently struggle with as “normal.”

So even though it has been difficult to follow through with plans and programs that were laid out before the worldwide health emergency, it will be useful to take a look at what one state has in mind, at least aspirationally. Speaking of hopes, in 2013 the governor announced Colorado’s intention to become the healthiest state in the Union. Regardless of what the other parameters may be, it is currently the least obese state.

A rocky history

In 2014, Colorado’s overweight and obesity rates had been growing steadily for at least 20 years. Of its high school students, nearly one in five was overweight or obese. For children, the proportion was higher — nearly one in four overweight or obese.

Still, in that measurement of health, it was the third proudest state, bested only by Hawaii and the District of Columbia. Not content with even such an excellent position, in that year Colorado’s Department of Education published a guidebook for school nurses, the Healthy Weight Toolkit. An impressive number of specialists and experts contributed to the contents of this 32-page document. The five major categories cover health team guidelines; screening; referral; health care plan; and resources.

A push for change

In the section on obesity and co-morbidity screening, the use of Body Mass Index percentile charts issued by the CDC is recommended. Routine screening should start at age three. For children of 10 years and older who are in the highest 5% in BMI, it is a good idea to refer them for certain blood tests. There is extensive information about the various possible co-morbidities.

Professionals are encouraged to make parents aware of the 5-2-1-0 plan, which had already proven useful in Maine. What it means, spelled out, is a daily goal of “At least 5 servings fruits and vegetables, 2 hours or less of screen time, at least 1 hour of exercise, and 0 sugary drinks.” More detailed information about the whats and whys of 5-2-1-0 is also included. There is also additional information about nutrition and physical activity.

A generous section is about motivational interviewing, a subject that has also been covered by Childhood Obesity News, that has to do with how and why people change. Here is a profound series of sentences from the motivational interviewing canon:

You are not listening to me when:

• You say you understand.
• You say you have an answer before I finish telling you my story.
• You cut me off before I have finished speaking.
• You finish my sentences for me.
• You tell me about your or another person’s experiences, making mine seem unimportant.
• Your response is not consistent with what I said.

Your responses and feedback are welcome!

Source: “Overweight and Obesity in Colorado,, 2014
Source: “Colorado Healthy Weight Toolkit,”, 12/01/14
Image by Aaron Yoo/CC BY-ND 2.0

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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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