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

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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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