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

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Profiles: Kids Struggling with Weight

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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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