How Much Should Schools Care?

Several years ago, a major hospital chain conducted an opinion survey in which 90% of the people responded that they wanted schools to play a role in reducing obesity. Regarding what that role should be, how many different pictures were in their minds? More physical education classes? Less junk food in the vending machines? Weigh and measure the students and send alarming letters to their parents? The survey did go further, and learned that 64% of the positive respondents were also in favor of the role being “major.”

In 1997, in a book called Schools & Health: Our Nation’s Investment, the National Center for Biotechnology Information published its viewpoint on the confidentiality of student academic and health records. When speaking of difficulties, they did not beat around the bush:

Providing health care in an educational setting requires consideration of separate and sometimes conflicting standards about clients’ rights to obtain health care and requirements for educators and health care providers to protect the privacy of their clients’ records.

Students are of two important subcategories — legal minors and legal adults — and different procedures are involved in the record-keeping.

Although client health and social service records may belong to the agency where the data are collected, the individual (parent or guardian, in the case of a minor) maintains the right of control over the information in the records.

That is as it should be, but no bureaucracy is error-free. No doubt there are some horror stories of mishandled records. When things go right, the student or parent signs a consent form, so that various agencies can see the records and coordinate their efforts on behalf of the patient. This is desirable for many reasons, like the prevention of medication conflicts. Most clients, or the parents responsible for them, are okay with that provision, but…

[…] this may be problematic when there is an issue related to mental health, drug use, or a sexually related condition. Further, some parents and guardians express concern for the consequences if such information — or information about health problems discovered at the school, such as asthma or seizures — might be obtained by their insurer.

Most people don’t set out to deceive their insurance company, but there is no point in letting them know every detail of a child’s condition before a diagnosis is confirmed or before there is a chance to sanely assess the situation. Obesity is not identical to a mental health or drug use issue, or a sexually related problem, but there might be valid reasons to control the flow of information to other parties. With insurers so eager to find disqualifying “pre-existing conditions,” confidentiality is important.

In the discussion of screening processes, the recommendation is to use “a relatively simple test to identify those who may have a particular problem.” Customary testing methods should be reviewed, and their relevance attested to. Financial resources and other factors will decide how to apportion the attention “between population-based screenings and targeted interventions for high-risk groups.” Here is the crux of the matter:

Unfortunately, screening programs are ineffective unless procedures are in place for ensuring follow-up of identified problems.

(To be continued…)

Your responses and feedback are welcome!

Source: “Schools & Health: Our Nation’s Investment,”, 1997
Image by Thomas/CC BY 2.0

What Should Schools Care About?

At the turn of the millennium, schools were being pressured to bring up academic test scores, no matter what. Meanwhile, the National Association of State Boards of Education (NASBE) had written:

Health and success in school are interrelated. Schools cannot achieve their primary mission of education if students and staff are not healthy and fit physically, mentally, and socially.

In those few words, the raw material can be found for an infinite amount of disagreement. Parents, politicians, teachers, school administrators, and many other interest groups have a stake in prescribing the mission of schools in America. Who gets to define physical health? Who gets to define mental health or — most volatile of all — social health? These monumental questions resist consensus and compromise.

In that quotation, see where it mentions health and fitness for both students and staff? Before going in more serious directions, this is a good opportunity to mention what Emily Richmond wrote several years later, when conditions had started to change, of her time as a reporter on the education beat:

I did some quality control spot checks at various campuses after the junk food ban was passed. I found that bottled water and graham crackers had indeed replaced the sports drinks and chocolate bars — with one notable exception: the machines in the faculty lounges were fully stocked with the familiar array of candy, chips and sugary sodas. That the ban didn’t extend to the adults on campus illustrates the larger challenge facing schools, families, and communities as a whole.

That larger challenge encompasses, on a regular basis, such issues as hypocrisy, as well as the reluctance to include or ignore particular bits of science, depending on the participants’ bias.

In 2004, the Centers for Disease Control published “The Role of Schools in Preventing Childhood Obesity,” whose nine pages included 10 strategies to improve student nutrition and increase the opportunities for physical activity. The document stressed the need for each school in the country to have a Coordinated School Health Program, including a coordinator and a school health council.

School strategies for reducing obesity

Administrators were encouraged to use the CDC’s School Health Index to list measures already in place, and note the elements that were missing but needed. Each state was tasked with determining whether junk food and sugar-sweetened beverages could be sold in schools. They needed to decide how much physical activity kids ought to engage in, and figure out how to induce them to do it. They needed to think about whether it was appropriate to encourage such programs as safe walk-to-school routes.

Great emphasis was put on improved meals. The “Role of Schools” paper is energy exchange formula-oriented, all about nutrition and activity; and does not include the words “weigh” or “scale,” and only mentions Body Mass Index in the context of defining overweight to discuss the national percentage of overweight kids. Other statistics were grim, too. Richmond mentioned that the rate of absenteeism was 20% higher among the children who were headed for obesity. She also wrote,

Kaiser Permanente conducted a nationwide survey and found that 90 percent of respondents believed schools should “play a role in reducing obesity in their community” and 64 percent supported it being “a major role.”

Your responses and feedback are welcome!

Source: “The Role of Schools in Preventing Childhood Obesity,”, 2004
Source: “Should Schools Be Responsible for Childhood Obesity Prevention?,”, 07/15/13
Image by ashish joy/CC BY 2.0

Schools and Obesity Tracking

The previous post asked, “Should Schools Stay in Their Lane?” What exactly is their lane, or area of competency and responsibility? This turns out to be a very complicated question. What ought schools to be doing about obesity, and on whose say-so? What happens if they go too far or don’t go far enough? How much of a child’s personal life is none of the schools’ business anyway? It is a sprawling area of inquiry, so we will look at some of the societal institutions that contribute input.

What gets recorded?

For the convenience of anyone who wishes to refresh their Body Mass Index knowledge, here are several previous posts that cover this topic:

For now, this is the measurement standard most widely used. One reason for not wanting to change is that switching to a different system would make longitudinal studies more difficult. When statistics are to be compared, the more alike they are, the better. Still, in some quarters BMI is falling out of favor.

Leaving aside the pros and cons of various methods, why do local, state, and federal agencies concern themselves with weighing and measuring school kids?

Extra weight is likely to correlate with other things that should have an eye kept on them — things like hypertension, type 2 diabetes, cardiovascular disease, and on and on. Some parents and legislators believe that very close attention should be paid by the school system, while others do not believe that the schools should be concerned with matters of physical health at all. The debate around that has only become more heated since COVID-19.

A 2017 document from Colorado’s Department of Public Health & Environment reflects years of objective study and increasing consciousness. At the time of publication, the state identified nearly one in five high school students as overweight or obese, and more than one in four children, which is an even worse ratio. And Colorado was one of the top three states!

The S-word

Back in 2013, the state had boldly declared tackling obesity as a “winnable battle.” A couple of years later the state government announced that…

[…] healthy eating, active living and obesity prevention have been designated as a flagship priority in the plan, Shaping a State of Health (2015-2019)…

STATEWIDE GOAL: Reverse the upward obesity trend by aligning efforts to develop a culture of health… Intensify efforts to create conditions to achieve healthy weight across the lifespan… Increase statewide capacity for coordinated obesity surveillance.

And that S-word, surveillance, is where a lot of people pull the brake cord and jump off the anti-obesity train. They feel that kids are already scrutinized far too closely for their own and their families’ good. A lot of Americans want no part of a system that includes screening, referrals, and record-keeping. They regard this observation, and what appears to them as an obsessive and excessive concern, as repugnant, and are against it on principle.

They have also accrued evidence that it doesn’t necessarily help. Some studies show that when certain kinds of attention are paid to body weight, eating disorders are likely to increase.

(To be continued…)

Your responses and feedback are welcome!

Source: “Overweight and Obesity in Colorado,”, 2017
Image by Elizabeth Lloyd/CC BY 2.0

Should Schools Stay in Their Lane?

Should schools mind their own business? To what areas of life should that business be limited? There has never been universal agreement on where the norm ought to be. In 1993, the American Academy of Pediatrics suggested seven appropriate goals for policy and practice in the area of school health:

1. Ensure access to primary health care.
2. Provide a system for dealing with crisis medical situations.
3. Provide mandated screening and immunization monitoring.
4. Provide systems for identification and solution of students’ health and educational problems.
5. Provide comprehensive and appropriate health education.
6. Provide a healthful and safe school environment that facilitates learning.
7. Provide a system of evaluation of the effectiveness of the school health program.

Over the years, the federal government stepped up with some major moves. The Elementary and Secondary Education Act (ESEA) of 1965 had laid out the basic tenets of governmental involvement in education. It was organized in such a way that states could opt into financial benefits by fulfilling the “requirements outlined in certain sections, or titles, of the act.” Later, as a Harvard University publication explained:

The 2001 No Child Left Behind Act (NCLB) marked a new level of federal oversight by requiring states to set more rigorous student evaluation standards and, through testing, demonstrate “adequate yearly progress” in how those standards were met. Flaws in the law quickly surfaced.

Then in 2004 came the Individuals with Disabilities Education Act, or IDEA 2004, whose Child Find Mandate applies to all children residing in a state, and says that “schools are required to identify and evaluate all children who may have disabilities,” from birth to age 21. It also specifies that “The law does not require children to be ‘labeled’ or classified by their disability.”

On the other hand, a certain amount of record-keeping and statistical calculation has to be done in any project of this kind. The citizens who pay for the program need to be shown that it yields good results, and charts are how we do this. In the course of doing legitimate accountability chores, bad judgment and error can creep in. Despite good intentions, undesirable classification and labeling of children seem to occur anyway. This is one of the issues that many parents and professionals are concerned about.

(To be continued…)

Your responses and feedback are welcome!

Source: “Schools & Health: Our Nation’s Investment,”, 1997
Source: “When it Comes to Education, the Federal Government is in Charge of… Um, What?.”, Fall 2017
Source: “Do Schools Have Any Legal Obligation to Identify and Test Students?,”, 06/03/2008
Image by Rick Obst/CC BY 2.0

Coronavirus Chronicles — The Dynamic Interactions of Chance

The previous post talked about the ripple effect, and how, if you look into it deeply enough, everything eventually affects everything else. Drop a second stone into the pond, and now there is more than one variable to deal with. Drop a thousand stones into the pond, and that’s life on Earth. It is a reminder that even in a country or a time when the majority of coronavirus victims are adults, chances are most of those adults have some vital connection with a child or children. When grownups sicken and die, the needs of children are not being met, and this is true everywhere on the planet.

Global involvement

The prognosis is not good. For the past few weeks, the picture has looked increasingly grim in many parts of the world, for several reasons, one of which is the lean, mean Delta variant.

In Russia, Moscow is the city with the worst daily death toll. One of the stats they racked up was 144 Covid deaths in a 24-hour span. That’s a lot, even for a metropolis.

When Delta hit the bigtime, Malaysia decreed a national monthlong lockdown, then reconsidered and extended it to “indefinite.” In the Australian city of Sydney (population over five million), a two-week lockdown was imposed in mid-June. Bangladesh recently instituted a new lockdown. In Portugal, the ferocious Delta is responsible for more than half the new cases. To slow the influx from Portugal, Germany has imposed bans and quarantines.

Team Vax

More than 35% of Germans are fully vaccinated. The U.S. includes low-vaccination states where the COVID-19 rates are described as “soaring.” They include Arizona, Arkansas, Missouri, Nevada, Oklahoma, and Utah. Bahrain’s vaccination rate is similar to America’s. Dr. Eric Feigl-Ding says,

Even though largely vaccinated, the Delta Variant ravaged through the country.

The United Kingdom is described as one of the world’s most heavily vaccinated nations. In Scotland, 49% are vaccinated. Sounds pretty good, right? Wrong. A bunch of Scotsmen went to England for a sports event and returned with enough cooties to spark up almost 2,000 new cases of the virus. The writer says Scotland now has “all-time record high Covid.”

Another much-vaccinated population is that of Israel, where, within two weeks, new COVID cases increased by 800%. Rich Mendez wrote for CNBC,

Even with 80% of adults vaccinated, Chezy Levy, director-general of Israel’s Health Ministry, said the delta variant is responsible for 70% of new infections in the country. Levy also said that one-third of those new infections were in vaccinated individuals.

Israel had relaxed its masks-in-public-places rules, but recently reimposed the requirement. Indonesia, currently the most severely afflicted southeast Asian country, is in real bad shape. The hospitals are described as overwhelmed, and a lot of vaccinated doctors have died — possibly because health care workers cannot be spared for a single day, even if there is a good reason why they should undergo quarantine. In India, only 6% of the people are fully vaccinated.

Your responses and feedback are welcome!

Source: “Dr. Eric Feigl-Ding,”, 07/01/21
Source: “Global report: rise in Delta variant cases forces tougher restrictions,”, 06/27/21
Source: “CDC says roughly 4,100 people have been hospitalized or died with Covid breakthrough infections after vaccination,”, 06/25/21
Image by subherwal/CC BY 2.0

Coronavirus Chronicles — Kids, the Virus, and the Ripple Effect

When humans first began philosophizing, surely one of the earliest natural phenomena to stir deep thought was the ripple effect. If a rock is thrown into a body of still water, it initiates a series of reactive movement that reaches all the way to the edge. Watching this very simple chain of causation cannot help but inspire comparison with other events in life.

Today, there is concern over the fact that children and teens can both catch and transmit COVID-19; and at the same time, from some quarters, there is also a continuous and ongoing denial of this reality. One nuance is that merely counting cases among the young does not tell the whole story. There is a school of thought that refuses to fuss about older people getting sick and dying. As long as the child numbers stay beneath their comfort level, no worries.

Everything connects

But children and teens are taken care of by adults, and many adults who become incapacitated by illness lose the ability to provide the necessities of life — both material and emotional — for the children in their charge. Parents die, or stay in the hospital, or need home care. They can’t work, or lose their jobs. They get “brain fog” and can’t cope with the simplest tasks. The grandparents who had volunteered to fill in for working parents get sick or die.

Sickness and death among adults affect children profoundly! To feel reassured because in certain demographics the numbers and the severity don’t seem too bad is to delude oneself. When the numbers go up in any age group, children cannot help but be affected. The overall horror of people continuing to die casts a heavy shadow over matters that used to seem very important — like preventing children from becoming obese.

As for the deniers…

Virus researcher Mitchell Tsai identifies some of the many factions that compete for attention:

[…] pro-mask, anti-mask, pro-lockdown, anti-lockdown, pro-aerosol, anti-aerosol, anti-reinfection, pro-vaccine, anti-vaccine, Covid doesn’t exist, Covid is a conspiracy, anti-New-York-Times, anti-Guardian, anti-Daily-Mail, anti-Wall-Street-Journal, pro-lab-leak, anti-lab-leak, pro-China, anti-China, pro-India…

Tsai, incidentally, is very aware of online platforms where COVID-denying trolls are likely to block important discourse between active COVID virologists, epidemiologists, and infectious disease specialists. To the astonishment of social media critics, he recommends Twitter as the social medium most amenable to serious discussions among experts.

Breakthrough cases

There is much talk about a term that journalist Rich Mendez explains:

Breakthrough cases are Covid-19 infections that bypass vaccine protection. They are very rare and many are asymptomatic. The vaccines are highly effective but don’t block every infection. The CDC doesn’t count every breakthrough case. It stopped counting all breakthrough cases May 1 and now only tallies those that lead to hospitalization or death…

Mendez also brings up the point that the Centers for Disease Control’s number of total active cases must necessarily be inaccurate because, for COVID victims who are not hospitalized or deceased, “data relies on passive and voluntary reporting.”

Not long ago, Childhood Obesity News mentioned some highly speculative yet potentially worrisome news about the relationship between COVID-19 and toxoplasmosis. Scientists from Utrecht University in the Netherlands have observed that people with coronavirus often have cats and dogs who test positive for the disease. Although not currently a top-level cause for concern, this is regarded as something to keep an eye on:

While cases of owners passing on Covid-19 to their pets are considered to be of negligible risk to public health, the scientists say there is a potential risk that domestic animals could act as a “reservoir” for coronavirus and reintroduce it to humans.

Your responses and feedback are welcome!

Source: “Censorship,”, undated
Source: “CDC says roughly 4,100 people have been hospitalized or died with Covid breakthrough infections after vaccination,”, 06/25/21
Source: “Pet owners urged to avoid their cats and dogs if they have Covid,”, 07/01/21
Image by Paul Eisenberg/CC BY 2.0

Talking It Out

We looked at how, not content to be third best, Colorado declared its intention to be the healthiest state. The Department of Education put together a guide for school nurses and other interested parties. The Healthy Weight Toolkit puts a lot of emphasis on Motivational Interviewing, which is all about the roots and growth of change in a person. Adults who are in a position to help the young are urged to talk less and listen more, a philosophy that includes even — to some adults — the radical step of actually asking the troubled youth’s permission before doling out advice.

Not your magical hero

In any counseling situation, the affirmation of a person’s strengths is important. But there can, as some troubled individuals have remarked, be too much of a good thing in that department. In reference to larger social unrest, many women (in particular) have said to the press, or to their social media connections, things like, “Don’t tell me how strong I am. Not when I’m dealing with garbage I shouldn’t even have to put up with in the first place. Don’t project onto me your fantasies of steadfastness and nobility. I don’t want to have to be strong. I want to be respected, validated, and sometimes even taken care of, in a way that the world and other humans seem unwilling to do.”

That is a prime example of how someone who is trying to help can miss the mark. Whether objectively they are right or wrong, some people just don’t want to be told, right now, how strong they are. It might be the wrong bullet point to lead with. At the very least, counseling a mixed-up kid might be different from dealing with a maladapted adult.

Motivational Interviewing

Motivational Interviewing has proven to be very useful in helping people with addictions, and one of the nuances to practicing this skill is the realization that people go through several stages in taking on the challenge of change. The earliest is the pre-contemplative stage, when the subject has not even considered the notion that change might be desirable. The usefulness of motivational interviewing lies in nudging the person along to the point where they are willing to contemplate making a change. Then, they need an effectively administered boost to another level, that of preparation.

From there, the person will hopefully (and with thoughtfully administered help) enter the action stage, which can be exciting and even exhilarating, at least in the short term. When being un-addicted or in some other improved state becomes the new normal, however, the person who offers guidance will need to switch into a different gear. The long haul, the daily sameness of the maintenance stage, will in the best-case scenario last a long, long time, and living within it may need a whole different kind of support.

This is why it is so important that teachers, school nurses, and parents understand the point and purpose behind motivational interviewing. These helpers often need help themselves, because they can’t always win. No matter how sincere their compassion or how well-honed their skills, helpers are sometimes unable to help, because the overwhelmingly necessary ingredient must come from the subject herself or himself.

That ingredient is commitment, without which no change is possible, and it has to come from within. There is no way to administer a dose of commitment, there are only ways to help an individual find their own unique path to commitment. From the Healthy Weight Toolkit:

You are listening to me when:

• You really try to understand, even if I am not making much sense.
• You grasp my point of view, even when it’s against your own view.
• You allow me the dignity of making my own decisions, even when you feel they may be wrong.
• You do not take my problem from me but allow me to deal with it in my own way.
• You hold back the desire to give advice (or only offer it with permission).
• You give me room to discover what is really going on.

Your responses and feedback are welcome!

Source: “Colorado Healthy Weight Toolkit,”, 12/01/14
Source: “Motivational Interviewing,”, undated
Image by Fotos PDX/CC BY 2.0

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

Who’s Who in Obesity

This blog recently discussed school involvement in weight monitoring. This is not a top-down, federal government type of decision, but is handled more locally, and it does not seem like consensus will be reached soon, if ever. It appears that for the moment, the best we can do is count the number of young people who are officially obese.

To start with some good news: The least-obese state, Colorado, is evenly tied with the District of Columbia. In both jurisdictions, the obesity prevalence is 23.8%. Colorado is a state of the young and the fit. The built environment evolved not randomly but through thoughtfulness and deliberation:

About 87.9% of children between 2 and 19 years old in the state have easy access to parks and playgrounds… About 89.5% of communities in Colorado are built in a way that promotes physical activity — which means having plenty of sidewalks, trails, bike lanes, and walking paths.

What state has the second-lowest obesity rate? The answer seems counter-intuitive — Hawaii. Isn’t it typical to imagine a population of laid-back people enjoying the weather and natural beauty, and not caring very much about fitness? But apparently, that is not the case. In addition to a low proportion of obesity, Hawaii boasts the highest life expectancy of all the states — an impressive 81.5 years.

A group called Consumer Protect aims to improve the lives of consumers by informing, protecting, and warning the public against “unfair and unsafe products, business practices, and technologies.” The organization helps consumers to file personal injury and product liability lawsuits, and will evaluate a potential case for no cost.

Consumer Protect has released its Couch Potato Index, with figures derived from the very official Centers for Disease Control and Prevention. This was written about by Richard Meyer for a website geared toward people interested in direct-to-consumer marketing, otherwise known as advertising. Meyer wrote,

Consumer Protect looked at states where adults engage “in zero physical leisure activity…” Kentucky was No. 1, with 34.4 percent of adults in the state engaging in zero physical activity. Mississippi and Arkansas followed behind with 33.2 percent and 32.5 percent, respectively.

By a strange coincidence, slothful Mississippi is, by the CDC’s accounting, the state whose obesity rate is highest, and also the state with the shortest average life expectancy. Kentucky is the fifth fattest state, and Arkansas is the third fattest. The point here is, there is a very strong correlation between obesity, lack of exercise, and a needlessly shortened lifespan. For anyone who can face additional numbers at this point, here are some more, as phrased by Meyer:

In 2016, diseases caused by obesity and being overweight accounted for 47.1 percent of the total cost of chronic diseases in the U.S. — responsible for $480.7 billion in direct health care costs, plus $1.24 trillion in indirect costs related to lost economic productivity. The total cost of chronic diseases due to obesity in 2016 was $1.72 trillion — equivalent to 9.3 percent of the U.S. GDP that year.

Your responses and feedback are welcome!

Source: “Most Obese States 2021,”, undated
Source: “This Is Where Colorado Childhood Obesity Ranks in the US,”, 6/17/2021
Source: “What We Do,”, undated
Source: “Couch Potato Index,”, 07/31/19
Image by Infrogmation/CC BY 2.0

Growth Not Always Good

This cannot be said too often: Childhood obesity almost inevitably leads to lifelong obesity. Somehow it needs to be nipped in the bud, and preferably without coercion or any other violation of children’s human rights. It is not surprising that the motives and methods of weight-loss proponents (and opponents) are sometimes questioned. The following quotation is relevant:

According to the CDC’s most recent obesity numbers, the state with the highest obesity rate is Mississippi, with an obesity rate of 40.8%. Mississippi also has the shortest life expectancy among all states at 74.5 years. West Virginia has the second-highest obesity prevalence at 39.7% and the second-lowest life expectancy of 74.8 years.

It does not take a genius to put it together: There is a very direct correlation between obesity and a needlessly truncated lifespan.

Who should be in charge?

The previous post looked at some of the diverse opinions surrounding the concept of requiring, or even asking, that schools should keep tabs on children’s obesity status. As it turns out, opinions are available from even more sources. A California study published by JAMA Pediatrics looked at “6,534 elementary and middle school students in at least the 85th BMI percentile,” reports MedPage Today staff writer Elizabeth Hlavinka. She explains,

Children have become increasingly weight conscious over the past several decades and public health interventions designed to alert or remind families of children’s weight status may not be having their intended effect…

The parents were sent body mass index report cards and the followup study did not show impressive results in terms of weight loss. It could seem like this approach is a waste of time, energy, and financial resources, in addition to squandering goodwill that might have otherwise accrued to grownups who only tried to help.

A very strong faction believes that the promotion of healthy behavior counts for a lot more than an obsession with pounds or calories. UC Berkeley’s Dr. Kristine Madsen told the journalist,

The way you talk to parents about children’s weight status really matters. Using terms like obesity with families of young children is completely demoralizing and it’s not at all effective.

An interest in weight perceptions and weight loss behaviors caused a team led by Francesca Solmi, Ph.D., of University College London to study three generations of children:

Researchers […] found youth’s weight loss behaviors increased in a stepwise fashion from 1986-2015, and more youth saw themselves as overweight in 2015 versus 1986, regardless of their actual weight.

Some of those young subjects had depressive symptoms, particularly the girls. Hlavinka reminds readers, parents and professionals alike, that overweight kids are rarely allowed to forget their fat. Harping on the subject can’t help, especially when the afflicted are not offered useful alternatives.

Your responses and feedback are welcome!

Source: “Most Obese States 2021,”, undated
Source: “Some Policies Aimed at Childhood Obesity Aren’t Cutting It,”, 11/16/20
Image by Micah Sittig/CC BY 2.0

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Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

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.

Food & Health Resources