CHILDHOOD OBESITY

How to Combat It In the American Education System

Joshua Lyzinski
English 138T
4/14/2023
Introduction

Schools are the cornerstones of a child’s physical and mental health. Not only are they

tasked with preparing their students intellectually, but they are entrusted with the health and

safety of society’s children. As a result of this, many schools have implemented programs

designed to educate students on how to live and maintain a healthy lifestyle. When the Covid-19

pandemic shut down schools across the country, many of these programs were unable to continue

to function in the virtual world. It did not help that children were stuck at home as many found it

difficult to exercise as mental health issues plagued their minds. Often, physical wellness was put

to the side as there were more pressing concerns to focus on. As a result, a rise in childhood

obesity became abundantly clear as the U.S. childhood obesity rate rose to 17 percent and one in

three children were found to be overweight or obese.1 With this in mind, it was clear that this was

a major concern, specifically in a pandemic that was not particularly kind to those struggling

with their weight. The

Center for Disease Control

found that not only did

obesity increase the risk of

severe illness from Covid-

19, but it actually led to

more than triple the risk of

Figure 1. The Prevalence of Obesity in Patients with Covid-19.
hospitalization from the

virus.2 Even as medicine continued to improve and a vaccine was eventually found, it became

clear that it would take a significant change in lifestyle to ensure the safety of societies children.

As kids reenter a life consistent with pre-Covid routines, it may be down to the schools to help
solve the problem. While childhood obesity has been a focus of United States’ schools in the

past, in order to better educate children on a healthier lifestyle schools must transition to a

consistent physical education program for later schooling years while also adjusting their meal

options to protect children’s health.

How to Determine Childhood Obesity

Childhood obesity is often more complicated to track as children continue to grow over

the beginnings of their lives. As of the now, the American Academy of Pediatrics uses body mass

index (BMI) to determine whether children from the ages of 2 to 19 are overweight. BMI is

normally successful at indicating how overweight a child is likely to become if they were to

continue to grow as they are now. As a result, it is not always accurate for every child and should

only be used to screen children for possible obesity so they can be aware of the possible effects

in the future. It is calculated by taking the child’s weight and dividing it by their height squared

which is then multiplied by 703 (weight / height2 * 703). If the child’s BMI is between the 85th

and 95th percentile, they are considered overweight. If it is over the 95th percentile, the child is

considered obese.3 It is of note to mention that this system can be inaccurate as it is a prediction

rather than a set fact. A doctor should always be used when interpreting the result so that they

can determine whether the results are truly concerning or not.

Factors Influencing Childhood Obesity

The rise in childhood obesity does not have one set cause that can be treated to prevent

the problem. Often, it is a combination of several factors that can vary on an individual basis.

Certain genetic makeups cause children to be predisposed to obesity. In general, there are three

types of genetic obesity: polygenic, syndromic, and monogenic. Polygenic obesity is perhaps the
most common of the three as it can affect almost anyone. Syndromic obesity is only present in

those with developmental abnormalities, like Down Syndrome. The rarest of the three is most

certainly monogenic obesity as it is a class 3 obesity that only occurs within people with

developmental delays. There are currently only twenty known genetic mutations associated with

this form of obesity.4 While these genetic abnormalities do cause obesity, they are all quite rare.

Genetic factors do not play the largest role in your tendency to gain weight and it does not tend

to be hereditary.

More commonly, childhood obesity is a result of a child’s lifestyle. Some physical

characteristics that have an influence on the problem relate to lack of exercise. A child is more

likely to gain excessive weight if they spend more time on sedentary activities, such as playing

video games or watching television.5 During the Covid-19 pandemic, many kids were forced to

stay in their homes and attend virtual schooling all day. This led to even more limited movement

as children often participated from their rooms, or even beds, and stayed in those places for a

large portion of the day. Kids with limited

outdoor space could not even escape to go play

outside on their breaks due to social distancing

concerns.

Even poor eating habits have been known

to increase the risk for obesity. Children who

inadequately consume vegetables, fruits, milk,

and protein and replace it with high-calorie

snacks and sugary drinks are more likely to be Figure 2. The Causes of Childhood Obesity.

overweight. A major issue is snacking, as it has been found that just consuming unhealthier
products outside of normal mealtimes accounts for 27% of the total calories of the average

American.6 Children who come from families that are more overweight are more likely to put on

weight, especially if they are in an environment in which they are consistently consuming high

amounts of calories, fats, and sugars.7 Children in poorer families often have poorer diets as

healthier foods can be more expensive to buy.

Furthermore, there are certain mental factors that have been found to contribute to

childhood obesity. Children in high stress environments surrounding their social or familial lives

can overeat to cope with problems that they are facing. In a study of 167 children with obesity

and 200 normal-weight children aged 9 through 16 in 2016, an interesting pattern was

discovered. Obesity in children was found to be associated with a notably higher rate of

depression and anxiety compared to the sample of normal children. It was even found that the

children struggling with obesity had lower self-esteem scores measured.8 Whether or not these

factors are causes of obesity is still yet to be seen, but there is certainly statistical evidence to

claim that it is the case.

The Current Physical Education System

It is up to the school district’s state to mandate how much time should be spent on

physical education throughout a child’s schooling years. Nearly every state has some form of

physical education guidelines that vary across each grade level. While 39 of the states require

some form of physical education in elementary school, only 37 have the requirement for junior

high students. Only 44 states make it mandatory for high school students while only 16 states

require some form of assessment created by the state.9 However, the issue does not lie in the

number of states that require physical education, but in the time requirements they have. Only 12
states mandate a minimum weekly time requirement for junior high students and only 5 states for

high school students.10

One clear example of the failure of the physical education system in the country is from

the state of Pennsylvania. The Pennsylvania State Board of Education requires that “Every

student in a primary (generally grades K-3), intermediate (generally 4-6), middle school

(generally grades 7-9) and senior high (generally 10-12) programs must be provided with

planned instruction that is aligned with academic standards in health and physical education”.11

While this seems reasonable and ensures all grades across the state are involved, the issue is in

its time requirements. The State Board of Education then says, “Neither the Pennsylvania

Department of Education nor the State Board of Education mandates a specific number of

minutes or times per week that health and physical education is provided. Each school district

has the authority to make the decision as to the most appropriate manner in which to schedule

classes as long as it is within the boundaries of the Pennsylvania School Code and

the Pennsylvania Code”.12 In the end, this leaves several questions, particularly what classifies as

“proficient levels” of physical education. It does not provide a set time needed to be spent on

physical education which leaves room for it to be omitted in its entirety.

Becoming a physical education teacher has a process that is at least slightly more

consistent. The requirements vary from state to state, but to teach a class you need to obtain at

least a bachelor’s degree in education, kinesiology, or athletic training. However, the system is

not necessarily flawed in who teaches the classes, but how they are taught. According to the

Center for Disease Control, nine different studies have found that PE teachers spend around 15 to

26 percent of their class time on management tasks. This could include taking attendance,

making announcements, or explaining activities.13 In a class meant to promote movement and

exercise, it is unfortunate that around 25% of that period is spent sitting around, especially with

the limited amount of time often provided. Yet, that is what many of the physical education

programs around the country seem to be doing.

The Current Meal Options at Schools

When looking at the goals of the current meal option programs in the country, it seems

they were on the right track. In 2010, former first lady Michelle Obama led her campaign for the

Healthy, Hunger-Free Kids Act. The legislation functioned as the first attempt to improve school

meals in more than twenty years up to that point. It focused on increasing the quantity of fruits,

vegetables, and whole grains required in school meals while also cutting down on the added

sugars and high-carbohydrate snacks. Under its branch, it included the National School Lunch

Program which affected thirty million students nationwide. The program focused on ensuring

adequate meals were provided to all students throughout the school day. It was built for lower-

income children and provided them with either free or reduced-price meals that were healthier

and better for them.14

The act proved to be successful as well. It was found in a nationwide study, that the body

mass index for children, which was adjusted based on gender and age, fell by .041 more units per

year than when the act was not in affect.15 It seemed that the program was on the right track.

However, the act has begun to be watered down over the years as Obama’s impact has slowly

decreased. Now, the act allows for less whole grains in meals, more flavored milks with

increased sugar, and more sodium to be present. It has even been reported that the U.S.

Department of Agriculture is considering changing the act to allow fewer vegetable servings in

school lunches.16 Now, the average BMI index has risen to the level it was before the Healthy,

Hunger-Free Kids Act, leaving children less well-off than they were ten years ago.
Recommended Action

From all of this, it can be clearly seen that childhood obesity is a major problem at this

time. While it is almost impossible to reform a child’s lifestyle at home, it is much more

reasonable to do so at school. However, the current system is implemented on a state-to-state

basis and does not allow for conformity of programs across the country. In order to justify

national intervention in public schools, the country must first decide that childhood obesity is a

nationwide concern. The only way to do so is to declare childhood obesity as a Public Health

Emergency under the Public Health Service Act. According to the Secretary of the Department of

Health and Human Services (HHS), a health concern may be classified as a Public Health

Emergency if it is determined to:

1. Be an imminent threat.

2. Pose a substantial risk to humans by either causing significant number of

human fatalities or permanent long-term disability.17

Identifying the issue as an imminent threat should not be a concern, as childhood obesity

numbers continue to rise, especially after the pandemic. This also accounts for the second point,

as it is clear that obesity poses a substantial risk to children especially when it is paired with

other infectious diseases like Covid-19. However, this will have to be considered and approved

by the HHS before any further action is taken. Once it is declared as a Public Health Emergency,

the Secretary of HHS can then begin to access additional funding and transform current public

health policies and replace them with their own.18 This adds additional powers that will allow for

national intervention to occur in public schools.

 The first aspect that should be reformed is the physical education systems in schools

across the country. According to the National Association for Sport and Physical Education, 81%

of adults and 71% of teens believe in daily physical education in schools. However, only 56% of

adults and 48% of teens believe they have the right amount of physical education present. It is

clear that the desire for some form of physical education is there, but the schools are simply not

implementing a solution correctly. By creating a consistent program throughout the country,

adults and teens can feel confident that children in public schools are receiving adequate time

spent on their health and wellness.

One important part of ensuring that the system is tailored to growth is by creating a

program that requires at least thirty minutes of physical activity a day at schools. This program

would be called the Progressive

Physical Education program and

would recognize that while it is

more beneficial for kids from

ages 6 to 17 to elevate their

hearth rate at least an hour a day,

that it is difficult to fit into most

school schedules. 19 Simply

Figure 3. The Importance of Physical Education in Schools. implementing thirty minutes a

day could be easily added and would still have a positive effect on a child’s physical health. It is

then important to make sure that the program provides a basic outline that evolves as the child

grows from elementary, to junior high, and lastly high school.

 When children are in elementary school, it is most important to find fun ways to motivate

them so that they want to continue to exercise. This means elementary school physical education

will center around enjoyable, natural activities that involve running, jumping, and skipping. Fun

games that could be implemented would be activities like sharks and minnows or tag that allows

kids to have fun while also receiving cardiovascular exercise. In the end, the elementary level

should be more focused on positive reinforcement and promoting the fun of physical activity

rather than a strict schedule. As students progress to junior high, the program will evolve to focus

more on teaching students how to maintain a healthy lifestyle. Now that the children are getting

older, it is more important to educate them and prepare them for how to make healthy life

choices. The program will focus on teaching basic cardiovascular skills like proper running

techniques, biking, and other activities that can elevate heart rates. It will continue to mix in

elements from the elementary school program, like fun games and activities, but less regularly.

This will hopefully continue to keep kids motivated and engaged while also providing them with

lasting health skills. By the time they reach high school, students should be properly educated

and experienced in the basics and then should be able to make their own choices for more

specialized classes. This could include further running or biking classes and could expand into

weightlifting programs or yoga. All classes would need to focus on cardiovascular health in some

way but would ultimately be up to the student and the school in choosing which classes to add.20

The implementation of this program would need to be nationwide and would have to be

monitored to ensure it was being done correctly. Physical education teachers would still need to

have at least a bachelor’s degree in physical education or kinesiology and would also need to

stay nationally certified through government created training programs and videos designed to

monitor and assess their knowledge of the program and its goals.21 School would then need to be
examined yearly to ensure adequate usage of the Progressive Physical Education program. If all

this is done correctly, students should be exercising at least thirty minutes a day throughout their

schooling experience.

As schools implement the Progressive Physical Education program, they also will need to

adhere to a nationwide school meal plan. The meal plan will be similar to Michelle Obama’s

Healthy, Hunger-Free Kids Act but with a few exceptions. The U.S. Department of Education

will be tasked with creating this plan with a focus on certain staple food groups that must be

present in school meals across the country. The challenge would be finding meals that are

nutritious and appealing yet healthy. All meals would need to contain more whole grains, milk,

fruits, and vegetables while cutting down on unneeded added sugars and fats.22 The meals would

contain leaner meats and poultry as well as fat-free or low-fat milk products. Snacks provided in

the schools would be replaced with healthier options, like vegetables and hummus, so as to avoid

extra calories.23

This nationwide meal plan would be presented alongside the National School Lunch

Program (NSLP) as before.

Seeing as NSLP is a

federally assisted meal

program, it should be able to

provide schools with low-

cost or sometimes even free

lunches for children during

the school day. This could

help allocate funding for Figure 4. Healthier Snacks are More Beneficial to Students.
students and schools in poorer areas that can not afford healthier meal options.24 According to the

program, “Children from families with incomes at or below 130% of the poverty level, and

children in families receiving Temporary Assistance for Needy Families (TANF) and children in

families receiving food stamp benefits are eligible for free lunches. Children in families whose

income is between 130% and 185% of the poverty level are eligible for reduced price lunches”.25

Through these two programs, students should find that they are eating healthier and should see

significant improvement in BMI averages.

Disadvantages

While the new Progressive Physical Education program has its benefits, there are a few

problems that could arise from its application. This program may be difficult to implement in

every school, as it can be hard to allocate thirty minutes of time for physical education out of an

already packed school day. However, if students and parents were to see the value of the program

and remain motivated, physical exercise could become less of an added feature and more of a

necessity in a school day.26

Similarly, it may cost more money to hire teachers who are more qualified to teach

physical education in schools. Not every school has the proper funding needed to hire specialized

PE teachers, so the role of educating students may fall on one or two individuals. This can never

be fully rectified, but more money could be provided to these schools if they need it under the

Public Health Service Act. Similarly, this issue should be less prevalent in high schools as

students are more likely to need supervision rather than further instruction for most PE classes.27

One drawback to the newer meal option program is that students may find the school

lunches less attractive and choose to pack their own lunches with unhealthier options instead.
This is something that cannot be controlled as it is a student’s every right to bring their own

lunch if they wish to do so. However, if the lunches were appealing enough while remaining

healthy, students would probably still choose to buy them. It is impossible to change the eating

habits of every student across the country, but the newer meal plan could help millions of

children.28

A Healthier Lifestyle for Children

The recent threat associated with being overweight during the Covid-19 pandemic has

revealed how important it is to combat obesity. While this may be a difficult lifestyle change for

most adults, children are at the prime age to learn from society’s mistakes. Attempts have been

made to combat childhood obesity in the past, however, many of them struggled to create a

lasting system that both educated and helped students to practice ways to live healthier lives. By

proactively declaring childhood obesity as a Public Health Emergency and reforming physical

education and meal plan programs, childhood obesity may begin to see a decrease in the long

run. However, the government can only do so much to combat this health issue. It is up to the

parents and schools to ensure that their children understand both the importance of combatting

obesity and how to do so. If done correctly, the United States will not only be able to stand

stronger against illnesses like Covid-19 but will be healthier as a result.

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obesity-102.

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19.html#:~:text=Obesity%20Worsens%20Outcomes%20from%20COVID%2D19&text=Having%20obesity%20increases%20the%20ris
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4 “Obesity and Heart Disease.” Beaumont, Beaumont Health, https://www.beaumont.org/conditions/genetic-factors-of-obesity.

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6 Roblin, Lynn. “Childhood Obesity: Food, Nutrient, and Eating-Habit Trends and Influences.” National Library of Medicine, U.S. National
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14 Kenney, Erica L, et al. “Impact of the Healthy, Hunger-Free Kids Act on Obesity Trends.” Health Affairs, Project HOPE: The People-to-
People Health Foundation, July 2020, https://www.healthaffairs.org/doi/10.1377/hlthaff.2020.00133.

15 Press, The Associated Press. “A New Study Offers Hints That Healthier School Lunches May Help Reduce Obesity.” NPR, 15 Feb. 2023,
https://www.npr.org/2023/02/15/1157176728/healthy-school-meals-nutrition-obesity-study.

16 Hester, Miranda. “Did the Healthy, Hunger-Free Kids Act of 2010 Improve School Nutrition?” Contemporary Pediatrics, 31 July 2020,
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17 Massachusetts Emergency Management Agency. “Public Health Emergencies.” Mass.gov, Commonwealth of Massachusetts,
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18 Ayton, Agnes, and Ali Ibrahim. “Obesity Is a Public Health Emergency.” The BMJ, British Medical Journal Publishing Group, 13 Sept. 2019,
https://www.bmj.com/content/366/bmj.l5463.

19 Cordeiro, Brittany. “10 Tips to Get Kids to Exercise.” MD Anderson Cancer Center, 1 July 2009,
https://www.mdanderson.org/publications/focused-on-health/tips-to-get-kids-to-exercise.h17-
1589046.html#:~:text=Kids%20like%20to%20have%20fun,friends%20to%20join%20the%20activity.

20 Cordeiro, Brittany. “10 Tips to Get Kids to Exercise.” MD Anderson Cancer Center, 1 July 2009,
https://www.mdanderson.org/publications/focused-on-health/tips-to-get-kids-to-exercise.h17-
1589046.html#:~:text=Kids%20like%20to%20have%20fun,friends%20to%20join%20the%20activity.

21 “Physical Education Teacher Evaluation Tool.” National Association for Sport and Physical Education,
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22 “National School Lunch Program.” Food and Nutrition Service U.S. Department of Agriculture, https://www.fns.usda.gov/nslp.

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