Walk into just about any public high school in the U.S. and you will see a lot of the kids overweight or obese. In fact, 40 percent (!) are. This disturbing finding has not gone unnoticed in the White House, where First Lady Michelle Obama has initiated the "Let's Move" campaign with its critical message that obesity is bad for our children's health, right now and into the future. But there is another message that has not yet reached the Education Secretary, Arne Duncan, or other educators seeking to improve education in this country: that message is that being overweight or obese interferes with a young person's ability to learn at school.
Last year I reported on an innovative program in a small group of public high schools in New York City, called The BODY Project (Banishing Obesity and Diabetes in Youth), that was screening students for excess weight, prediabetes and brain functioning. (Watch a video about the project here.)
More recent information from the The BODY Project shows that obese youth have problems with reading and arithmetic, memory, attention, and decision-making. Imagine how learning, and consequently school performance, will be impaired if you are having trouble in these essential areas of brain functioning. And, by the way, the more overweight youth are the more they experience the medical consequences of obesity, and the greater the difficulties they have in all these areas of cognitive functioning.
With so many children in our schools having trouble with exams, scores on standardized exams, staying in school and graduating, maybe there is a cause we have not adequately recognized, or done anything about?
These overweight youth show specific problems with insulin (they are prediabetic); too much bad cholesterol and too little good cholesterol; and high blood pressure. The heavier a child is the more likely he or she will be to have the medical problems associated with obesity, namely sugar, cholesterol or blood pressure problems. Kids who are not overweight do not have these problems (with rare exceptions). Youth of color and living in poverty are the most at risk — no surprise — thereby potentially interfering with the opportunities that education provides them to escape their circumstances. But their fate is not sealed because we can reduce their risk of pre-diabetes, bad cholesterol and high blood pressure. We can do something about the medical problems that are impairing their brain function, the problems that make education their nemesis, not their friend.
What can be done?
We do vision exams because kids who cannot see cannot succeed in school. By the same logic, we need to test for the medical problems caused by being overweight: abnormal fasting blood sugar and insulin levels, good and bad cholesterol and high blood pressure.
When students and their parents “know their numbers” and the consequences of those numbers, they are more likely to do something about them. High school students are old enough to feel empowered to take responsibility for their health and education — when we give them that chance. And they can see the results of their efforts as their health measures improve. We also get away from the horrors of calling kids “fat,” which does nothing for their self-esteem and has not been effective in reducing weight. People of all ages understand and are motivated to manage their numbers (and doctors' practices are all about managing numbers like blood pressure, blood sugar, cholesterol, and a growing number of other measures of health and illness).
The BODY Project, developed by Dr. Antonio Convit, is actually doing something about improving the health and school performance of kids in New York City schools. First, all kids in the schools where they are working have their height and weight measured (these are the two measurements that give us the BMI, or body mass index).
Students with high BMIs are selected for the project because they are most at risk for sugar, cholesterol and blood pressure problems — and thus for problems with reading and arithmetic, memory, attention, and decision-making, problems that can impair school performance. Parental consent is obtained for these students, with their interest and support, so that Dr. Convit's team can take their blood pressure, sugar, insulin and cholesterol levels.
All kids get a user-friendly report of their medical results. The report illustrates, in English and Spanish, their results in a green, amber or red chart. Green is good, amber is a warning and red is bad. In addition, the entire family is instructed in what simple measures they can take to improve health — lifestyle changes in food, activity, and smoking. Lifestyle changes are more likely to happen when there are abnormal numbers to inform and motivate change. In addition, those students with red results are contacted at home through their parents and encouraged to take action and see a medical professional.
Results
The BODY Project is reducing weight, blood pressure, bad cholesterol, and improving insulin functioning in those students it is serving. There is emerging evidence that the problems with brain functioning improve as the medical problems associated with obesity improve, as the student loses weight and becomes fitter.
The BODY Project is also measuring school grades and brain function to see if those get better too — though results are not yet in. But if it were your child, what would you do? Would you wait, or maybe look for a way to help now?
Disclosure: Dr. Sederer is Acting Director of the Nathan Kline Institute for Psychiatric Research, the site of Dr. Convit's research (in conjunction with the New York University Langone Medical Center).
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Originally published in the Huffington Post on April 4, 2011
The opinions expressed herein are solely my own as a psychiatrist and public health advocate.
Visit Dr. Sederer's website at www.askdrlloyd.com — for questions you want answered, reviews and stories.
