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Lloyd I. Sederer, MD

Lloyd I. Sederer, MD

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The Body Project: School Program Measures Obesity Right Along With Grades

Posted: 04/ 4/11 08:27 AM ET

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 (http://www.huffingtonpost.com/lloyd-i-sederer-md/obesity-linked-to-poor-sc_b_646747.html).

The Huffington Post visited the Norman Thomas High School in Manhattan to see how the BODY project works in real life. (Video by Hunter Stuart)

WATCH:


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 NYC 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 -- body mass index).

Students with high BMIs are selected for the project because they are most at risk for sugar, cholesterol and BP 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).

The opinions expressed herein are solely my own as a psychiatrist and public health advocate.

Dr. Sederer receives no support from any pharmaceutical or device company.

Visit Dr. Sederer's website at www.askdrlloyd.com -- for questions you want answered, reviews and stories.

 
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...
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...
 
 
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11:08 AM on 04/26/2011
The purpose of this article was not to attack people who are overweight or obese. The purpose of this article is to show how obesity in the U.S. is on a rise and ways in which we can reduce it. Students are without doubt more overweight and obese than ever before. For the first time ever, this generation of children are not expected to out live their parents. With this said, it is very important to screen children at a young age and discuss with them health and risk factors associated with being overweight. Studies have shown that being physically active helps increase cognitive knowledge amoung all subject areas. This article just proves the importance of having a quality physical education program in the schools because physical education class is more than rolling out the ball and playing sports all day. It is giving students the tools necessary in life to become healthy life long movers. Without quality physical education programs, the children of this country will continue to become more overweight or even obese.
10:18 AM on 04/26/2011
I was pretty shocked to read some of the comments below and find out that most of the people believe this is a stab at people overweight. As a future physical education teacher I take this article as a plus and a minus. I feel with the correlation found between people overweight and lower academic test scores is showing how important physical education is in schooling. The downside is physical education has been around and still there are overweight students and students who are becoming obese. As I move through my career a physical education should consist of activities that teach students skills or games they can use outside of the school to be active. Also a well run physical education should focus on cardio vascular endurance, muscle strength and endurance, and should inform the students of the importance of physical activity. So if a school has a well run physical education program students should start to see the importance of physical activity and schools who do not have physical education could possibly see a rise with numbers and lower test scores. By no means do I think a person who is overweight will automatically score bad on tests.
01:20 AM on 04/26/2011
I am a future physical education teacher and I was surprised that some people thought that the purpose of this article is to attack overweight or obesed people. This article is concerning a big problem which is backed up by reseach and projects all over the US.It does not say that this applies to everyone who is overweight.
Nobody should feel attacked but it is a reality that the US has a huge obesity problem and I think therefore it is a great idea to screen children early enough to intervene and also give their parents information about what consequences this lifestyle will bring with it. In fact a lot of parents are not aware of all health implications which will occur in the future as a result of being overweight and obesed. I am form Europe and the probably smartest people there are from schweden. Ironically, there is no obesity problem in schweden, that lifestyle does not exist.
Moreover, as Pat already mentioned TriFit and FitnessGram are great tools to assess the fitness of students and it also shows the parents problem areas and makes them aware of their negative impact on the child's development.
Physical Education programs should receive more attention and I am glad that this is another article which shows the importance of PE programs in school. What they learn in a PE classroom is important for their whole life and as important as maths and English today!!
01:52 PM on 04/19/2011
This article is great indicator to how the delivery of information can make a difference. As a future physical educator this is something that my profession deals with. Students are in fact more out of shape and unhealthy than ever. It is important to understand what contributes to living a healthy lifestyle. The stigma physical education class has is that all you do is play games, when in fact a properly run program educates students on topics of cardiovascular fitness, BMI, and blood pressure. There are programs similar to this that are used by some schools. For example FitnessGram and Tri Fit are both excellent programs that are used to assess student fitness and health. It shouldn't take a "project" experiment for a few schools to realize that this information actually is relevant to students. Physical education programs across the the country should contribute some money to make these available in the classroom. The public also needs to realize that physical education is not just playing games, its the process of learning how to become efficient and healthy lifelong movers. What is more important is that these are tools that provide learning for students. Not only do they become better educated about fitness, but as a result, as stated numerous times in the article, students perform better in other academic subjects. Without quality physical education programs, our youth weight problems will continue to be on the rise.
02:45 PM on 04/18/2011
I have to say that I am surprised at the comments and reactions based off this article. I do not think the purpose was to attack 'fat' people and accuse them of being unintelligent. I think it was just displaying that there is a correlation between being overweight and having difficulties in math, reading, memory and problem solving, which would affect learning. As a future physical and health educator, I think it is important that we educate our youth about where they are now and how they can improve their health at an early age so they will develop healthy habits for the future. As touchy as a subject this might be, I believe it needs to be addressed and ideas like the BODY project need to be implemented to reduce the current obesity rate in America.
11:20 AM on 04/10/2011
Hmmm, so my straight As through, high SAT score, genius-level IQ and Master's degree must be some kind of fluke.

Or maybe, this entire concept is just poppycock, someone's looking for a scapegoat and as usual, fatties are an easy target. Yeah, I'm going to go with that one.

How about actually helping people instead of just demonizing fat kids? I grew up as one and trust me, the other kids will take care of that all on their own without your "help."
02:57 PM on 04/19/2011
The purpose of this article is not to attack "fat kids". The purpose is to discuss the obesity epidemic on the rise in the US and ways in which we can overcome it. It also explains how overwieghtness can be linked to less success in school. It has been proven that the more fit an individual is the more successful they will be academically. However, there are definitely exceptions to this finding, as in any other research finding. The idea here is to promote physical activity and overall health. I understand that the link to being more successful in school is not appealing to you. However, maybe you can think of it this way...the more physically fit you are the longer you will live. Physical education is an area which is focused on that idea. Our job as physical educators is to promote life long fitness and wellness techniques. We want our children to live long, healthy lives. Our content area is constantly being threatened to be removed from schools, by using the research to prove that PE helps improve students academic performance it helps our case to remain in the academic curriculum :)
01:26 PM on 04/07/2011
"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. "

Oh, THAT’s why I was only twelfth in my class of 700+. Come to think of it, the valedictorian and salutatorian were both thin girls. That’s totally it! Finally it all becomes clear to me!

Me and my second-master’s-in-progress can give up now, as my almost-4.0-GPA (while working full-time and parenting a small child) must be an illusion. Fat’s clearly making me stupid and always has.

Has anyone considered that part of the reason fat children might be struggling academically is that they're faced with constant bullying and, in many cases, struggle with self-esteem issues as a result?
11:33 AM on 04/06/2011
Einstein said, "Not everything that can be counted counts, and not everything that counts can be counted." Basic science textbooks say, "Correlation does not prove causation."

The Health At Every Size(SM) approach has been scientifically proven superior to the weight-loss approach. Weight-loss approaches inevitably reinforce stereotype, prejudice, discrimination, and stigma for fat people. Health At Every Size(SM) instead promotes social justice.

This program may have good intentions, but it runs the real risk of doing harm: psychological, physical, political.

In brief, Health At Every Size(SM) encourages people of all sizes to love their bodies instead of trying to lose weight. People are encouraged to follow internal cues of hunger and fullness, to eat a variety of nutritious foods. People are also encouraged to exercise joyfully, not out of duty or as punishment. In one piece of research comparing weight-loss treatment to Health At Every Size(SM) the weight-loss group saw no lasting weight loss, no lasting health improvements, and no lasting behavior change. The only lasting change was increased depressed and lower self-esteem. In the Health At Every Size(SM) group, people had no lasting weight loss, but they had lasting behavior improvements and lasting health improvements (bp, sugars, cholesterol).

Are we going to follow the scientific method? Or are we going to promote stereotypes?

A scientific approach would jettison the failed model of weight-loss interventions and adopt Health At Every Size(SM), an approach that celebrates weight diversity and actually improves health!
HUFFPOST SUPER USER
DrP
11:23 PM on 04/05/2011
Knowing what a high-carbohydrate diet did to my moods and mental functioning before I "saw the light,", it is no wonder that obesity is linked to lower grades. The blood sugar and insulin roller-coaster caused by dietary carbohydrate creates swings from mania to brain fog and mental "coma." I'm amazed I made it through grad school while I mistakenly following a low-fat, high-carb diet. My son had severe "ADHD" (although he was not overweight) that nearly wrecked his adolescence. It is so sad to ponder what he could have accomplished if I had restricted his carb intake as a child. Happily, he and I are both low-carbers now and enjoy excellent health with no more energy swings.
03:00 PM on 04/05/2011
Remove all the fattening and fast foods from the schools. Remove the soda vending machines. Provide better lunches. (Oh wait, that means the government has to provide more money for the school lunches, - which they won't) Instead of having milk breaks for kindergartners - provide vegetable breaks - or take turns with them. Sometimes the poorest of children do not get anything to eat that is nutritious unless it is at school. Some kids don't even know what broccoli is. Some don't know the difference between an eggplant and a cucumber! We can't blame the schools totally, but yes it is their fault too.

Let's face it. Pasta and bread are cheaper than veggies and fruits. Parents don't want their kids to be hungry and therefore will feed them what they can afford, and what they can buy the most of for their money.
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HUFFPOST SUPER USER
lauraly20017
San Francisco Bay Area, CA
02:59 PM on 04/05/2011
When I was in grade school they would bring me into the nurses office every week to weigh me and I had to give an accounting of all my food eaten that past week. I really didn't get what was going on back then because I was so little. All I knew was that I was one of three of my class mates that were singled out to have to go through this and the other kids made fun of the three of us because of it.
02:48 PM on 04/05/2011
Please refer to Harvard neuropsychologist, Dr. John Ratey. He wrote a WONDERFUL book entitled "Spark" that has tons of research linking aerobic activity and brain development. There are people who are "overweight" who run marathons. There are underweight people who are in deplorable shape. Yet the overweight have billions more neural connections due to their level of activity. The school system is going about it wrong, though. There are other schools (Naperville & others) that are growing brains without labeling kids. How? EVERY child is expected to spend 20-30 minutes per day in his/her cardio training zone. If you build the program so everyone can and is expected to be successful, you will have a successful program. There are elementary, middle and high schools that are showing HUGE gains in academics...and the only variable program that has been put in place is amazing phys. ed. where every child can succeed. Kids have gotten off ADHD meds. Folks have recovered from depression. Miracles happen. We started swimming laps daily with my son who is on the autism spectrum and has severe ADD as a result of attending one of Dr. Ratey's conferences. It has changed our son's life. Truly. Read his book.
07:58 AM on 04/05/2011
Wow, this sounds so counter-productive. I was an obese child but have been a very fit adult. I have a pretty high IQ and attained graduate degrees from prestigious universities. There are many contributing factors as to why kids are fat. But just weighing them and looking to see if they're stupid is, well, pretty stupid.

Rather than trying to find a correlation between obesity and academic performance, why not sponsor a gym where these overweight youngsters can learn how to exercise in a healthy environment, provide family counseling in both lifestyle and culinary choices to the child's family--All this without the taunting from the more physically gifted. Then measure their academic performance with their attainment of optimal health.

These kids already know they're fat. Why not provide a solution rather than feeding the stigma of which they already live.

This study just seems like a total waste of money and effort.
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HUFFPOST SUPER USER
NotEve
Facts are of no use against the irrational
01:27 PM on 04/05/2011
They're not "trying to find a correlation between obesity and academic performance," they're responding to an already identified trend.

These kids probably do know that theyre fat, but that doesn't mean they know what to do about it. The point of the program is to educate and inform them, and give them thre resources they need to lose wgt. Seems to me like a perfectly appropriate and reasonable intervention.
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gravity defiant
Maybe reality has a liberal bias.
01:59 PM on 04/05/2011
Because they're living under a rock? I hate to break it to you, but there is NO ONE in this country who doesn't know what to do about being fat. We ALL know. And yet 2/3 of the population is overweight. "Educating and informing" people obviously doesn't work.
07:27 AM on 04/05/2011
I'd like to know what evidence based studies show that tracking weight in the school system is beneifical. AND THEN - I'd like to know if there's an increase in the numbers of students diagnosed with an eating disorder. Before schools go messing around with stuff like this, they better make darn sure the students aren't susceptible to bullying, eating disorders, anxiety, depression. There's a big difference between checking eye-sight and reporting on weight.
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HUFFPOST SUPER USER
NotEve
Facts are of no use against the irrational
12:16 PM on 04/06/2011
By 'eating disorder' I assume you mean the classic examples of anorexia nervosa & bulimia. These are both very serious diseases with complex (and not completely understood) mechanisms of onset. Furthermore, why should you assume that an obese gradeschooler doesnt already have an eating disorder - but one that doesn't fit into your narrow stereotype?

But you also seem to be making an assumption that its better for these children to remain obese, which I completely disagree with.

Its better to treat the life threatening condition that they have, then to not treat it for fear of some statistically improbable development of a later condition.

Of course the intervention should be informed and designed to mitigate any future complications. But fear of MAYBE developing an uncommon eating disorder is not a good reason to withhold intervention of an existing, life-threatening condition.
GHO
Sooner or later you run out of other peoples money
04:10 AM on 04/05/2011
Thank God someone has come up with yet another way to make fat kids feel bad about themselves. Let's tell them that being fat makes them dumber than thin kids and weigh them right there in school. Swell.

While we're at it, it's also nice to see we've found yet something else ot make schools responsible for. Haven't parents already abdicated enough responsibilities to the schools? We just keep adding more and more that schools are to be responsible for, thus taking away time from the academics that schools are actually intended to teach.

Now making sure your children aren't obese will become the schools' responsibility too??
06:13 AM on 04/05/2011
Some weeks ago in the german TV came an UK report about IQ levels of pre-schoolers and 1-2 grade school kids. As far as I remember there were 20.000 participants and the study took several years. What they found out was that the kids who between the 3th and the 8th year ate more fast food ets.instead of homemade healthy meals, had at least 5 points less in their IQ charts.
I find it important that the issue should be addresed with facts instead of pushing it into emotional direction.Hopefully some kids will take the wake up call at school and won't feel dumber or bad about themselves later on.
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gravity defiant
Maybe reality has a liberal bias.
12:54 PM on 04/05/2011
F&F. You read my mind.

I meant to include your second paragraph in my comment, too. ;)