September 23, 2012 from WAMU
One in three children in the United States is
overweight or obese. Significant numbers of those young people are
grappling with health problems like heart disease, high blood pressure
Those conditions can be
difficult for children to manage in any setting, but they can pose
particular challenges for children during the school day.
Yolandra Hancock used to be an elementary school teacher, and it shows.
She's patient, encouraging and has an endearing way of ending her
sentences with "my love" and "my sweet."
patients include a 13-year-old who weighs 400 pounds; a child whose
teeth are so rotted she can't bite into carrots; and many preteens who
are diabetic. Today, Hancock is examining Derek Lyles, 13. He's 4 feet
11 inches and weighs 256 pounds.
look at his body mass index, which is how well his weight and height
balance out, his BMI today is 46.7," Hancock says. "For an adult male,
we like to see a BMI of 30 or less."
Hancock is also troubled by dark patches of skin around Derek's neck.
little ones, especially around the back of the neck, have that sort of
thick, almost velvety appearance to their neck, it means that their
bodies are becoming less sensitive to insulin," she says.
checkups for patients like Derek mean lots of follow-up work for
Hancock. Their belly fat pushes down on their bladders, so she'll have
to write notes to principals, asking that her patients be allowed to go
to the bathroom frequently. She must also draft requests to excuse
children whose sleep apnea makes them appear drowsy in class, or whose
joints hurt as they walk between classes.
Practical Challenges, For Kids And Schools
accommodations also mean more work for schools, says Camille Wheeler, a
nurse at Bell Multicultural High School in Washington, D.C.
a lot. It really is," Wheeler says. "It takes a lot for the student,
for the nurse, the parent and the school. Especially the school. Because
the majority of the time the students are here, you know?"
says it's not unusual for a child to arrive at school at 8 a.m. and
depart at 6 p.m., depending on a family's aftercare arrangements.
"That's a large chunk of their time," she says.
On a recent afternoon, Wheeler is thumbing through stacks of paper, racing to process students' health information.
have a whole stack here of many, many health certificates, dental
forms, health records," she says. "It's about well over 200 forms in
here, and I'm getting them daily."
the forms are related to obesity. Children with diabetes need midmorning
snacks. Some are on special diets and some need medication. All this
means time away from the classroom.
not be in the forefront, like a broken bone for example, but it's there
and it affects the students every day," says Shirley Schantz, nursing
education director for the National Association of School Nurses.
says that nurses from across the country are increasingly calling her
organization, asking for guidance on how to deal with childhood obesity
in schools — even preschools.
"They see students that can't walk upstairs,"
she says. "They see students that are absent because they're overweight
or obese, [who] don't want to go to physical education."
physical aspects of living with obesity can be difficult enough for a
child. But there's an emotional toll, as well. Bullying is a common
problem for obese kids. Derek says other students often called him fat
in middle school.
Taking A Toll On Learning
these challenges can also affect learning. Dr. Hancock says there is
evidence that children who are obese score less well on standardized
tests and basic classroom tests.
researchers believe that there may be something physiologically that's
affecting the child's ability to learn," Bell says. "Others believe,
because of self-esteem issues and bullying, it makes them less eager to
attend school and participate in school activities."
Derek wants to lose weight so he can "walk fast like other kids." And he really wants to start playing football again this year.
training camp, I couldn't do most of the, like, exercise that other
people was doing," Derek says. "I just couldn't do it."
many obese children, even maintaining their weight when they're not in
school is challenging. This summer, Derek could eat whenever he wanted,
and the fridge was always stocked with food. At school, he says, he ate
cereal or a muffin for breakfast. But over the summer, he often ate
sausage and eggs. The pounds piled on.
Hancock hopes eating meals at school will help Derek get his weight under control. She embraces Derek as she says goodbye.
right, handsome, give me some hugs," Hancock says, embracing Derek. "I
have faith you'll be able to make changes, because you've done this
As Hancock reminds her young patient, it's a brand new school year — an opportunity to start fresh.