With one in three children in the U.S. now classified as overweight or obese, there's an increasing focus on helping overweight kids navigate challenging environments — in particular, the school hallways and classrooms. One person working on this goal is Dr. Yolanda Hancock, a former elementary school teacher, whose patients need guidance on how to navigate the unique challenges that come from being an overweight student.
Kavitha Cardoza, writing about Hancock for NPR, explains that her patient list includes children are 12 and younger who have the body mass index as high as 47. On the day Cardoza visits her office, Hancock is examining a 13-year-old boy who weighs nearly 260 lbs and whose appearance indicates that he is pre-diebetic.
Back-to-school 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.
The effort behind these accommodations don't just fall on the students, but also on their schools. Camille Wheeler, who is a nurse at Bell Multicultural High School in Washington D.C., says that making sure that all students, including overweight ones, function well requires a combined effort from the students, their families, the medical and the instructional staff — and even school administrators. Due to the fact that the school is where students spend the majority of their waking time, in some ways the task before the school staff is greater even than for the children's families.
Wheeler 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.
"I 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."
Increasingly, these forms have to do with issues arising directly from children's weight such as insulin shot schedules for those with diabetes and special diet-related instructions for those on a doctor-monitored diet. Shirley Shantz, the nursing education director for the National Association of School Nurses, explains that even as medical staff in schools are looking to get educated on ways to deal with overweight students, there are a limited number of places they can turn to for advice.
Shantz 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."