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Obese Children Miss More School Days

Teasing, health woes may contribute, researchers say

FRIDAY, Aug. 24 (HealthDay News) -- As children get ready to head back to the classroom, a new study finds school absenteeism is higher among overweight kids.

Obese fourth-, fifth- and sixth-graders miss an average of 12 school days over the school year -- about two days more than their normal-weight peers, according to research published in the August issue of Obesity.

"This is the first study of its kind," noted study author Gary Foster, director of the Center for Obesity Research and Education at Temple University in Philadelphia. "We're not saying that obesity leads to absenteeism, but whatever the relationship is, mathematically, as more kids get obese, more will be absent. That has lots of academic implications."

Foster and his team looked at 1,069 fourth-, fifth- and sixth-graders in nine inner-city Philadelphia elementary schools. More than 80 percent of these children were eligible for free and reduced-price lunches.

Homeroom teachers recorded the student's attendance for the school year, and the youngsters' weight was measured in the second semester. The kids were put into one of four weight categories: underweight, normal weight, overweight and obese.

The study found that obese children were absent significantly more than normal-weight children: 12 days versus 10 days over the school year. Even after the researchers adjusted for age, race/ethnicity and gender, obesity was still a significant contributor to the number of days a student was absent.

"This study suggests that it is possible that obesity prevention programs could have the effect of improving school attendance in addition to reducing weight-related health risks," said Dr. Thomas N. Robinson, an associate professor of pediatrics at Stanford University and director of the Center for Healthy Weight at Lucile Packard Children's Hospital at Stanford. "If obesity prevention also increases school attendance, even small improvements may produce very large benefits across the population as a whole."

The researchers don't know why obesity and absenteeism are linked, but Foster said the reasons are more likely to be psychosocial than medical, since there aren't as many medical issues at this young age. That said, childhood obesity has been linked with health problems such as asthma and type 2 diabetes.

"The most immediate problem for obese children is the reduced self-image and insecurity caused by explicit teasing or implicit disapproval from peers, parents and other family members," said Dr. Michael Dansinger, an obesity researcher at Tufts-New England Medical Center. "Obese children are often teased and bullied by other children, and this could certainly lead to extra days of missed school. Excuses for staying home from school become much easier to find if school is often unpleasant or scary," he said.

Foster suggested that future studies look more closely at the relationship between obesity and absenteeism, particularly since this is the first study to discover the correlation, and the study has some limitations. For example, even though the two extra days of school missed are statistically significant, it's unknown if they will have a great impact on a child's academic performance.

The researchers were also unable to show how obesity and school absenteeism were linked. This is partially because the children's weight and attendance were not recorded over time, Dansinger said.

"The researchers were unable to rule out the possibility that an underlying factor, such as relatively high or low family income, was a contributing cause of both obesity and absenteeism," he said. "Also, the researchers studied only inner-city children, a group with relatively low income and relatively high rates of absenteeism regardless of body weight. The link between obesity and absenteeism may differ somewhat for suburban, rural or private schools."

Still, the findings may encourage parents and the school system to work harder to keep children's weight in check. Foster recommends that parents be good role models, limit TV time, and create a healthy environment, including healthy eating and lots of physical activity.

"This study is just one view of the tip of the iceberg in which childhood obesity may have much more far-reaching negative effects on our society than any of us can imagine, and it should trigger us to be even more vigilant in finding solutions," said Robinson. "If more school absences are occurring now, these cannot be made up for in the future, and we may be losing a generation or two while waiting for action."

More information

For more on childhood obesity, visit the Obesity Society.

SOURCES: Gary Foster, Ph.D., director, Center for Obesity Research and Education, Temple University, Philadelphia; Thomas N. Robinson, M.D., M.P.H., associate professor of pediatrics, Stanford University, director, Center for Healthy Weight, Lucile Packard Children's Hospital at Stanford University, Palo Alto, Calif.; Michael Dansinger, M.D., obesity researcher, Tufts-New England Medical Center, Boston; August 2007, Obesity

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