Several factors contribute to the higher obesity rates in rural areas 23:

  • Limited access to healthy and affordable food related to the increased cost of trucking foods to rural areas;
  • Cost of gas for families to drive to local shopping centers;
  • Rural diets are higher in fat and calories than the average American diet;
  • Lack of nutrition information and nutrition programs;
  • Fewer opportunities to be physically active related to a lack of safe areas to be physically active (i.e. along busy highways);
  • It takes time and gas money to transport children to safe play areas;
  • Lack of funding to develop space for physical activity in sparsely populated areas;
  • Challenges related to community infrastructure, such as lack of sidewalks, trails, and exercise facilities;
  • Rural jobs tend to be more sedentary; and 
  • Poverty is more prevalent in rural areas. Twenty-nine percent of individuals living in rural areas live at or below the poverty level 23. Higher poverty rates in rural areas compound the childhood obesity problem.  Poverty is associated with the greatest prevalence of childhood obesity 4, 22.  In the lower socioeconomic class, the rate of overweight and obese children is 23% higher than that of the upper socioeconomic class 30.  In Wyoming, 28.2% of children on Wyoming Medicaid are either overweight or obese, while only 23.9% of children on private insurance are overweight or obese 26.


An effective home-based pediatric weight management program provides a viable solution to this dilemma. Positive Patterns for Life, LLC has developed such a program called Back in Whack.  This program was initially implemented into a pediatric clinic in rural Wyoming. Children and teens who complete the Back in Whack Program have successfully adopted healthier eating and lifestyle habits and have lowered their body mass index. It is not just the youth who have made healthy changes.  Whole families have adopted healthier eating and lifestyle habits as a result of the Back in Whack program.

Back in Whack is available in three different formats: 

  • The home-based program called the Back in Whack Home Pack; 
  • The blended program which combines clinic-based education and physical assessment with home-based education and follow-up phone calls; and 
  • The group program which utilizes the home packs in a group setting and comes with the Back in Whack Group Facilitator Manual.

Currently, a program through the Wyoming Department of Health is utilizing the home-based format of the Back in Whack Program and has been able to make the program available to children and teens across the state of Wyoming.

Click  HERE to learn more about the Back in Whack pediatric weight management program.

There is an absence of effective pediatric weight management programs in rural America 21, 23, 32. Many rural communities do not have the resources to address this critical health concern. Rural healthcare facilities are less likely to have nutritionists, dietitians, or weight management experts available to work with obese children and their parents 23

In the United States, 16.9% of children 2 through 19 years of age are obese 27. Rural areas experience higher rates of overweight and obese children than the nation as a whole. Children living in small rural areas have a 25% increased likelihood of being overweight or obese 21, 32. 

​In the absence of an effective obesity treatment program, 80% of obese children and teens will continue to be obese into adulthood 3. A large percentage of the severe, morbidly obese adults in our country have been obese since childhood 30.  Adults who have been obese since childhood, experience much more serious health consequences than adults who became obese as an adult, and they have increased mortality rates at younger ages 3, 28.

The obesity issue is so serious that experts predict that unless the trends reverse over the next several years, the current generation of American children will be the first to live shorter lives than their parents 28

Childhood obesity has a negative impact on a child’s quality of health and length of life. Leaving children in rural America without an effective treatment option for childhood obesity is not acceptable when you consider the consequences of untreated childhood obesity!! 

Click HERE to see a list of supporting references.

Providing Weight Management Solutions for Rural America

hEALTH AND NUTRITION EDUCATION SERVICES for FAMILIEs / childcare providers / ECE / healthcare providers