The rate of obesity among children is skyrocketing—and this is something to worry about. After all, as you might expect, obese children are at a higher risk for diseases such as diabetes, arthritis and heart disease.

But there are some other things that you might not know about childhood obesity and its implications.

1. For example, did you know that…by the age of four, one out of every five children is obese? Yes, a full twenty percent of children are obese by the time they are four years old.

2. Obese children also tend to have low self-esteem, poor grades, and are less likely to attend college (particularly girls).

3. Children from low-income families and those of Hispanic, African American and Native American heritage are at a higher risk of falling prey to obesity.

4. Poor diet and lack of exercise are the two main culprits. Simply put, sedentary behaviors are on the rise. The average American youth watches 1,500 hours of television per year and they go to school an average of 900 hours per year – the math right there should tell you something about where our kids are learning the most, and how it is being absorbed.

During the 1500 hours of television watching, experts tell us that children are mostly eating high calorie snacks. Additionally, American society is riddled with fast food, refined foods and processed foods that calorie laden. Is it any surprise that so many children in this country struggle with their weight?

5. Television and other activities at home are not the only factors to blame, though. Our K-12 schools are also playing a role in the rise in obesity and unhealthy lifestyles among kids. To start with, many schools lack physical education programs, with a mere 4 percent of elementary schools, 8 percent of middle schools, and 2 percent of high schools offering daily physical education.

6. Perhaps the oddest point when it comes to the rising rate of obesity is this: American culture teaches children that thin is better, and that you simply cannot be too thin. Rising rates of anorexia and bulimia among young women and men are the result of poor messages about body image that children frequently hear. These eating disorders generally begin between the ages of 11 and 13, particularly for girls. In fact, nearly half of all girls from grade 1 to grade 3 want to be thinner. The top wish for girls ages 11 to 17 is to lose weight.

Obviously, messages American children receive from the media and society in general need to change. Young girls learn that to be attractive and to be a success, you must be thin. Boys receive similar messages and learn that thin and muscular is the preferred body type. As a result, boys as young as 10 years old are bulking up at the gym and many young men are taking steroids to build muscle, at great detriment to their overall health.

So on one hand, children learn that they need to remain thin to be attractive and successful. But on the other hand, they do not have the resources to establish healthy eating habits on any level – and schools are really no help.

For schools to really get behind a healthy approach to body image, diet and exercise, an atmosphere that promotes acceptance of self and the importance of overall health should be established. Classroom and learning materials should portray different body types and images. Ensuring students know a thin body isn’t necessarily a healthy body and that healthy bodies come in all shapes and sizes is also important. It is not enough to simply tell them though; students need to be equipped with healthy lifestyle tools to make the right choices when they are on their own.

What do you think we as Americans do to better address both the obesity and unhealthy body image issues that run rampant among K-12 students? Please leave a comment in the comment section below—I would appreciate hearing your thoughts.