Elementary schools nowadays send notes home from the nurse, that your child is obese and it poses a health risk. I don't know for sure, but I'd imagine they do follow up of some sort, asking what you've tried to do. I have also read/heard stories in the past few months of Child Services removing grossly over weight toddlers from their homes. Its one thing being fat and active, another when you roll over in bed and start wheezing from the activity.