"That's what's most frustrating," he said.
"It's a public health emergency," PEIA's Henderson said. "These kids are at serious medical risk.
"When CARDIAC first began screening, a lot of people didn't believe the problem was that bad," she said. "Now it's hard not to see it."
"West Virginia children are developing adult diseases early in life because of their lack of physical activity, because of obesity and overweight," said Gina Wood, manager of the West Virginia Diabetes Prevention and Control Program. "That is frightening.
"Where is the public concern?" she asked. "We are very alarmed when our children and adults die of acute diseases like flu. But there doesn't seem to be the same amount of concern about the chronic illnesses that are easily preventable."
"Why aren't parents in the streets? If that many fifth-graders suddenly developed a deadly condition like bird flu, parents would be standing in courthouses all over the state demanding that something be done," said Sam Zizzi, West Virginia University professor of sports and exercise psychology.
"It's happening so slowly and invisibly, it doesn't make headlines," he said. "We've gotten used to it, but that doesn't make it any less dangerous.
CARDIAC also measures kindergartners and second graders. In 2010:
"The problem can start earlier," CAMC's Jeffrey said. "High birth weight babies are at risk. Babies that are not breast-fed are at greater risk of obesity."
West Virginia has the nation's lowest rate of breastfeeding.
Since 1998, CARDIAC had tested, on average, 43 percent of eligible children. Their numbers match those from the state Department of Education, said Melanie Purkey, director of the department's Office of Healthy Schools.
Chronic diseases associated with obesity eat up 70 cents of every West Virginia health care dollar, according to Thorpe, the economist who predicted the state's health care would doubt by 2018.
In that sense, the CARDIAC project measures the state's future financial risk.
Many doctors don't mention it
Every year, CARDIAC sends a letter to the parents and doctor of every child with high numbers. It basically says: Talk with your child's doctor and make a plan. If your child gets more exercise and eats a better diet and quits drinking pop, the numbers will come down.
How many parents took their child to the doctor, changed their child's diet or got their child up and moving? Nobody knows.
CARDIAC has surveyed parents, with limited success. One finding: Only 20 percent of parents of obese children said their doctor told them their child's weight could lead to diabetes and chronic disease.
Those findings echoed a 2011 national survey. In that survey, four in five obese adults said their doctor had not told them their weight threatens their health.
School nurses receive a copy of the CARDIAC findings, but no statewide policy requires them to follow up.
School nurses are overwhelmed with the duties they already have, says Becky King, who coordinates school nurses for the state Office of Healthy Schools.
"We have some hopeful signs," Dr. Neal said.
"Those are still terrible rates," Neal said of the fifth-grade numbers, "but at least they're not rising. It may mean we're doing something right."
In some ways, obese kids need a different kind of help than obese adults do, Dr. Jeffrey said. Kids need more physical activity during school and ways to be active after school, she said, an alternative to texting and video games. Counties need ways to build and maintain community centers and parks. "The whole community has to be thinking about this, for it to work," she said.
In Morgantown, Dr. Murray agreed. "Medical solutions are not the answer for most kids. We need ways to get them moving and get them eating a more healthy diet."
The Centers for Disease Control have predicted that one in three children born in 2000 would be diabetic by 2050. "It will be one in two in West Virginia if we don't do something about it," Neal said.
In 2011, CARDIAC collaborated with WVU and Marshall faculty to launch two major school research projects on ways to help obese children. CARDIAC staff also helped organize a state physical activity plan released in mid-January.
"I don't know what it will take to make real progress," Neal said, "but we're going to keep trying."
Reach Kate Long at (304) 348-1798 or katel...@wvgazette.com."The Shape We're In" was produced with the assistance of the Dennis A. Hunt Fund for Health Journalism, administered by the California Endowment Health Journalism Fellowships, a program of the University of Southern California's Annenberg School for Communication and Journalism.