In 2006, the university in Pennsylvania introduced its Fitness for Life programme with the aim of encouraging students to lose weight.
They demised that if a student had a body mass index (BMI) - a ratio of weight to height - of above 30, then they should take some college-sanctioned steps to show they had lost weight or at least tried.
These might include activities such as walking, exercises, various fitness games, etc.
If those who were assigned to take these courses did not complete them, they would not be allow to graduate. Similar in concept to United States high school "Exit Exam"...