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Getting Treatment
Weight has been a struggle for my son for years— probably since he was about 9. For my daughter, it’s been a struggle for the past year or two. Once she reached puberty, she put on a few pounds. Because of her height, if she could lose 15 or 20 pounds she’d be okay. But especially because of her hypertension, I don’t want her to fall into a habit of putting on weight every year. I see it coming now because of what happened with my son, so I can try to do something to prevent it.
As my daughter was beginning to get older, she was getting heavier. Both her father and I have had weight issues, and I did not want my daughter to have them too. There is also a history of diabetes in the family and I did not want that for her. So when she was starting to be off the charts at the doctor’s office, our pediatrician recommended we start a weight loss program.
Seeing her benefit from the program and her increased exercise has helped. And knowing that we are teaching her to be healthy and to take care of herself and her health feels good. I know she will have these skills all of her life.
Carrie gets all of her papers together before her appointments. I try to keep her involved in the program so she feels she has a say in what happens. I have also changed our rewards to things that have nothing to do with food.
If you can, you should definitely talk to a nutritionist. Inform yourself about what is healthy and what is not, because I think a lot of people have the wrong ideas. Try to keep healthy food around and not junk food, because having junk in the house makes it much harder on the child and it’s not fair to them. Besides, it’s a good idea for the whole family to eat healthily. I carry a lot of guilt and I think it’s easier for me to say to somebody else, “Don’t do that” and “Don’t give up.” Weight loss plans can be very frustrating for you and for the child— it’s hard!
I would say that our nutritionist has been helpful in making up food plans specifically for my daughter. One thing that I was apprehensive about initially and found somewhat stressful was people assuming that we took her to fast food places three times a week and let her sit in front of the TV and eat bags of chips and donuts. We’re somewhat educated about healthy foods and haven’t fed her that way, although we’re certainly not perfect. The fear of being judged as parents was stressful.
Try to let your children know that you’re taking them to the clinic because you love them, you’re concerned about them and you want them to be happy, and that it’s worth giving whatever it is a try. There’s nothing to lose, and you may end up healthier and happier. Hopefully that’s the goal, and that’s what will happen. But I think you have to convince them of your own motivation, and suggest that they may actually feel better, and not just feel miserable.
It was actually Melissa’s pediatrician who prompted us to seek treatment. He noticed at her checkup that she had gained an incredible amount of weight. She was off the charts for both height and weight, but he was more concerned about the weight. He asked us to try to cut back and to follow up in three months, but when we did there was actually another increase in her weight. So then he recommended the clinic.
My daughter always looks forward to [weight loss] clinics. Even when we know that we’ve had a bad couple of months, we go every 6 weeks, unless we have to cancel or something comes up; over the summer, we had to skip a clinic because we were away. My daughter will say, “I know, Mom, that I didn’t lose weight this time. I hope I grew a lot so I can get a prize. I’m really going to try next time.” That’s her attitude. So she’s really adjusted well to the program, I think. I’m lucky.
Take the clinicians’ advice with an open mind, because they’re really trying to help. Try not to blame yourself or take what they say as if they’re blaming you, because they’re not. I know that they’re not. I think that if you can have an open mind, it’s only going to help your child.
Korey’s pediatrician saw some black spots on the back of her neck, and he thought they might have contributed to other health factors. So we took her to an endocrinologist. They did some testing and her results came back showing that she has insulin resistance, which means she has a high risk of developing Type II diabetes down the line. We didn’t want for that to happen, so they referred us to a doctor in the [weight loss] clinic. Since then, my daughter has lost just shy of ten pounds, she has become more active, and her eating habits have totally changed. Her nutritionist put her on a diet with hardly any sugars at all. Korey has just made fabulous headway. As a matter of fact, the other day she was choosing a snack, and I said, “Wow, her eating habits have totally changed,” because she picked something very healthy and good for her over junk when she had a group of friends over. I was very proud of her.
I certainly don’t want my daughter to develop Type II diabetes. So my husband and I are working to instill [better habits] in her. We were a healthy family to begin with, but after meeting with a nutritionist, we are on track a little bit better.
Don’t hold anything back from your clinicians! Be honest— completely honest. If you’re not completely honest and you can’t say, “Yes, he does buy candy,” or “No, we don’t buy the low fat yogurt,” it’s not going to work. It’s not as though the clinicians aren’t able to tell if you’re not being honest anyway.
Advice for a First Appointment I wish I’d kept a record of what he ate for a few days before coming in to my first appointment, to show the nutritionist. My advice would be, try to look back and see if there was any special incident during which your child ate more or less. That way you can say, “Sometimes when I see him get upset, I see him eat more,” or something like that. You should track that kind of thing: the times he’s eating, and any stresses that might be causing him to eat. Also, my son is very against change, so I’m going to mix his old cereal with a new one to get him to try it. Sometimes you have to get them out of the mode: “This new cereal tastes the same as the old one, but I don’t like it because I don’t like the way the box looks.” Some of the information we got was overwhelming initially. At first I said, “Wow, this is going to be really tough. Can I do this?” So I took in what I could about portion control and worked on that more than changing all of his foods and making a huge change in my shopping routine.
I just told my daughter that it was a regular doctor’s visit— a health issue. It’s more of a support source. I think of the clinic as a very positive thing; it’s a good resource for her. And they’re always nice; no matter what, they never put you down and say, “Why didn’t you lose weight?” There have been plenty of times when we’ve gained weight or not met our goal, but they’re always supportive. So I keep going, because when we don’t go, it becomes a problem. My daughter had met her goal, but then we didn’t go and she gained all of the weight back. Now we’re in a position where we’re having trouble. I really have to struggle with her over it right now, because unless she wants to commit to the plan, it’s very difficult. You have to look at every issue to see why it’s not working; you have to gear it towards the individual. So if my daughter wants certain things, I just say “You can’t. You just can’t. I’m sorry. That’s unhealthy, and this is the way to eat.” Teenagers can be easier because they are more conscious of how they look. My teenager is actually on the food plan too, and she doesn’t seem to mind it because her whole lunch table is doing it. They’re more conscious of how they look, whereas the younger kids can just put on a big sweatshirt and big pants. But my younger daughter has to understand that it’s a health issue; unless you want to be diabetic, you have to follow this.
Review the materials that the clinicians give you at your own pace. Don’t forget to refer to them. The nutritionist gives out a lot of good menus that you can look at if you get stuck. She also plays a game where half of your plate is supposed to be salad, and the other half is broken down into thirds. We usually keep that as a reference for how our plates should look— how much protein we need etc. If we’re having a bad day, we go back to that so that we can gain some control over a day that’s gone out of control in terms of eating and making healthy choices.
A few things prompted me to seek treatment for my child. She has always had a little bit of extra weight on, and when she got to be about 8, it started to become more pronounced. Also, her eating habits weren’t the greatest; she’s not a vegetable or fruit-eater, although she’s learning to be one. But the thing that concerned me the most was that she was getting into years when kids can get mean and I didn’t want her to have to deal with that; I want her to feel good about who she is. The other really important thing is that genetically, she is set up on her paternal side so that she will most likely struggle with obesity. I wasn’t quite sure if that was her issue, but if it was I wanted her to learn at young age how to grow up with that and be healthy. So for her happiness I wanted to see if something like this would help her.
Waiting until a Child is ready I knew about the program for a long time. I talked to her pediatrician about it several years ago, and when I read about the program in the newspaper, I wanted her to be a part of it. But I think you want to make sure that your child’s heart is in the program, and that whatever you choose to do with your child is something they want to be a part of. So I waited for Abby to tell me, “I would like to go and find out about the program.” Before that, I had told her that it existed and that if she was ever interested I would be happy to go with her; I would be her partner in this. That’s what I stressed to her: “I am your partner in this, and I’ll do as you do.” And then I try to set examples so that she will do as I do. Hopefully those are all helpful things. But I try very hard not to make the program the focus of our existence, or of her existence, because she’s still a kid and she needs to be a kid- to be happy and to do the things that children do. I don’t want this to be an obsession. So I waited for her and she did finally say, “Yeah, let’s do this.”
I think my daughter had only one teasing incident, and it was a mild incident- it was a comment. She told me about it, and it wasn’t a hugely traumatic event. I just said to her, “You’re a beautiful person and the child who said that to you is probably just as nice as you. But they don’t know what they are saying, and even if they do, it doesn’t matter what they are saying.” It wasn’t long after that that she asked to explore the program. I think we staved off the teasing; we came and started addressing things before it got to the point where it became a lot of terribly cruel experiences, and that was part of our motivation. But when I heard about that incident, I really prayed that she would want to do this, because I didn’t want it to explode and become an everyday thing.
Pre-program, he used to get very upset, nervous, and worried about getting on the scale, because the doctor really warned him to lose weight, and he was having a very hard time doing that. He didn’t have any set direction like, “You need to eat better and exercise more,” but the OWL program gave us direction so that we could complete the weight loss goal.
Obesity runs in my family, and I was by far the worst case. So when I noticed that some things with my son Greg were going in the same direction as they had for me, we wanted to just cut that out before it got any worse. He was putting on weight that was not proportionate to his growth as a boy; he was putting on weight faster then he was growing into it. We also noticed that he was eating a lot of carbs and that he was not really doing as much physical activity as we might have wanted.
I think the Optimal Weight for Life clinic is an opportunity to address issues that a child might otherwise have to deal with as an adult. I know that as a child I was taunted constantly because of my weight, and that was another thing that prompted us to pursue this opportunity for Greg— so he would not have to endure that. On the flip side, he actually goes to a private school; he is very happy there and there doesn’t seem to be a lot of ridiculing of students.
Reasons for Going to the Clinic We started taking Greg to the clinic because we were afraid that he might be experiencing some body image issues. Even before the OWL clinic, he was saying that he didn’t like how his stomach looked. He would look in the mirror and become discouraged, and we were concerned that he would become self-conscious. Greg has a similar body type to my husband’s, and we were scared that he might have some of the same issues my husband had.
I thought it was also helpful that the nutritionist went over with Greg what he likes to eat and incorporated that into his specific diet. She also went over good nutrition with him, but at his level, and that was really helpful. Even though he is six, he understands. Like when I say, “I don’t want you to have seconds on this because it has too many carbs, but you can have this,” he understands. At six years old he is able to understand health, and as he gets older his understanding is going become much greater.
He was about five when he started experiencing some teasing and we noticed that he was putting on weight. I felt incredibly depressed about that; I felt so bad for him. But what I said to him was, “You know what? Mommy and Daddy could help you with that— do you want some help becoming healthier?” At first we didn’t know where we could turn to. When he started saying he didn’t like the way he looked we knew that we needed to get help. When we asked him, “Do you want help?” he said, “Yeah.” And when we asked him, "Does this bother you?" he said, “It does.” So he saw the problem himself and wanted help. Maybe if he hadn’t indicated that he was troubled we wouldn’t have gone as quickly as we did; it might have been put off longer. We might have kept trying the low carb diet, but we really had a lack of understanding when it came to healthy eating. Without the clinic it was hard to stick to our diets. We were also unsure if it was dangerous to lower the carbs ourselves without a program; we were not sure if we would restrict him too much and he would get headaches. Sometimes he would be moody and we would worry that he wasn’t getting enough sugar. We just had some insecurity about doing it ourselves, especially when it came to the kids because we were not sure if we fully understood what he was feeling and experiencing. The OWL clinic made sure we were losing weight safely. |
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Hospital Boston Department of Psychiatry. All Rights Reserved. The information on this website should not be taken as medical advice, which can only be given to you by your personal health care professional. July 10, 2005 |
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