Hope For Teens Struggling with Severe Obesity
Childhood obesity has increased seriously in the last decade and has reached crisis levels, according to the American Academy of Child and Adolescent Psychiatry. Approximately 12.7 million, or 17 percent, of children and adolescents are obese. Overweight children are much more likely to become overweight adults unless they adopt and maintain healthier patterns of eating and exercise, notes the group. The disorder is also one of the easiest to recognize, yet most difficult to treat, according to AACAP.
Lacey Tomaiolo, a Shrewsbury teen, knows well the struggle with weight. Overweight most of her childhood and adolescence, she became increasingly frustrated as her own individual efforts made little difference in the long term.
“No matter what I did to lose weight, my results were never successful,” said Tomaiolo, who eventually decided to seek help at Good Fit Teen Weight and Wellness Clinic, located in UMass Memorial Children’s Medical Center.
“When I decided to join the clinic, I was nervous in the beginning, but very excited,” she said. “I started off by going in for monthly appointments to meet with each team member, to come up with new meal plans, exercise routines, which helped me get on track for doing these things regularly.”
Good Fit has been serving teens in Massachusetts for close to four years and was created specifically for adolescents who are struggling with obesity and its side effects. The clinic pairs patients aged 13-18 with a multidisciplinary team that helps them create and reach personal goals while decreasing their risk for developing medical health problems. Their six-month teenage obesity treatment program is designed for patients with a Body Mass Index (BMI) over 35 and who are seeking to focus on the importance of lifestyle changes, including healthy nutrition and physical activity in the battle for weight loss.
“It was clear to me we have severe obesity epidemic in our community,” said Dr. Jennifer Bram, medical director of Good Fit. “When you are on front lines seeing patients daily, you have an idea of needs of community. I became more aware of treatment options for kids battling severe obesity. There really was nothing else in community for kids struggling with this severe form of disease. When we started there were limited options for these kids and this was borne out of a feeling that we had expertise and the ability to offer more treatment options.”
Through Good Fit, Bram is partnered with Katherine Bailey and Jeremy Aidlen, both pediatric surgeons who perform bariatric surgeries on patients who choose to pursue it as part of their treatment program. The clinic was also inspired by the stories of patients coming to an already established weight loss center at UMASS for adults who would report that also had other family suffering at home.
“We had adults come in frequently and say ‘I have a teen struggling. I don’t want them to have to wait 20 years to have a surgery,’” said Bram.
Ultimately, it was surgery that helped Tomaiolo turn her own corner in her weight-loss journey.
“I was at the point with myself where I knew that I wasn’t going to lose weight as quickly as I wanted and the amount of weight I had to lose seemed beyond my capabilities,” she explained. “After talking with the team about pursuing the surgery, I thought that it would be the best thing for me, and I was exactly right.”
Now down more than 100 pounds, Tomaiolo says the surgery has been life changing, but her success would also not be possible without the behavior and lifestyle changes she learned through her work at the clinic.
“Throughout this process, I’ve learned that sweets, junk food, and all that other bad stuff is not worth eating,” said Tomaiolo. “Reading nutrition labels on foods, and seeing how much sugar is in these products, makes me not even want to look at it. The food you’re consuming may taste good in that one moment, but that temporary satisfaction is gone in the next minute. Viewing it in that perspective, I learned to cut all of that unhealthy food out.”
Bram says in addition to lifestyle changes, it is crucial for family to be involved in a teen’s weight loss journey in order for them to reach their goals.
“Teens, while they are developing independence, really function best in the context of family,” said Bram. “It is important for family to be engaged, and front and center, in their treatment. We make an effort to ensure the caregiver is really involved and we incorporate them into the treatment plan. While teens need to be recognized as the center of the plan, we know most are not buying the groceries. It’s really critical that family be involved in process.”
Bram advises any parent with a child or teen struggling with obesity to start with a discussion with their pediatrician to discuss appropriate next steps for tackling the problem. Obesity, she noted, needs to be viewed as a disease that needs treatment, and most who struggle with it have already been subjected to hurtful comments, so the language used in approaching it is also important.
“Weight-based bullying is one of the worst kinds of bullying globally,” she said. “Many kids are teased and humiliated at home and at school. Be careful about the language you use when talking to your teen about their weight. Frame it in the context of health. Let them know ‘If we do this work, it is going to prevent you from developing diabetes.’ Don’t focus on the scale, but on healthy habits. Even if they don’t lose a pound, they are still going to be healthier. “
Talking about weight can be a tricky thing for parents. Dr. Jennifer Bram offers these five tips to help guide the conversation.
1. Be mindful of your words. In general, it can be much more helpful to talk about “healthy habits” with kids rather than “weight.”
2. Frame the issue as a family problem and ask for the child’s input. For example, “It’s really important to me that everyone in our family keeps their bodies healthy. What do you think we could work on together to keep us all healthy?”
3. Do an environmental scan as a family – what things in your home encourage healthy habits? A reusable water bottle for each family member, fresh fruit on the counter where people can see it, simple exercise equipment like resistance bands or yoga mats are examples. What things don’t encourage healthy habits? TV in bedroom, junk food on counter, soda in fridge, etc. Try eliminating some of these less healthy cues and increasing some of the healthy ones.
4. Work on a meal plan together as a family where everyone has input and responsibilities for what is prepared and served. Don’t introduce it as a “diet.” Have older kids search for online recipes. Every meal prepared at home will have more nutritional value over takeout or fast food. Getting kids involved in this process is critical for long-term success.
5. Set goals that are achievable and track those goals together. For example, a goal could be to prep three meals for the busy weeknights on Sunday afternoon so we won’t need to order pizza. When you achieve your goals talk about that success and what you can do next to sustain and build on it.