Stanford Medicine Newsletter Updates For the Local Community

 

Making weight loss work

A huge change, a new life

Sam Feldman, 11, made fun activities a big part of his weight-loss regimen.

   

Sam Feldman cocks his head, remembering a kid he used to know. The boy was self-conscious about his weight, and as a result he lacked self-esteem. He felt different from other kids.

That boy was Sam before he enrolled in the six-month, behavior-based Pediatric Weight Control Program at Lucile Packard Children’s Hospital. To say he changed would be a vast under-statement.

What the internationally recognized program offered Sam, 11, was a way to take control of his own health—something even many adults can’t manage. Starting at 48 percent above his ideal body mass index (BMI), the Palo Alto youngster has worked his way down to just 7.5 per-cent over his BMI. He says this shift was both monumental and surprisingly manageable.

“You see a huge change in your life, but the point of the program is that it’s slow-paced and pretty simple,” he said.

Program Medical Director Thomas Robinson, MD, MPH, said the team takes the best science about weight loss in children and makes it work with real-world families.

“Decades of weight loss research have taught us what works best,” said Robinson, who also directs the hospital’s Center for Healthy Weight. “The evidence is in our results. I have not heard of any other programs that come close to our participation and completion rates.”

Breaking bad habits

Like many kids, Sam and his family had tried various regimens in the past: low-fat diets; high-protein, low-carb diets; boot camp–type programs. But as Sam’s mother, Robin Feldman, said, “Those efforts were just one piece of the big picture and didn’t really make a dent.”

The big picture meant assessing not just what Sam ate but also how he spent his time.

“I would come home from school and watch TV, eat a junky snack,” Sam said. “Now I come home and play sports, and if I’m hungry, I have a whole-wheat quesadilla and some fresh fruit. I used to get very little exercise. Now I do two hours a day, including half an hour of intense cardiac workout.”

Sam Feldman before he started Packard Children's Pediatric Weight Control Program.

   

The essence of the weight control program wasn’t simply a collection of rules he had to follow blindly—it focused more on allowing him to see for himself how different patterns could make him feel better. In some cases, he went well beyond what the program asked of him.

“One of our assignments was to cut out my screen time for a week. No TV, no computer, nothing with a screen at all. That was a big thing, because I used to watch TV every day,” Sam said. “But it turned out it was really fun to turn off the screens. I got to do a lot more activities than I usually did, from reading to playing sports with my neighbors. So instead of just a week, I ended up going three months.”

Sam’s mother had some eye-openers, too. “The biggest surprise for me was learning about ‘habit foods’—all those 100-calorie packs, granola bars, frozen yogurt, things made with artificial sugar,” she said. “The theory is, you get in the habit of eating those, and then it just feels natural to go to McDonald’s and have a Big Mac and shake. It’s not that the program doesn’t let you have them, it’s that you learn to budget how much you have and try to cut down progressively.”

Of course, changing the contents of one’s pantry is just part of the solution. As Robin Feldman points out, there are sleepovers, birthday parties, holidays and trips to the grandparents’ house to contend with—all potential wildcards when it comes to the kind of food being served. “But the program really understands those challenges kids face,” she said, “so they help them develop strategies for those situations.”

The program has had widespread impact well beyond the Bay Area. “We get calls from other hospitals and clinics around the country,” said Program Manager Cindy Zedeck. “They want to know more about our success and how to establish their own programs.”

Zedeck and her team have hosted onsite visits from a Japanese hospital, and a team from India is planning a trip to learn more.

A new attitude

For Sam, now a sixth-grader, the program’s achievements came into clear focus one day on the track at his school. The year before he started the program, when everyone had to do the mile run, he clocked in at 13 minutes. After he finished the program, he cut his time down to an astonishing seven minutes.

“I lapped the best runner in the class,” Sam said. “He does track—and I lapped him!”

Sam was thrilled to observe the physical changes the program brought about. Some people didn’t even recognize him after he dropped the weight, he said. More important, coming to Packard Children’s each week didn’t just help him change his physique, it helped him change the way he thinks.

“It’s great to do this while you’re young, because when you get older, it’s harder to change your bad habits. Once the whole train is off the track, it’s harder to get it back on,” he said. “What you do learn is self-control and how to be a healthy person for the rest of your life. To me, that means you have nothing to lose and only something to gain.”

Learn more about Sam and the Pediatric Weight Control Program at Packard Children’s Hospital at tiny.cc/feldmanCHW, call 650-725-4424 or e-mail weightcontrol@lpch.org.

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