Six Months At An Obesity Clinic

By Harriet Barovick

Some kids need more than a good PE program. Bernadette Williams and her son Wayne Wilson, an overweight, Boston-area fifth-grader, both credit a leading pediatric obesity clinic--which offered focused personal attention on medical, nutritional and emotional issues--with turning their lives around. "Before I went, I would never have asked basic questions about how to eat and exercise, for fear of seeming stupid," says Bernadette. "But the program offered us some simple solutions."

In many ways, Wayne was a typical sedentary kid. He liked candy, watched too much TV and played too much Nintendo. But his parents, who split when he was young, had infrequent contact. A few schoolmates had been teasing him about his weight. His grades were dropping. His self-esteem was so low he would refuse to take off his shirt in blistering heat for fear of "repelling" family members. And since the mocking increased when he exerted himself--biking in the neighborhood, say, or trying to climb a rope in PE--he was spending most of his free time indoors.

When endocrinologist David Ludwig, director of the Optimal Weight for Life (OWL) Clinic at Boston's Children's Hospital, first met Bernadette and Wayne in May last year, he found that Wayne was 25 lbs. over his ideal body weight. Then came the shocker: on the nape of Wayne's neck was a dark, velvety area, an abnormality neither Bernadette nor Wayne's grandparents, whom he saw daily, had noticed. The skin condition indicated risk for Type 2 diabetes. While Wayne didn't yet have the disease, advised Ludwig, he would need to be monitored. Wayne was so stunned he was "speechless."

Yet in that office and in the following hours with dietitian Jan Hangen and psychologist Johanna Sagarin, Wayne and his mom also saw there were real solutions. When Wayne told Hangen he was there "because I eat too much, I'm lazy, and I don't exercise enough," she told jokes, explained concepts by having him draw proteins and vegetables on a plate, and assured mom and son that dietary changes would need to be "slow and kind." Hangen strongly advised enlisting the support of other family members. The idea was to balance a carbohydrate (a fruit, say) with protein and unsaturated fat at every snack or meal. The 1,000-plus calories from the 15 cups of juice a day Wayne had been drinking, along with the big portions of rice in Bernadette's West Indian cooking, were not going to cut it. Anxious about reducing rice but relieved to have a handle on some of Wayne's problems, Bernadette agreed she would try to adjust.

Wayne met with the OWL staff monthly and lost about 2 lbs. every five weeks, progress Ludwig described as "just right." (OWL stresses a different way of eating and living, not rapid, extreme weight loss.) With a structure and system behind her--psychologist Sagarin even offered to serve as a conduit between the family and Wayne's school--Bernadette became better able to help her son. Last summer Kevin Sibley, a mentor at a local YMCA, picked Wayne to join Sports Scholars, a physically demanding daily program for young boys. In a journal that Sibley required, Wayne drew an early picture of himself: sweaty, rotund, sad. At summer's end, a new doodle showed a beaming, muscular boy in a superhero's cape. By his November visit to OWL, Wayne had shed the dark skin on his neck--and lost 10 lbs.

--H.B.