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When her 10-year-old son hit 176 pounds and his 8-year-old brother nudged up to 105, Rene Doubrava knew she had to make some big changes.
The Westlake, Ohio, mother didn’t want her sons to start another school year pushing the extreme edges of obesity, occupying the ranks of dangerously overweight tween boys in a country where the fat epidemic is only now leveling off.
“I was concerned,” Doubrava said. “Even the term obesity is scary to me.”
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Doubrava was right to be worried. Federal health experts say that the soda-swilling, video-watching habits of boys ages 6 to 19 mean that about 15 percent are now extremely obese, up from about 9 percent a decade ago. Those are kids like Garrett and Nathaniel Uterhark, whose body mass index for age, a standard measure for judging weight, has exceeded the 95th percentile.
'You'd really better do something'
“That’s the alarm that really needs to be heard by parents today,” said Dr. Thomas Inge, director of the Surgical Weight Loss Program for Teens at Cincinnati Children’s Hospital Medical Center. “If you’ve got a kid at the 95th percentile, you’d really better do something, and do something effective.”
Last spring, Doubrava decided to take action, thanks in part to the help of a Cleveland Clinic program that targets the heaviest kids and their families.
She banned soda from her family’s refrigerator and cut out fast food and high-fat snacks. She filled bowls with fruit and platters with vegetables and she sent everyone outside for long walks and bicycle rides.
What a difference a summer can make.
By the time Garrett, 10, started the fifth grade last month and Nathaniel, 8, entered second grade, both boys were taller and thinner, wearing the same size clothes as a year ago.
Curbing kids' obesity
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Rene Doubrava shares the changes that have made the biggest difference with her boys:
- Say no to soda. Like many families, they were big fans of sweetened beverages. Doubrava herself admits a weakness for Coca-Cola. Now, the boys and their parents drink water instead. Personalized water bottles made it more likely the kids would comply.
-Don't have junk in the house. Doubrava says she has cut way back on the amount of chips and snacks in the cupboard. If it's not there, the kids can't eat it, she says.
-Follow the 2-3 rule. Everyone needs two servings of fruit and three servings of vegetables everyday, Doubrava says. That means fruit with breakfast and platters of veggies at dinner. If your kids don't like spinach, let them make their own plate of cucumbers and carrots.
-Exercise is not optional. The family rule is that everyone exercises an hour a day, Doubrava says. It can be a family trek around the track or bicycle rides for the boys, but everyone, including mom and dad, makes sure to move.
Garrett is happier and more confident than before, with more friends and less teasing.
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“People stopped calling me fat,” said the youngster, reached by phone at his family’s home.
The changes made by Doubrava, 42, a nurse, and her husband, Chris Uterhark, 39, a delivery driver, were tough but necessary, said Dr. Eileen Kennedy, a pediatric psychologist who works with the Fit Youth program at the Cleveland Clinic Children's Hospital.
Click for more information on Fit Youth
Since 2005, Kennedy has helped 211 families with kids ages 7 to 16 grapple with the most extreme weight problems. The Fit Youth program only accepts children with BMIs for age in the 95th percentile and above.
“We see 7-year-olds who may weigh 100 pounds,” Kennedy said. “We see teenagers who weigh 250.”
With an emphasis on weight management, not dieting, and life skills, not deprivation, the 12-week, $250 program focuses on changes that obesity experts say all families with overweight children need to make.
Soda is out, first thing, replaced by drinks with less than 10 calories per serving. Fruits and vegetables go up, snacking goes down, and families are urged to eat regular meals at the table together. An hour of exercise a day is the rule and screen time is slashed to two hours.
But isn’t this just common sense? Hasn’t everyone heard those messages for years?
“What we’re trying to do is show them the ‘how,’” Kennedy said. “They know the information, but they don’t have a tangible, practical way to apply it to life.”
Learning and applying such lessons early is crucial, said Inge, whose program offers weight-loss surgery for teens whose average BMI is 58 and whose average weight tops 375 pounds.
Once teens and young adults reach a certain level of obesity, even surgery might not help, Inge said.
“The kids that are approaching the 90th percentile and rapidly approaching the 95th percentile, that’s the time where parents have the opportunity to change things,” he said. “If they don’t, it’s hard to reverse.”
Changes come just in time
In Doubrava’s case, she’s intervening with the boys just in time. When Garrett started the program, he was 5-foot-3 and weighed 176 pounds, which gave him a BMI of 31.2. Nathaniel was 4-foot-4 and weighed 105 pounds, which gave him a BMI of 27.3. Both boys were in the 99th percentile of BMI for age, according to the Centers for Disease Control and Prevention calculator.
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Now, they’re on their way down, having lost weight and grown taller over the summer. Doubrava's not tracking specific pounds, although Garrett had lost more 8 pounds and 16 centimeters off his body by the end of the program in June. The progress is a relief for Doubrava, who said she and her husband both struggle with weight issues, but didn’t want the same fate for their kids.
“Once I saw my lifestyle reflected in my sons, especially my son Garrett, it was an eye-opener,” she said. “As a parent, I want them to have a healthier lifestyle, not to be fat or sluggish.”
At first, the boys were resistant to the changes, Doubrava admits. They still wanted 12-packs of soda in the grocery store or McDonald’s chicken nuggets on the way home.
After several weeks, however, it got easier. A “stoplight” system that divides foods into red high-calorie foods, yellow moderate-calorie foods and green low-calorie foods makes it easy for the boys to understand their choices. Everyone gets one “red food” a day; the rest of the time, it’s up to them to choose from the smarter options.
“I just ask them, ‘What would Dr. Kennedy think about that choice?’” Doubrava said. “It’s so nice not to say ‘You can’t have that.’ It makes it easier for me as a mom.”
Fewer fights, better choices
Now there are fewer fights about food at home. The boys pack their lunches at night because they discovered that the offerings in the school cafeteria aren’t healthy. High-fat snacks at home have given way to new choices.
“If you come into my house right now there’s always fruit: bananas, peaches, fruit in season,” said Doubrava. “There’s a whole bowl of it right now.”
It’s still early in the school year, but Doubrava believes she’s seeing positive changes in both boys, but especially in Garrett. He just started middle school, a touchy time for anyone, but so far it seems to be going OK.
“Every day he comes home and it’s ‘I’ve made a new friend, I’ve made a new friend,’” said Doubrava, sounding relieved. “He’s certainly more confident in himself. It’s just better.”
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