Programs help local teens weigh actions

It was a long road to weight-loss camp for Greg Mauldin and his mom.

Mauldin's body type probably destined him to be big, but as he approached his teen years, his mom, Michelle Ward, became concerned that he weighed too much. He was becoming involved in more activities, and he ate the junk food that went along with them: chips and soda pop at the youth group, doughnuts at church.

When she brought him in for evaluation at Children's Hospital's adolescent clinic, Ward was told not to worry about her son's weight. He would always be a big person, they told her. Then, at 13, he had his cholesterol tested to establish a baseline during a checkup with his pediatrician. It was not over the top, but it was borderline high.

"It began to be a health issue in my eyes," Ward said. "I made the decision for him to go (to weight-loss camp). I told him, 'You have backed yourself into a corner.' "

Mauldin said Camp Pocono Trails in Reeders, Monroe County, taught him about being active, making good food choices and cutting back on portions.

"I sort of felt there were choices, but I felt out of control sometimes, and I wondered how to deal with it," said Mauldin, 14, who will enter high school in Upper St. Clair this fall.

Ward did not want to discuss her son's exact weight or weight loss, but she said the experience is teaching him to take responsibility for his own health.

"The real key is going to be implementing what he has learned at camp when he gets home," she said.

The Mauldin-Ward family has bumped up against what health officials are calling an epidemic of overweight in childhood and adolescence, and they have learned its first lesson: Weight is not a vanity issue anymore. It's about health.

Focus on health risks

Twice as many children and almost three times as many adolescents are overweight now compared to 1980, according to statistics announced in December by Surgeon General David Satcher. Overweight adolescents have a 70 percent chance of growing into overweight or obese adults. Health care professionals define overweight as the weight at which a person risks medical complications; obesity is a weight that shortens one's life span.

"Overweight and obesity may soon cause as much preventable disease and death as cigarette smoking," Satcher wrote in his Call to Action.

Much of the western world is affected. Canada and Australia have reported statistics similar to the United States'. In Europe, the number of overweight children is rising, but not as fast.

The health consequences are dire. Children as young as 13 are developing type 2 diabetes — formerly known as adult onset diabetes — which puts them at risk for all the complications that diabetics face: blindness, amputation, heart disease and kidney failure.

Many of the complications do not show themselves for 15 to 20 years, said Dr. Silva Arslanian, a pediatric endocrinologist at Children's Hospital. So, while it's one thing to develop type 2 diabetes at 60 and face complications at 75, Arslanian said, "teens are looking at complications at 30 or 35."

"It's sad," she said, noting that in many cases, childhood diabetes can be cured with weight loss. "Parents and society have to realize it’s not just an issue of looks any more, it’s health."

Children's Hospital is taking the problem so seriously that it is considering gastric bypass surgery for some teens, spokeswoman Melanie Tush Finnigan said. The procedure reduces food consumption by reducing the size of the stomach, but because of the risks, many health care providers consider it a last resort.

Nurses at North Hills School District heard the surgeon general's message and decided to do something about it. In April, the school mailed 100 letters to parents of seventh-graders, informing them that their child was more than 20 percent over the recommended weight, citing the health risks of obesity and asking parents to return the note with their plans for addressing the problem. One in four students received the letter.

Parents protested that the school was stigmatizing their children with what soon became known as the "fat letter," and North Hills dropped its plans to send warnings to parents of elementary school and 10th-grade students.

"We began to worry about the emotional harm the kids would endure," district spokeswoman Tina Vojtko said. "There was no question the intent was good, and the administration fully backs the project."

A 13-year-old girl who is 5 feet 3 inches tall would be overweight at 132 pounds and obese at 152 pounds, said Dr. Sergio Buzzini of Children's Hospital's adolescent clinic. A boy of the same age and height would be overweight at 127 pounds and obese at 147 pounds or more.

Such measures do not take into account how much of the weight is muscle and how much is fat. A muscular child whose weight is high according to the charts may be just fine. Parents are advised to check with the child's health care provider.

Lisa Hirth of West View received a "fat letter" about her daughter, Lauren.

"When I first read it over, I was really mad," Hirth said. "But I took a second look. I appreciated the fact that they were telling me about the options."

Hirth said she believes her daughter is within a normal weight range, though she did not want to cite the number on the scale. "She's getting into her size. She's going to be really tall, and I knew it would even out."

Hirth said school officials could take positive action by taking a harder look at the nutrition of what it's serving in the cafeteria: nachos and cheese as a main lunch dish, for example, and baked potatoes topped with chili meat and cheese.

Lauren, 13, at first adopted her mother's attitude that the school was trying to help. But she became upset when she returned to school and the other kids made fun of those who had received the infamous letter.

She said the incident has made her "more paranoid about my weight. I'm going to be more active at home. I know I just sit around a lot."

It would have been more helpful if the school had offered an after-school exercise program instead of sending letters, Lauren said. Then she could have signed up on her own.

As she enters eighth grade this year, she said she hopes the letter fades from memory. Lauren said, "I'm just going to try to forget about it and hope everybody else did, too."

Vojtko said the school district has no plans to send "fat letters" again, but she would not be surprised to see the information conveyed in a different way. Perhaps letters would go to all parents, she said, not just those whose kids are overweight.

Why kids are overweight

Nobody will be surprised to learn that genes play a large role in determining how susceptible people are to overweight and obesity. Buzzini said people inherit tendencies to burn calories and store fat.

But too many people don't realize the overriding factors that influence weight. As Buzzini puts it, "too much food and too little physical activity."

One-third of high schoolers do not get enough regular physical activity, he said. More than half eat too much fat, and less than 20 percent eat the recommended five daily servings of vegetables and fruit.

Ignorance about the cause of overweight is widespread. Several years ago, the Jewish Healthcare Foundation of Pittsburgh conducted a focus group with overweight teens and found that participants didn't believe their actions had anything to do with what they weighed.

"They thought some people are thin, some are fat and that's the way it is," foundation President Karen Wolk Feinstein said. "They didn't really think their diet or exercise had anything to do with it. They saw skinny young people who do eat a lot."

Overemphasis on fat content has contributed to misunderstandings about fat-free, high-calorie foods such as soda pop, health care officials say. According to a study published in February 2001 in The Lancet, an extra soft drink a day gives a child a 60 percent greater chance of becoming obese.

The study included sodas, Hawaiian Punch, lemonade, Kool-Aid, sweetened iced tea and other sugared fruit drinks. A 12-ounce can of soda contains about 140 calories and 10 teaspoons of sugar. The U.S. Department of Agriculture recommends no more than 10 teaspoons of added sugar a day.

Nor do many people understand the impact of one fast-food meal, experts say. A Big Mac, french fries and a regular soda — at 1,000 to 1,200 calories — can make up the bulk of the entire 1,700 calorie daily quota for a teenager.

Inactivity is another problem. Tony Sparber, 46, president of Camp Pocono Hills, was an overweight kid who learned better habits. Where the camp attracted mainly girls a decade ago, Sparber said, today the ratio of boys to girls is about equal.

He said television, computers and computer games are diverting youngsters from more active pursuits. "We’re raising a generation of button pushers," he said. "Our fingers are in great shape."