It begins with tossing out the adult world’s tired, worn-out notions of weight loss.
Obesity? Don’t even think about muttering that word in this place. Around here, there are no such things as weigh-ins, dieting or calorie counting.
No, the driving force at the Spectrum Health Helen DeVos Children’s Hospital Healthy Weight Center is commitment—to think, to learn, to do.
“We are very specific in the terms we use,” said William “Bill” Stratbucker, MD, the healthy weight center’s lead clinician. “While doctors, the media and statisticians often say ‘obese,’ who likes that word? It’s a turn-off for everyone and it’s not going to help a child in any way to be labeled by it.”
Children who join the healthy weight center program will undergo an initial evaluation, but beyond that it’s free from traditional dieting trappings.
Instead, the healthy weight center believes that participants—their ages range from toddler to late teens—all face unique circumstances that are best managed on a case-by-case basis, with collaboration from everyone on the clinical team.
The staff is led by Dr. Stratbucker and fellow pediatric obesity specialist Hanna Jaworski, MD. Other team members include pediatric psychologist Adelle Cadieux, PsyD, and exercise physiologist Lucie Smith, MS. Staff dietitians and social workers are also involved.
Old approaches focused on the scale aren’t something you’ll find on this program’s itinerary.
“Emphasizing weight, numbers—it’s dangerous in kids,” Dr. Stratbucker said. “Yet, our society has been programmed to chase weight loss with a diet. That can backfire and lead to even bigger problems if the child feels it’s impossible, or they’ve disappointed mom and dad.
“This program succeeds by taking the pressure off,” he added. “The weight will lose itself when the time is right, and when the child is making self-directed choices based on healthier thinking they’ve learned.”
“I’m not called the fat kid at school now. But I think the best thing is that I’ve learned how to eat healthier foods and to keep track of what I’m eating. I eat less wheat products and no junk. I love vegetables.”
Dr. Cadieux agrees.
“It’s not a contest,” she said. “There isn’t a weight goal. It’s learning to get up off the couch (and) decide that you want to have an apple, for example. In order to foster change, success is important—even if it’s one baby step at a time.”
The program’s specialists support not just the child, but the entire family, Dr. Cadieux said.
“Our team can help their team,” she said. “It only works if everybody is willing to do his or her part. It can be a challenge for parents, too, because we are seeking change in areas that affect daily life: thinking, eating and behaving. Some of that has to be mirrored by the parents in order to help the child.”
Some children gain weight slowly and steadily, while some gain quickly in a short period. The healthy weight center is designed to help them all.
“The child who will thrive with the healthy weight center is not just a few pounds overweight,” Dr. Stratbucker said. “He or she will have a body mass index score that causes a pediatrician or a parent to take notice.”
The program also helps children whose excess weight is a component of other conditions, such as neuro-developmental impairment, cognitive barriers or autism spectrum diagnoses. And because the program meets individual needs, there is no one-size-fits-all approach.
Nathan Koelwyn’s mom, Wendy, remembers her son was about 11 years old when he began to eat “out of control.”
As Nathan gained weight, Wendy would find herself intervening with growing frequency, yet the problem only continued.
Nathan’s pediatrician put him on a diet and requested checkups every six months. Nothing changed. Wendy ultimately told her own physician about her son’s struggles, and she showed him a photo of Nathan.
Her doctor recommended she contact the healthy weight center.
As with all new families, the initial consultation with the Koelwyns took about two hours. The family met with a pediatrician, an exercise physiologist, a dietitian, and a social worker.
At the onset, participants undergo a simple tolerance test to gauge their condition. There’s also a mental health assessment to identify any issues with socializing, parent interaction, school performance, or eating disorders.
Each family meets with the healthy weight center team to learn about the many aspects of the program and its requirements for the youngster and parents. They discuss the child’s lifestyle, family environment and genetic factors.
Said Dr. Stratbucker: “For many young people, excessive weight gain is driven by a mental health component that has led to emotional eating. It’s crucial to work together.”
In Nathan’s case, he had a stable and supportive home; he simply had trouble curbing his consumption. So the focus was to “take action.”
Nathan said he didn’t know what to expect.
“Once we were there, I thought, ‘Sure, this will help me lose weight,’” he said. “It sounded like a good thing. I thought it was cool because their goal was to help me maintain my weight as I grew and learned a healthier lifestyle.”
He poignantly recalls that no one told him “he had to lose this many pounds.”
“I had tried dieting with my sisters, so I thought this would be better,” he said. “I knew I needed to lose a few pounds and was good with it.”
Dr. Stratbucker said parents often need to remember that the healthy weight center doesn’t emphasize weight, “and neither should they.”
“It’s simply dangerous in kids and can set the stage for greater problems in the long term,” he said.
Healthy weight center participants are scheduled for visits based on age and need.
For Nathan, a visit every six to eight weeks has been ideal. At each check-in the team has asked about his plans and his progress, his setbacks and his goals. Each visit is also a great opportunity for him to receive much-needed encouragement.
“They just want to wrap those loving arms around you,” Wendy said. “There is so much positivity there.”
Nathan agrees: “Even if I missed a goal, they never said anything bad. They made me feel good about myself and what I was doing. I wanted to reach my goals.”
Dr. Cadieux said children need full support to stick with the program.
“If a goal isn’t being reached, let’s scale it back rather than fail to meet it,” she said. “Success, no matter how small, is far more effective than disappointment.”
Nathan’s primary goals have hinged on eating healthier foods containing more fiber and less sugar, reading nutrition labels on food packages, and exercising more. He plays basketball and soccer and he and his family regularly attend the YMCA.
“I got really inspired,” Nathan said. “I said we should go as often as we can to use our membership, and I want to lose some more weight.”
For her part, Wendy said the healthy weight center team’s involvement has taken the pressure off her.
“I didn’t feel like I was nagging him all the time about what he was eating,” she said. “The team was his lead.”
While there haven’t been any particularly difficult aspects to the program, Nathan said he did have to learn to be diligent about writing down everything he ate.
“It taught me a lot, like measuring my food,” he said. “It was kind of crazy, but it helped me see how much I was eating.”
With two check-ins remaining in his program, Nathan can confidently say he has gained confidence, tenacity and self-control.
“I used to get mocked,” he said. “They called me the fat kid.”
The program helped him learn to respond to bullying.
“I’m not called the fat kid at school now,” he said. “But I think the best thing is that I’ve learned how to eat healthier foods and to keep track of what I’m eating. I eat less wheat products and no junk. I love vegetables.”
If kids offer him junk food at lunchtime? “I say, ‘Nah, I’m good,’” he said. “I could care less about that stuff now. I don’t even want it, since I’ve learned so much. I know that what I’ve learned has changed my life for the better.”
Nathan has some words of encouragement for peers who may be struggling with excess weight: “Work your hardest until you feel like you’ve accomplished something and you are eating healthier. It really doesn’t matter what others think of you. You can do it.”