Fitness takes focus

MARYSVILLE – The moment of truth for Rachel Daunais came during a shopping trip in February.

She saw a skirt she liked and instinctively grabbed a size 13. But she couldn’t fit into it.

Then she tried a size 15. It also was too tight.

Later at home, the 16-year-old pulled out all of her pants. None of them fit, not even those she had worn last September.

“I realized at that moment, ‘Oh my god, I’m fat! ‘”

“It finally clicked,” she said. “I had to lose weight. I had to become healthier.”

Rachel had tried diets before. She would lose weight, then gain it back. She would start a diet, then two days later eat a candy bar.

It was time to change that pattern, she thought.

During a doctor’s visit a few weeks later, she heard about a new group for teens who wanted to lose weight offered by the Marysville branch of The Everett Clinic and the Marysville YMCA.

The program wasn’t about diets. It was about reasonable adult guidance.

It wasn’t that Rachel had never heard about healthy eating and nutrition at school. But school lessons “don’t actually help you make a full-blown change,” she said. “Half the problem with teens is they feel like they’re not guided.

“If you’re not guided, it’s not going to work.”

The Marysville YMCA Fit Teen program – the first of its kind in the Puget Sound region – combined nutrition, counseling and exercise to help teens slim down. The goal was to teach them how to eat right and burn calories on their own, for life.

The program, which ended Tuesday, provided the teens with a personal trainer to supervise their exercise sessions.

A counselor met with each teen to talk about eating habits, such as using food as a psychological reward, and to make the connection between disappointments and eating.

There weren’t any lectures, there were discussions. Some of the rules of thumb that were talked about: Eat when you are hungry or to fuel workouts. Don’t eat because you’re bored or depressed.

They were never told that fatty foods such as pizza or hamburgers were “bad” or banned. Pizza and hamburgers taste good, that’s a fact. So the teens were shown how to monitor how much they eat, and how often.

A key part of the 12-week program was that a parent had to accompany each teen. The hope was for families to take on the project of changing eating and food-buying patterns so the teen wouldn’t be fighting the battle alone in a kitchen swimming with quick, calorie-laden foods and high-fat snacks.

Rachel was more than motivated to join. In addition to her shopping experience, she was tired of being frustrated by other people’s presumptions about her because of her weight.

For example, she said, many of her fellow students at Marysville-Pilchuck High School thought of her as overweight and assume she’s out of shape. They often are surprised when they heard of one of her after-school activities.

“I’m a dancer,” she said, her smile emphasizing the point as much as the bold yellow letters on the back of her navy blue sweat shirt: Pilchuck Dance Academy.

At 5 feet 1 inch, she’s shorter than many dancers and has a more solid build than that of the classic, sinewy – and sometimes borderline bulimic – ballerina.

The hip-hop dance group she joined includes routines with choreographed jumps, kicks and movements so vigorous that students are red-faced and sweating after only a few minutes of practice.

“When I get onstage, this alter ego gets onstage and dances,” she said. “It’s such a thrill. Better than riding roller coasters.”

Imagine how she felt when she ran into a friend from elementary school she hadn’t seen in several years.

“Rachel?” he said undertainly as she approached. “You’re a lot fatter than I remember.”

Teased and ridiculed

“One of the things we know quite well is that overweight and obese kids are stigmatized,” said Kelly Schloredt, a clinical psychologist at Children’s Hospital and Regional Medical Center in Seattle. “They’re bullied, they’re teased and ridiculed.”

Being overweight puts teens at odds with what they and their peers consider the social norm, she said, and that sets them apart.

Children often discriminate against others who are overweight, and social discrimination is one of the most immediate problems of overweight kids, according to the U.S. surgeon general.

Rachel sees it all the time.

“High school has a lot to do with how you’re perceived by your peers,” she said. “If you’re to be popular, you cannot associate with fat kids. That’s the line.”

Fat is size 9 or above, she said. “You could be the ugliest girl in the world, but if you’re a size 7, you’re popular.”

Overweight adolescents tend to have emotional problems, such as poor self-esteem, that can linger into adulthood, a 2000 federal study on youth physical fitness found.

“It’s just really odd to see how weight can really depress you,” Rachel said. “I felt horrible … I was size 11 last year and – oh my gosh! – this size 15 doesn’t fit.

“It’s so slow and gradual, you don’t realize it.”

Despite the psychological toll, the number of children affected by obesity nationally has grown so rapidly it’s being called an epidemic.

In Snohomish County, 14 percent of eighth-graders, 12.6 percent of 10-graders and nearly 14 percent of 12-graders were classified as overweight in the 2003-2004 school year, or in the top 15 percent for their height, sex and age.

Nationally, 16 percent of children are obese, ranking at or above the top 5 percent of kids of the same age. And children are gaining weight at twice the speed their parents did in the 1970s and 1980s, according to a recent University of Iowa study.

“To see that big a difference over that short a time was pretty amazing,” said Dr. Patricia Davis, an associate professor of neurology who headed the study.

The prescription for avoiding these problems has remained the same for a decade: Adolescents need at least 20 minutes of heart-thumping exercise three or more times a week.

Yet, 35 percent of high school students don’t get any regular, vigorous exercise. Walking and bicycling by kids and teens dropped 40 percent between the 1970s and 1990s, according to a federal Centers for Disease Control and Prevention report on youth fitness.

Breaking barriers

The idea for the Marysville YMCA’s fitness program for overweight teens grew from seeing more and more children who were overweight.

Carole Clark, a pediatric nurse practitioner at The Everett Clinic’s Marysville office, recalled the near desperation in the voice of Caroline Brown, health and fitness director at the Marysville Y, over the lack of resources to help educate families about obesity.

Clark, who has been at the clinic about 10 years, said she sees the problem regularly as she treats teens and conducts physical examinations.

Yet, when letters were sent to 34 families with overweight teens in the spring inviting them to participate in the new program at the Y, only four kids and their parents turned out.

“Sometimes it’s scheduling, sometimes it’s transportation, sometimes they’re not ready to make a commitment, not ready to act on it,” said Dr. Nancy Thordarson, a pediatrician at The Everett Clinic office in Marysville. “We’re trying to break down some of those barriers.”

The American Academy of Pediatrics in April awarded Thordarson an $8,400 grant, one of only 16 proposals funded nationally. The money will be used for another 12-week class at the YMCA beginning this fall or winter. This time, the target will be younger overweight kids, 8 to 12 years old.

Family involvement is key to success with exercise, nutrition and weight goals, said Schloredt, the Children’s Hospital psychologist.

“I can’t emphasize it enough,” she said. “It really needs to be a family affair as opposed to you – you have a weight issue.”

The Marysville YMCA program is among numerous efforts throughout Snohomish County this year to stop the obesity epidemic and get kids more active.

Schools in Monroe and Snohomish have designed walking programs, and this summer Providence Everett Medical Center and its foundation, The Everett Clinic, Medalia Medical Group and The Herald kicked off a summer exercise program for kids.

More than 600 children enrolled in the Get Movin’ program, which is similar to a summer reading program and rewards participants for being active for at least 20 minutes three times a week.

Rachel danced at the Get Movin’ kickoff last month.

No doughnuts

In May, around the time Rachel and her fellow Marysville-Pilchuck 10th-graders were taking state academic tests, there was caloric temptation aplenty.

One day, kids were chomping on Starburst candies. “I pulled out meat, cheese sticks, carrots and an apple,” she said.

Another day, kids brought in doughnuts to her second-period honors English class.

“It took so much strength to restrain myself,” she said. “I said to my friend, ‘Want to go get milk with me?’ By the time I got back, all the doughnuts were gone.”

She was applying some of the lessons taught at the YMCA class: Be conscious of what you eat, check portion sizes and have a nutritional life vest – healthy alternatives at arm’s reach – when sugary or fatty snacks are nearby.

Students learned simple ways of estimating portions without measuring cups. The seven recommended daily servings of vegetables should be about the size of your fist. The three suggested daily serving of fats, such as butter or cream cheese, should be about the size of your upper thumb.

“I realize what I’m eating more,” Rachel said. “I realize I can enjoy things, but I can’t enjoy a whole bunch. “

One day, she craved a cinnamon roll. So she sliced it in half and ate only that half.

“It’s all proportion, counting your calories and making sure you’re paying back everything you’ve eaten with exercise,” she said.

Rachel’s mother, Denise Daunais, said Rachel was often in the kitchen at 6 a.m. preparing her own school lunches. “She used to just hurry out the door and eat the stuff at school,” she added.

At the YMCA, Rachel now walks confidently into the weight room. Often dominated by men and “music so loud they can’t hear each other,” she initially found it daunting.

Her exercise program is designed to strengthen her stomach, hips and arms.

Twenty-five minutes into a recent workout, she was doing bicep curls with a 25-pound barbell. “Oh, my arms feel like Jell-O!” she said.

She approached a device called the Roman chair, one of the hardest pieces of equipment in the room, and not just for her. With her arms holding her off the floor, she lifted her legs and held them parallel to the floor.

“I call it The Killer,” she said. “At first, I couldn’t raise my legs once; now I’m at seven (reps).”

Rachel finishes her workouts with stretches and abdominal crunches. She figures she has increased her strength by 35 percent since beginning the workouts.

Rachel’s noticed other changes, too. Her endurance in dance class has increased; she has more energy; she’s more conscious of what and how much she eats.

“Before, if I was upset, I would just keep eating,” she said.

At the beginning of the class, she hoped to lose two pant sizes. The more she learned about exercise and nutrition, the more she questioned whether that was realistic.

Now, she easily fits into a size 15 and some 13s, and someday hopes to get back to size 11 or 9. “I feel like I’m on the right track,” she said. “But it doesn’t happen overnight. It’s not a one-month thing. It’s a three-year thing.”

She hasn’t lost much weight, but she has lost fat as she’s built muscle.

Her pants are looser, her face has thinned and her friends have noticed. “Did you do something to yourself?” they ask. “Is your hair different?”

Rachel can’t weigh or measure some of the biggest differences, including her ability to challenge comfortable old habits, having more confidence, and negotiating setbacks, such as the day she scoured the house for chocolate only to be doubly frustrated by not finding any.

“It really wasn’t that hard of a step when you’re ready,” she said, “when it hits your mind: ‘Oh! Something needs to change.’”

Tips for families

Here are some tips from Caroline Brown, health and fitness director of the Marysville YMCA, on what families can do to battle childhood obesity.

Parents are mentors:Children will be as active as their parents. Ask yourself, “How active am I?” Do you come home after work and sit in front of the TV with a bag of chips? Get off the couch, turn the TV off, throw the chips out and get moving.

Family activity plan: Put dinner in the oven or light the charcoal 30 minutes before dinner. Play a game, or take a walk together. The family pet might need activity, too.

Reward with activity: Take a trip to the park to play softball; go swimming at a pool or lake; participate in a local fun walk or run; or learn a new activity, such as inline skating, skateboarding, rowing or kayaking.

Prepare food together: Find a good cookbook with healthy meals; have everyone help plan the meals, shop for the food and help prepare it.

Most important: Have fun together. Fitness activity for children and teens is not 20 minutes on the treadmillit is play. When was th elast time you went out to play?

Here are some Web sites with tips on nutrition and exercise for kids: