Last year, Jeremiah Coon, 12, often found himself asking friends at school for their lunch leftovers. Instead of cooking at home, he and his dad would eat fast food for dinner a few times a week and Jeremiah rarely exercised, despite loving basketball.
“We used to go get pizza all the time, McDonald’s, just so I didn’t have to cook,” Larry Coon, Jeremiah’s father, said. “That’s how we ate and that’s normal, it’s what a lot of families do.”
But on Jan. 13, all of that changed. That day, the then-overweight seventh grader began Eastern Maine Medical Center’s Way to Optimal Weight, or W.O.W., program and started a journey to a physically and mentally healthier life.
The program, which is open to boys and girls ages 15 months to 19 years old, typically lasts 12 to 18 months and consists of several phases of care. Children and their families learn about healthy living — eating nutritiously dense food, mindfulness and exercising.
For Coon, that meant learning about making lifestyle changes and about not watching the numbers on the scale, but what he was putting in his mouth and what it meant for his body.
“It completely changed [my life],” he said. “I know how to eat better and I’m exercising better than I used to, so I’m getting stronger.”
The program, which began in August 2009, has helped almost 500 Maine youth become healthier and is expanding through a partnership with the Center for Youth Wellness located at Tufts Medical Center in Boston.
Patients are recommended to the W.O.W. program by their primary care providers.
In the beginning, participants meet with doctors, nutritionists and physical trainers once a week. They learn age-appropriate information about portion control, setting healthy goals and the importance of staying active. As they progress, the frequency of meetings lessens and teens are expected to take more responsibility for keeping up with their new lifestyles. For the youngest patients, parents are more heavily involved in goal setting and learn about activities to do with their children and the importance of encouraging healthy living from a young age.
Doctors stay away from talking about numbers on the scale and instead focus on building confidence and teaching patients that with a few simple lifestyle changes positive things can happen.
“There’s a cultural stigma about weight that can be very emotional,” said Valerie O’Hara, pediatrician, obesity specialist and director of the W.O.W. program. “As kids come in and we see them change, we see their self esteem start to go up and so many things start to change.”
Patients mostly come from the Greater Bangor area, but a handful travel from almost two hours away. Staff also have been working with primary care providers from as far as Aroostook County to talk about the program and expanding resources to children and teens in far-flung communities.
“I understand how difficult it can be to get services [in The County],” O’Hara said. “We want to provide resources within the community, and now with technology it’s possible to make it easier [for people] to get care.”
A family affair
Two key components of the program go hand-in-hand — confidence and family involvement.
“Confidence is built around change … we work with them as a team, moving towards better health,” O’Hara said.
Staff help patients set realistic goals and offer positive reinforcement, incentives and praise. Many times, the rewards are simple. For example, while physical activity at the recreation center at the University of Maine in Orono is part of the program, many patients also see it as a bonus.
“We would rather not have them told what they’re not doing, but what they’re doing well,” O’Hara said.
They also heavily involve families in making a plan that makes the most sense for the patient’s existing activities and lifestyle. For Coon, that meant his father, who is home with him and his sister after school, had to start learning to cook.
“We eat totally different now,” Larry Coon said.
The family made changes slowly. They replaced unhealthy foods with lean proteins, fruits and vegetables. Jeremiah switched from drinking sugary juice and soda to water. He started playing basketball again and the whole family now goes grocery shopping together and encourages one another to stay active and healthy.
“We realized that you have to stay involved to keep him going and I can’t make him do it and have the rest of us not do it,” Larry Coon said.
By involving families, patients see that change can be a good thing for everyone.
“We’re asking families to make a fair amount of change so we want them to make it fun and something they can sustain,” O’Hara said. “A lot of times they’ll say, ‘Well, I don’t do sports,’ so we’ll try to talk to them about lifetime activities — hiking, fishing, going for a walk.”
After kids ages 11 to 18 years old have successfully completed at least two phases of the W.O.W. program, they can join an extended pilot version of the program known as the W.O.W. Wellness Academy. The academy is a collaboration with the Center for Youth Wellness at Tufts Medical Center and participation is funded through a grant.
It aims to further encourage those teens who have thrived in an individual setting by introducing them to peers who also have been through the program.
The groups meet once a month and participants continue learning about nutrition, exercise and healthy living in a more fun, social setting than the traditional W.O.W. meetings. According to a news release about the program, the group-based component offers a non-judgemental environment that empowers them to take charge of their own lives.
It also includes a mindfulness piece known as MMA — Mindful Martial Arts. During each session, teens take some time to learn about meditation, deep breathing, yoga and tai chi — activities that can help improve decision-making and impulse control, which can influence eating behavior.
The idea is to help them become well-rounded and aware of the need to have the body and mind in sync.
“We ask them to be mindful of physical, emotional and overall wellness,” O’Hara said. “It can help with alleviating stress and one can reinforce the other.”