Heavy Pressure : Obese Adolescents Join Groups to Help Change Image in Mirror

Mike Harrington has always been a big kid. Mike’s mother said he has been taller and heavier than most children his age since he was 2 years old.

In the past year alone, the blond, blue-eyed Costa Mesa seventh-grader has grown 5 inches. At age 13, he already stands 5 feet, 10 inches tall. The problem: As he has gained height, he has also gained weight. Too much weight. He now weighs 250 pounds.

Mike said he didn’t become aware of his weight until he was in the fifth grade. His size prevented him from finding clothes that were as stylish as the other kids wore. And, he said, it was tough to fit in: “Because most of them were skinny, they didn’t want to hang around with a chubby person.”

Did the kids at school make fun of him being overweight?

“Yeah,” he said.

Barbara Harrington, seated with Mike in their living room one day after school, gently prodded her son to elaborate.

“Didn’t they call you blimp, a couple of those boys, when you were in sixth grade?” she asked. “What were some of those names?”

“I don’t know if I should repeat them,” Mike said. “Names like lard butt. Blimp. . . . Whenever we’d play soccer, they said I could roll through the goal.”

How did he react to the name-calling?

“Just ignored it,” he said.

How did he feel inside?

“Hurt.”

Mike is not alone in suffering the pain of being an overweight adolescent.

Indeed, it is ironic that, in a society that places such a high value on being trim and thin, recent studies show the proportion of overweight children in the United States has increased dramatically in the past two decades.

According to a study released last year by the Harvard School of Public Health and the New England Medical Center, one in five U.S. adolescents is obese--a 39% increase since the 1960s.

In Orange County, many overweight young people are taking a long, hard look at themselves in the mirror and--often acting on the advice of their family physicians--are declaring war on their excess pounds.

“I really made a commitment,” said Mike Alexander, 18, a Fountain Valley High School senior who has lost 72 pounds, going from 237 to 165 pounds in a year. “I was really fed up with it. I was just tired of looking at myself big.”

“I always wanted to lose weight, but I never set my mind to it,” said Emily Porter, 13, of Fountain Valley, who has gone from being a “chunky” 5 feet, 5 inches and 153 pounds a year ago to a svelte 5 feet, 7 inches, 123 pounds.

“I had to have my physical and my doctor said, ‘You should lose about 25 pounds.’ After that I came home and looked in the mirror (and thought): ‘Gosh, I am fat.’ ”

Mike Harrington has lost 6 pounds in the past two months. His goal, he said, is to drop from 250 to 170 pounds.

Mike Harrington, Emily Porter and Mike Alexander are among those overweight adolescents who have turned to weight-control programs such as Weight Watchers and the Body Shop, a 10-week diet and exercise program for children ages 8 to 18 that is sponsored by Hoag Memorial Hospital Presbyterian in Newport Beach.

Overweight adolescents who do not take control of their weight when they are young put themselves at risk for medical problems that may surface when they are adults.

But it is not concern that being overweight could contribute to the development of heart disease or diabetes--or that they may already have high blood pressure or elevated cholesterol levels--that typically brings them into weight-reduction programs.

“I’d say the major reason these children come in to us is not because they’re physically at risk, it’s because they’re being teased,” said Rebecca Smith, a registered dietitian and coordinator of outpatient nutrition services at Childrens Hospital of Orange County.

Gary Bart, area director of Weight Watchers in Orange County, agreed: “That would be the main motivation because they live on a day-to-day basis with these other kids, and kids forever have been cruel. I was an obese child myself, so I know exactly what it was like.”

As the heaviest kid in his high school in Far Rockaway, N.Y., Bart weighed more than 300 pounds. He said the worst part was walking to his classes: “Nothing but jeers. I hated going to school.”

Although those jeers are universal, overweight children growing up in the county may find it particularly difficult to escape peer ridicule.

“I think because we have such a slim-conscious society in Southern California and because it’s a warm climate you tend to show more of your body, and they’re more conscious of it,” Smith said.

“So if a child is 10% or more above ideal body weight, they’re teased in school as a rule. In the Midwest or Southwest, it wouldn’t be as big a problem socially.”

By the time overweight children ask her advice, Smith said, “their self-esteem is suffering, and the teasing is part of it. And when they go clothes shopping and nothing fits them for their age group and bathing suit season comes and they don’t even feel comfortable taking off their shirts and shorts, it’s embarrassing for them.”

Smith recalled one 12-year-old boy who “was really being picked on, poked in the stomach and physically harassed because of his supposedly being chubby--and this boy was not what we’d consider overly obese. He was only 10% to 15% over ideal body weight, which is not that significant and which you wouldn’t think is such a big deal, but it is with a lot of children.”

It can be even more traumatic for those adolescents who are extremely obese.

Dr. Barton Blinder, chairman of Hoag’s department of psychiatry and director of the eating disorder program for the department of psychiatry at the UC Irvine College of Medicine, said: “For teen-agers with (extreme) obesity, we consider it a medical and psychological emergency because of the dangers of the profound effect on their self-esteem and social development--as well as on their health in the future. . . . Such children should have coordinated medical, psychiatric and psychological support and follow-up guidance.”

Although obesity is not included in the psychiatric definition of eating disorders, Blinder said that in some cases, mild obesity (25% to 40% more than ideal body weight) can precede the onset of an eating disorder such as anorexia nervosa (severe dieting and fasting) or bulimia (eating large amounts of food then regurgitating).

Blinder also said: “There is a great deal of research into the neurobiology of appetite and eating, which may someday give us more rational approaches to the treatment of obesity. Until then, rational measures such as tending to general health, proper nutritional intake, exercise and a social support system seem to be the best methods.”

Diet experts cited varied reasons for the growing number of overweight children in America:

Poor eating habits.

At the outset of the 10-week Body Shop, participants turn in two-day food and activity records. “Most of those, we find, are eating foods that are real high in fat,” said Rosalind Philips, a registered dietitian who coordinates the Body Shop regimen. “Some eat sweets, some don’t. But the high-fat foods are a pretty common denominator: snack foods, cookies, chips.”

Some studies show that up to 60% of teen-agers’ diets consist of junk food. But, Philips said, some adolescents simply have a problem with basic portion size: “Their idea of a serving is huge.”

Lack of exercise.

Overweight children simply do not burn enough calories for the amount of food they eat.

When it comes to exercise, Philips said, “one consistent report is they do attend PE class in school, and they think that’s enough. But obviously, for them, it’s not counteracting their other (eating) behaviors or lack of activity.”

Last summer the American Academy of Pediatrics began a campaign to promote innovative and better-financed physical education classes in schools and more awareness of the importance of fitness at home. The campaign began, in part, as a result of recent statistics cited by the President’s Council on Physical Fitness: Of boys ages 6 to 12--and girls ages 6 to 17--40% cannot do more than one pullup. One-third of boys ages 6 to 12 and 50% of girls cannot run a mile in less than 10 minutes.

Too much TV.

Many overweight adolescents are not getting enough exercise simply because they’re spending too much time hunkered down in front of the TV. A national Public Health Service survey shows that for every hour of TV watched in a week, a teen-ager’s chance of being obese rises by 2%.

Children not only are inactive sitting in front of the TV but, according to researchers at the New England Medical Center, they tend to eat more while watching TV, and they eat more of the foods advertised on TV.

Of the commercials on TV, 30% are for food, according to the American Academy of Pediatrics. Philips said: “It’s really enigmatic because all the commercials you see for food are encouraging everybody to eat as many fattening foods as they can, but at the same time they’re advertised by slim, trim, very fit-looking people, and we know they can’t stay that way if they eat that way.”

Saturday morning children’s TV programs are even more insidious. Tina Bradvica, a registered dietitian at UCI Medical Center, cited a national study showing that 19% of children’s Saturday morning viewing time is taken up with advertising and that 66% of the commercials are for food: candy, cakes, cookies, sugared cereals and fast food.

Bradvica said that because eating habits are established early in life, the best time for people to lose weight or keep weight down is when they are children. She said studies show that if an obese child doesn’t slim down by the end of adolescence, the odds against doing so as an adult are 28 to 1.

By losing weight when they’re young, Philips said, children can avoid all the “emotional trauma that goes along with being overweight through your adolescent years.”

Because children need calories, protein and calcium for adequate growth, the dietitians said deprivation diets should be avoided.

“Anytime you put them on a crash diet, it will work for a few weeks or a couple of months,” Smith said. “But usually when you start re-eating you put the weight on, because nobody can stay on those diets, and with children there’s the danger of stunting their growth.

“Also, we’re not looking to change their eating habits for a month or two. We’d like to see a slow weight loss over an extended period of time or even, depending on whether there are no medical problems as far as their weight, to keep them stable while they grow in height. That way we’re changing their eating and activity habits for a lifetime and not for a few months, so that they will keep the weight off.”

Smith also said: “A lot of people think weight control is diet alone. I try to emphasize that exercise is at least 50% of the program. The chance of achieving weight control without an increase in activity is very slim.”

Because overweight children are often being teased and have low self-images, weight-loss programs that deal with adolescents typically include sessions on building self-esteem and self-confidence. At the weekly Body Shop meeting, participants 8 to 18 years old not only attend sessions on diet and exercise but sessions on “personal growth,” which are designed to increase poise and self-confidence.

“They learn to set reasonable goals for themselves, not only in eating but all of life,” Philips said.

Parents of those children who have lost weight in the past year said they have noticed a major increase in their child’s self-esteem as a result.

“It’s just changed her attitude and everything,” said Emily Porter’s father, Tim. “She’s got a much stronger sense of self-worth and self-esteem and more confidence.”

“I’m not so down on myself,” said Emily, who has learned to eat less and exercise more at Weight Watchers. “I feel a lot better, and I know when people say ‘fatso’ they don’t mean me, because they used to call me that.”

Mike Alexander, who went from a 38-inch waist size to a 31 after joining Weight Watchers a year ago, said: “My self-confidence is a lot higher. I always thought I could never lose weight because it was so hard. You have to want it.”

Leslie Drozd said that’s the key to her daughter, Jaime’s, weight loss at the Body Shop.

“This is her thing and she did it herself,” Drozd said. “She’s a lot more self-confident than before. I think it’s the most exciting thing she’s done for herself. I’m just bubbling with pride.”

Barbara Harrington said her son has never had a problem with self-image, but there’s no doubt his self-image will improve as he loses weight.

Mike said he has learned to eat better and to eat less. He has cut down on snacking, doesn’t watch TV while he eats, and when he goes to a fast-food restaurant, he no longer orders bacon burgers, large fries and a milkshake. Now he orders a simple cheeseburger and a diet Coke.

Mike said he is motivated to lose weight. He looks forward to the time he will no longer have to hide behind a T-shirt when he goes swimming and can run longer laps at school.

But, his mother suggested, isn’t there another reason he wants to lose weight?

The 13-year-old boy grinned.

“It’s easier to get girls, because they like skinnier people.”

Gary Bart, area director of Weight Watchers in Orange County, agreed: “That would be the main motivation because they live on a day-to-day basis with these other kids, and kids forever have been cruel. I was an obese child myself, so I know exactly what it was like.”