Overweight overhaul

Twelve-year-old Madi Hankins loves to shop, but not when the only clothes that fit her are in the women's department, where her mother shops. And while she'd like to go out for the volleyball team, she wouldn't be caught dead in the tiny shorts worn by the girls on the team. Sure, Madi could wear longer shorts to hide her thighs -- but then her uniform wouldn't match her teammates'.

"I could tell when I was doing certain things that it would be easier if I wasn't as heavy as I was," Madi says. Even going up the stairs at school, moving at an "average person pace," was difficult and, even worse, embarrassing.

"It wasn't pretty. I came up looking like I just ran a marathon," she says. "I would try not to talk, and smother the sound (of my breathing). At our school the flights don't have as many steps as the average flight of steps, so that's even worse. I knew something was not right."

Madi's doctor worried about her weight, too, and recommended exercise and dietary changes. This summer, Madi and her mother, Angie Hankins, registered for Shapedown, a 10-week program offered by Saint Francis Medical Center for children and families concerned about weight management.

"I want nothing to hold Madi back. I want her to be all that she can be, and I know that weight can hold you back," says Angie, who's struggled with her own weight for most of her life. "I'm a tough cookie, and she is, too, but why do we have to be so tough?"

The program, designed for children, teens and their families, meets weekly and is part education, part exercise. According to Dana Glass, health promotion specialist and group fitness instructor at Saint Francis, Shapedown is not about weight loss, but teaching healthy lifestyle changes that may lead to natural weight loss. Because so many lifestyle factors, like meals and exercise, are shared by a family, Shapedown aims to encourage healthy habits for all family members, rather than pinpointing one person.

"It goes generation to generation and we want to break the cycle," says Glass. A number of topics are discussed, including portion control, self-esteem, grocery shopping and keeping an exercise routine. Participants try new healthy foods each week, and while the parents sit in for more discussion, the children try new exercises with Heidi Dunn, fitness specialist and group exercise instructor at Saint Francis.

"A lot of children don't think about later in life, when they're older and the weight actually becomes an issue, even with carrying groceries up the stairs or being able to play with their children or grandchildren," says Glass -- and that's not to mention the higher risk of cardiovascular disease and diabetes for overweight or obese people. "It's about quality of life. If they tackle the changes early, it becomes a lifestyle; it's more natural. It's not something they'll have to fight when they get older, when it's more challenging to change."

Shapedown participants measured their strength, flexibility, endurance, weight and blood pressure at the first and last meetings. Madi and her mother began exercising together every day, eliminated all the junk food from their house and controlled their portions with smaller plates and bowls. By the end of the program, Madi had lost weight and inches, especially around her thighs. She improved in all three assessment areas and feels better about tackling the stairs at school this year. As for the other three participants, Glass says each one lost significant inches and body fat percentage.

These children are not alone in their weight struggles. In the United States, about 18 percent of children ages 2 to 19 are overweight or obese, says Raina Childers, registered dietitian at HealthPoint Fitness of Southeast Missouri Hospital. In Missouri, 31 percent of children ages 10 to 17 are overweight or obese. There are many reasons for the increasing numbers, including less physical activity, more restaurant and fast food consumption, and more consumption of sweetened beverages.

Southeast Missouri Hospital offers P.H.I.T. (Promoting Health in Teens), a 12-week, medically supervised program focusing on lifestyle changes, exercise and healthy eating. Led by Childers, P.H.I.T. is designed more for teens than for children, and participants continue to work with dietitians and fitness trainers after the the 12-week period, for a full year of support.

"Certain sessions are marked where a guardian attends with the child, but for others, we really believe children need the freedom to talk and be with each other," says Childers. "When parents are there, we talk about meal planning and grocery shopping, because they're a big part of what comes into the house and what's prepared."

P.H.I.T. combines weekly educational meetings and twice-weekly exercise sessions with a fitness trainer. "The goal is to start some healthy habits that we hope will translate into improved health, as a primary goal, and weight loss, if necessary," says Childers. "We want them to fall in love with feeling healthy."