Childhood Obesity News salutes the launch of an 18-week trial study of Dr. Pretlow’s W8Loss2Go iPhone app, in collaboration with three institutions in Alelaide, Australia — Flinders University, Flinders Medical Centre, and the Child and Adolescent Mental Health Service (CAMHS).
Dr. Leigh Roeger, Research Manager at CAMHS, calls the app “youth-friendly” and Paediatric Nurse Kerri Sutton, whose contact with the participants forms an important aspect of their experience, sees a program that will “engage with young people and keep them motivated towards addressing their very serious health problems.”
We especially celebrate the cover story in the current Southern Health News magazine, written by Sarah Garvis. We also appreciate the sentiment expressed by bariatric surgery patient Ellen Burne that access to a program like W8Loss2Go would have a difference in her life, if such a thing had been available when she was younger.
The point and purpose of the gastric band surgical procedure is to make it physically impossible for the patient’s stomach to hold a large amount of food. This is “portion control” achieved by the most direct means. It is wonderful that several variations of the surgery exist, and that treatment is available to young people suffering from morbid obesity. But any surgical procedure, no matter the stage of perfection it has reached, inevitably comes with risks, and everyone from the patient to the medical institution would naturally prefer non-surgical means if weight loss can be achieved that way.
The first 10 weeks of the W8Loss2Go study are concerned with identifying the problem foods that kids and teens find particularly difficult to stay away from, and, as Childhood Obesity News has mentioned, these foods are not the same for every person, although certain ones tend to appear again and again on their lists. The application provides a number of techniques and motivational tools to develop coping skills, and the problem foods are eliminated one by one.
Then the program goes on to address the amount of food consumed, in other words, portion control. This is a problem that knows no age limits, racial boundaries, or gender distinctions. Everyone, especially in first-world countries where food is readily available and most people can afford it, encounters the temptation of eating too much.
Dr. Pretlow’s book, Overweight: What Kids Say, includes plenty of mentions of portion control. One of the difficulties is that, obvious as it may seem, many kids and teens just don’t realize what a portion size ought to be. If they were raised in households where parents heaped up the dinner plates and insisted on consuming everything, or in households where unlimited snacking was the family habit, they have no idea of what constitutes a reasonable meal-sized portion.
Using a scale helps, until a person learns what a reasonable portion size looks like, depending on the different food groups. Once this is established, the goal is to serve out only the appropriate amount, and not take “seconds,” and to stop eating even if the sensation of fullness is not present. The brain needs a little time to catch up and realize that food consumption has taken place, and often just waiting a bit will solve that problem. After doing that enough times, the body starts to understand what a reasonable amount of food feels like, and adjusts.
One of the techniques kids can use is to take the serving they would customarily consider appropriate, and then cut it in half, saving the rest for another meal. Among the thousands of communications Dr. Pretlow has received via the Weigh2Rock website, some kids have reported that this is an effective technique for them and cited the importance of portion control in their own success. These two quotations are from Heather, age 15, and Hannah, age 13:
In 8 months i lost 70 pounds. i still cant believe it. after the first three days of cutting calories and meal portions your stomach will be adjusted so its really not all that hard as we all think it is.
At dinnertime I would cut every portion in half and eat one half. Then I would cover the rest with plastic wrap and pop it in the refrigerator. The next day I would eat it for lunch. I had been doing this for about a month… I had already lost ten pounds…
Unfortunately, as Dr. Pretlow has also learned, many young people battling obesity say they are unable to exercise this much self-discipline. It is also difficult to follow the “eat slowly” precept. And, of course, a good rule for everyone to follow, under any circumstances, is to avoid between-meal snacks. Dr. Pretlow writes:
Many overweight kids graze continuously throughout the day and may have never actually felt true hunger, only emotional hunger.
This emotional hunger is the crux of the problem, and the obstacle which prevents so many desperately unhappy young people from following sensible advice. Dr. Pretlow also writes:
Once kids are provided the information on how to lose weight, most seem unable to follow it, even though they desperately wanted the information.
Advice is not enough, and this is the problem that the W8Loss2Go application is designed to deal with.
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