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A Big Fat Problem
Special Meals to Melt Away the Pounds

by Jeff Worley

Photo of Tiffany DuncanTiffany Duncan, a senior at Paul Laurence Dunbar High School in Lexington, has lost 45 pounds since joining UK's HMR program last January

James Anderson has been helping children and teens take off weight for over 20 years, and he admits he and his staff have had their share of challenges.

"I've seen 10-year-old, 200-pound children. I've seen an 11-year-old, 300-pound girl, a 350-pound 12 year old, and a couple of adolescents who weighed 500 pounds," Anderson says. "And it's been very gratifying to work with these kids through our HMR program and see them shed significant weight."

HMR is the acronym for Health Management Resources, a national health-care company in Boston that specializes in programs for weight and health management. HMR provides programs to health-care professionals in more than 400 medically supervised weight-management programs nationwide. Anderson heads up UK's HMR program, which began in 1985.

"The great thing about using these products," Anderson says exuberantly, "is that this way we don't have to put anyone on a liquid diet, and there are quite a few meal choices." Entrees, with vegetables, include chicken creole, turkey chili and chicken pasta parmesan, and are typically 220 calories. Bars (160) and milkshakes (120) are also available. "This is the easiest diet to follow, because it requires so few decisions about what to eat."

Here's how the program works. Each week while on this low-calorie diet, the patients attend a 90-minute group session led by a trained health educator. In these sessions, some of the basic program fundamentals are taught: specific "how to's" of weight loss, including easy ways to lower fat and calories in the diet without feeling hungry, and simple strategies to build physical activity into the daily routine.

The weight-loss phase of the program comes next. This typically lasts for around 18 weeks. The last stage is maintenance, during which participants attend weekly classes to continue to receive support while learning additional, simple strategies for successful long-term weight management. A personal "coach," Anderson or one his staff, works closely with each patient to practice healthy weight-management skills until they become second nature. The cost to participate in this program depends on the level of medical supervision required.

Anderson is pleased at the results of the most recently completed program, in which UK partnered with weight-loss experts in HMR programs at the University of Kansas Medical Center in Wichita, in Dallas-Fort-Worth, and Springfield, Illinois.

This study included 49 adolescents—11 males and 38 females—age 12 to 18. The participants averaged BMIs of 36.8, which put all of them in the "obese" and "morbidly obese" categories. After attending weekly education classes and getting information about HMR meal replacements as described above, the participants began the weight-loss phase of the program. For 18 weeks, they were allowed from 1,000 to 1,500 calories a day from the meal replacements, vegetables and fruits, and the teens continued to attend weekly class during this time.

James Anderson, who has helped children and teens take off weight for over 20 years through UK's HMR program, talks with participant Tiffany Duncan.

"The results were really impressive," Anderson says. "Weight loss in this group averaged 33.6 pounds, with 31 of the teens losing more than 10 percent of their initial body weight and 16 kids losing more than 20 percent." For 16 of the adolescents who had BMIs over 40, which put them in the morbidly obese class, weight loss averaged right at 50 pounds. One adolescent lost 176 pounds during this 18-week program and subsequently, after she went into the maintenance phase, lost another 75 pounds.

"The ringing, self-evident conclusion," Anderson says, "is that self-motivated adolescents can lose substantial amounts of weight in an intensive weight-loss program such as this." These results were presented at an annual nutritional conference in San Diego in 2002.

Self-motivation is the number 1 indicator of a teen's, or child's, probability of success, Anderson adds. "You absolutely have to be disciplined. You have to"—and here Anderson sounds like a baseball coach telling a kid how to get a hit—"stay in the box, meaning that you have to stick strictly with the HMR offerings and vegetables and fruits. If kids and teens stay in the product box, we can guarantee that they're going to lose weight."

This may sound easy; oftentimes, it's not. Peer pressure is one obstacle. What if you're trying to stay in the box, but a friend sitting across from you at Dairy Queen taunts you into having a couple of bites of his hot fudge sundae? "It's tough to turn away from temptation like this," Anderson says, "and the problem isn't really a couple bites of ice cream as much as a teen then saying, 'Well, I've already blown my diet today, so I may as well have a few bites more.'"

Parental involvement is a huge factor, too, in a teen's success at belt-tightening. Even though parents are encouraged and coached to be weight-loss partners in this program, that can sometimes be psychologically tricky. "Usually, if a child or adolescent is obese, one or both parents and grandparents are also obese," says Anderson. "So when the teen wants to break out of that mold, it's an affront to the parent. 'So you don't like the way we are? You don't want to be like us?' It's tough."

Asked why, at the ripe retirement age of 68, Anderson continues to do this work, he smiles, clasps his hands behind his neck, and says, "Let me share an anecdote with you.

"In 1986, we enrolled a 13-year-old girl in our program. She weighed 340 pounds. I had never treated anyone that young who weighed so much. We designed a safe nutrition program for her using our meal replacements, giving her about 800 to 900 calories a day. She lost 180 pounds—let me repeat that: 180 pounds—in a little over a year. She went from 340 to about 160. That flabbergasted me. I happened to run into her in Winn-Dixie two weeks ago. She's 32 now and her usual weight, she told me, is about 210 pounds. OK, it's not 160, but she's still keeping off more than two-thirds of the weight from when she was 13. I think we did alter the course of her life, and, yes, that makes me feel pretty good."

For information about UK's HMR program, call 859/422-4671 or visit the Metabolic Research Group website.

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