At 16 and more than 300 pounds, Steven was in a desperate situation. His weight was taking a toll on him physically and emotionally. He suffered from sleep apnea, “excruciating” headaches, showed signs of type 2 diabetes and was depressed.
Just a few minutes of light activity left him out of breath. He became housebound, spending much of his day in his room and in bed, taking classes through a home program.
Hope in short supply
So eight months ago, Steven and his mother, Terri, made the three-hour trip from their home in northern Minnesota to the Weight Management Program at University of Minnesota Amplatz Children’s Hospital as a last-ditch effort. They assumed his only option was to undergo weight loss surgery, something neither of them wanted.
“We felt pretty hopeless about Steven’s situation,” says Terri. “We felt surgery was our only chance to turn Steven’s life around.”
“Steven’s situation, while it may sound extreme, is probably happening in many homes across the country, given the dramatic increase in numbers of youth with extreme forms of obesity,” says Claudia Fox, M.D., director of the Weight Management Program at our children’s hospital. “Fortunately, for Steven, he had the courage to come forward and seek treatment.”
Transforming eating habits
Today, with help from his interdisciplinary team at the clinic, Steven is 70 pounds lighter and a new person, all without surgery.
Terri and Steven describe his transformation into a normal, happy teenager as nothing short of amazing.
“Yesterday, I walked a mile from where we parked to Target Stadium and a Twins game,” he says. “I wasn’t winded at all. And then I walked all around inside the stadium and a mile back to the car!”
Claudia “not only took the time to listen, but she actually heard Steven,” says Terri. “She took the time to get to know him. That helped Steven talk openly. Best of all, she let us know there were options other than surgery.”
His care team developed an individualized care plan that includes:
- a 2,000-calories-per-day meal plan consisting of three meals and two snacks
- instruction to eat all his meals and snacks at the table to associate eating with being at the table rather than being in his room
- no-calorie drinks
- a prescription medication to help control overeating
- a referral to a physical therapist who would help Steven improve his physical functioning.
Skeptical when he left the clinic that first day—he heard “eat less” before—the first week at home was tough but “I wanted to give it my best shot,” he says.
It became a little easier as the medication started to work. At the end of the first week, they called Mary Deering, weight management nurse coordinator, with great news: Steven had lost 10 pounds.
“I’d never been able to lose any weight before,” he says. “We were ecstatic,” says Terri.
His weight loss continued but so did the headaches, which hindered Steven’s improvement by keeping him sedentary.
Persistent stumbling block
“We were missing something,” says Claudia. He was scheduled to meet with a neurologist but, on his way there, he had such a severe headache that Claudia directed them to our children’s hospital Emergency Department (ED). In the ED, Jeffrey Louie, M.D., questioned whether the headaches might be caused by chronic carbon dioxide retention related to his sleep apnea.
Steven’s pulmonologist conducted a blood gas test in the early morning, when carbon dioxide in the blood can be the highest, and his team determined that, when he slept on his side and stomach, his sleep apnea mask was pushed off center and put pressure on his chest. This exacerbated his sleep apnea.
His pulmonologist ordered a new type of mask, and his weight management care team ordered a hospital bed for him.
“We wanted to see if elevating his head would help him avoid pressure on his chest,” says Claudia. While it took a while for Steven adjust to the bed, the headaches started to slowly abate. Today, he’s nearly headache-free.
Terri believes that the comprehensive care Steven is receiving is what differentiates our program. “Until we met with Dr. Fox, no one ever took the time to really listen and put all the pieces together for us,” she says. “She looks at the whole picture.”
A new way of life
As his weight loss continued, Steven’s family worked with his care team to learn new ways of eating.
Terri admits it’s been a struggle. “I needed to try new ways of cooking,” she says. “Portion sizes are important. Now, I dish Steven’s plate up at the stove. And I’ve stopped using food as a reward. I didn’t even realize I was doing that.”
The new eating habits have had other positive side effect. Terri’s lost 12 pounds, and their grocery bill has decreased.
While he’s striving to lose more weight, Steven is already doing things he and his mother never thought possible, like playing catch outside and riding his bike.
“Just to hear him laugh again is a treat,” says Terri.
Continuing to work with his care team, Steven offers hope to others in similar situations.
“You can certainly do it but it will be a challenge,” he says. “Changing who you are is a lot of work, but it’s definitely worth it.”
With rising levels of childhood obesity, our program demonstrates our commitment to improving the health of mothers and children.
Story courtesy of the Fairview Intranet.