In the 1960s or ’70s, it was common for families to sit down for meals together. Today, it is all too common for mealtime to consist of going through a fast-food drive-through.
Family routines have become relics of an earlier era. That change has happened in about the same time frame as the explosive increase in excess weight and obesity in the United States.
There has been a lot of information in the news about the obesity epidemic in the United States recently. So what is the difference between overweight and obese?
Justin D. Rosenberger, D.O., a general and bariatric surgeon at PinnacleHealth, explains that today, obesity is defined based on the body mass index.
“Body mass index is measured by multiplying one’s weight in pounds by the square of one’s height in inches. Just as healthy weight and underweight ratios are defined through this index, obesity and overweight ratios are determined as well. A BMI over 30 is considered to be obese,” says Rosenberger.
Many experts and medical professionals cite family routines, especially eating meals together and being physically active together, as areas that can help increase the success of weight loss and maintaining a healthy weight.
Karen Hackman and her son Brady put the family meal back into their lives as they took part in Shapedown, a weight-loss program at Lancaster General Health.
Brady, 14, lost 25 pounds and Karen lost 22 in the 10-week program held at LGH’s outpatient pavilion in Lancaster.
Karen and Brady’s routine went out the window almost five years ago, says Karen, when a motorcycle crash took the life of her husband, Scott.
Grieving, Karen at first lost about 25 pounds, but then gained that back and added another 20. She was depressed and spent a lot of time on the couch. They stopped sitting down to eat together because it was too hard without Scott at the table, says Karen. They began eating out a lot. Over time, Brady started to gain weight also.
Healthy diet and exercise starts with family routines. Parents set the tone for health habits.
A family doctor suggested the Shapedown program to Karen, and it was a time when she and Brady were ready to take the step.
Now, they support each other in their weight loss and goals. They take walks together and play a little tennis. And Brady has made a short-term goal of running in the 5-mile Firecracker race on July 4. It was a race his father had done regularly.
Lifestyle changes
“Healthy diet and exercise starts with family routines. Parents in particular can set the tone for health habits within a family. To help your family combat obesity try to take walks after dinner or spend an hour each day outside being active. For meals, make sure you are aware of portion sizes,” says Dr. Rosenberger of PinnacleHealth.
Ron Williams, M.D., of Penn State Hershey Medical Center also sees family habits as important. Williams is director of the Pediatric Multidisciplinary Weight Loss Program for Penn State Children’s Hospital.
“Kids can’t do this in a vacuum. It starts with the parents. This is a family issue, not a child issue. Parents have to lead by example,” says Williams.
Stop bringing sugary drinks into the house, he says. Even if you aren’t the one who needs to lose weight, you shouldn’t tempt your child by having them there.
Water is best, he says. “If water is all you’ve got, that’s all you drink,” says Williams.
Families need to reduce portion sizes, and parents need to weave in more healthy food choices, he says, such as a piece of fruit over a 100 calorie cookie pack.
“Cut down how often you eat out,” Williams adds. Kids end up eating 1,000 calories in one meal at fast food restaurants, he says.
People need to get physically active, stresses Williams. He tells his patients to start at 2 to 3 minutes of cardio each day and work their way up to 9-10 minutes a day. Then each week they should increase it a little more.
Surgery
There are times, though, when a person’s weight has reached a point at which more drastic measures are needed along with lifestyle changes.
A mother and daughter from Lancaster County went down that road together, having bariatric surgery within one month of each other in the spring of 2011.
Deb Louthian, 55, and her daughter Kristen, 30, both were more than 100 pounds overweight. Extreme obesity is something that runs in the family. Four others in their family also have had bariatric surgery.
Deb, who was a licensed practical nurse for 36 years, says she was 302 pounds at her heaviest. She has lost 121 pounds so far. She went from a size 4X to a 14.
Kristen, who is a nurse’s aide, says she reached 350 pounds at her heaviest point. She has lost 142 pounds.
Their health has improved dramatically since surgery. Deb had serious kidney disease, and now her kidney readings are normal for the first time in her adult life, she says. Her type 2 diabetes and sleep apnea have improved.
It was a blood clot in her lung at 28 that helped push Kristen in the direction of surgery. Deb was frightened for her daughter and signed them both up to hear a talk about a new procedure called the gastric sleeve, in which 90 percent of the stomach is removed.
Deb says the surgery was the best thing she has ever done for herself.
Kristen says, “It is definitely lifesaving.”
“I am more active. My asthma is better so I can do more. I don’t have to use an inhaler as often. I can work all day and not come home completely wiped out,” Kristen explains.
No easy out
But James Ku, M.D., medical director of bariatric surgery and healthy weight management at LGH, doesn’t want anyone to think having surgery is the easy way out. Ku did bariatric surgery on Deb and Kristen Louthian and their other family members who had surgery.
After surgery, the lifestyle changes that a patient must make are crucial.
“I believe in a programmatic approach to weight loss. [Patients] are not just seeing me, but seeing an exercise physiologist, dieticians and psychologists to make healthy changes even months before surgery. We look at each potential surgical patient individually, and if they are clearly not interested in making changes, in exercise, dropping sodas, eating fast food less, I won’t offer them surgery,” he says.
Ku suggests that everyone start the day eating breakfast because not eating only puts your body in starvation mode. He also says that having snacks throughout the day helps a person to be less hungry at the end of the day. Then dinner doesn’t have to be so big. Not eating all day until dinner is harmful for those trying to manage weight, Ku says.
Obesity and excess weight is a nationwide problem, but one part of the solution is much smaller in size: The family.
“This is a whole lifestyle change for the whole family. Otherwise, you are doing this with three hands tied behind your back,” says Williams of Penn State Hershey.
LIGHTEN UP LANCASTER COUNTY
Lighten Up Lancaster County (www.lightenuplancaster.org) began five years ago. It is a coalition of 500 organizations and individuals with the mission of increasing the number of people in Lancaster County who maintain a healthy weight. It was founded by Lancaster General Health, which is a major financial backer of the organization.
Getting fresh fruits and vegetables into the inner city via mobile markets has been one of its projects. This summer there will be farmers selling produce at Eastern Market and at the Spanish American Civic Association in Lancaster.
These locations will also stock free cookbooks that include healthier versions of traditional recipes from three cultures: Pennsylvania Dutch, Latino and African American. There is also a guide to free and low cost activities.
The coalition is also at work advocating for more biking and hiking trails and promoting Lancaster as a bikeable city. “Shapedown,” a successful weight loss program for kids, is held regularly at LGH’s outpatient pavilion.
