Beating Obesity

Brevard - In March, a few days before he left Wellspring Academy of the Carolinas, Santee Wells, 15, admired his reflection in a glass door.

He saw arms knotted with muscle that once bulged with excess flesh. He saw angled cheekbones in a face that had been soft and round. He saw a defined jaw instead of a double chin.

He saw the results of nine months of hard work, work that chiseled 130 pounds from his body.

Santee left his home on the Prairie Island Indian reservation near Redwing, Minn., last August. He came to North Carolina to jump-start his weight loss with a Wellspring Adventure Camp. Then he enrolled in Wellspring Academy, a boarding school for overweight teenagers. At the end of the four-month semester, he wanted to leave, but his parents urged him to stay three more months.

"He just screamed and ranted and raved; he lost it," said Susan Borgman, the school's clinical director. Now, Santee is one of the school's biggest success stories.

Teenagers who come to Wellspring trade carefree days and the comforts of home for rigid schedules and little contact with the outside world. They get up early, exercise before breakfast and dinner, and face lights-out before 10 p.m. They have access only to food that has been prepared specifically for them.

Many of them are veterans of weight-loss camps. Wellspring Academy, one of few weight-loss boarding schools in the country, represents a much bigger commitment. The school opened last year.

Parents who have tried everything -- nagging, gym memberships, bribes -- to encourage their children to lose weight are willing to shell out $25,000 to $50,000 to send them to a place that could have the answer. They also have to be willing to take a hard line with children who resist such a drastic solution. Most of Wellspring's new students are not happy there at first. "They've left their parents and their siblings and their friends and their pets and their couch and the TV," Borgman said. "Here, they have no TV, no video games. Friends and family are far away."

Even after they become accustomed to the routine at Wellspring, most of the students can't wait to leave. But when the weight begins to drop off, they tend to buckle down in order to move through the various levels that are part of the program. When they reach the "Adventurer" level and remain there for 60 days, they have clinical blessing to leave.

To be Adventurers, students complete a variety of tasks, including averaging 12,500 steps a day (more than five miles) and keeping a food log about three-fourths of the time. The requirements do not mention weight loss, but weight loss results from carrying them out.

When Santee left home last summer, he weighed 296 pounds. When he left Wellspring on March 21, he weighed 166 and had grown 2 inches. In those last few months, he said, "I got a lot more active. I lost another 50 pounds." Now he is glad his parents made him stay.

At 14, Santee was a fat kid on the verge of developing diabetes. He had trouble fitting into desks at school, and he avoided tight spaces where he might get stuck. When his parents separated, food eased his anger and soothed his emotions. He hung out at McDonald's.

Eventually, Santee took stock. "Man, I'm big," he said. In 2005, he went to a weight-loss camp for the summer. He lost some weight, but he now realizes that he wasn't mature enough for the lessons to stick.

"I gained all the weight back and more," he said.

Santee decided that Wellspring might work for him, so his father worked out an arrangement for his Sioux tribe to pay Santee's expenses -- $6,250 a month for room, board and tuition, more than the equivalent cost for attending Harvard University.

The terms of his tribe's arrangement required Santee to complete the program and bring the lessons he learned back to his tribe. He will soon give a presentation about weight control.

"A lot of Native Americans are obese now," Santee said. "That's our epidemic."

Equal opportunity

But the epidemic isn't limited to American Indians.

About 60 percent of American adults are considered overweight or obese, said Dr. Joseph Skelton, an assistant professor of pediatrics at Wake Forest University School of Medicine. The rates for children vary by region. Recent data from Forsyth County shows that more than 40 percent of the children are overweight or obese, he said. About 34 percent of children in the U.S. are considered overweight or obese.

Obese teenagers have an 80-percent chance of being obese adults, Skelton said. Now, experts are looking at the risks to younger children. Skelton is the director of the Brenner FIT program at Brenner Children's Hospital. The program is designed to treat children with weight problems who are also at risk for weight-related diseases, such as heart disease or diabetes. The outpatient plan uses the same broad categories as Wellspring -- behavior modification, improved nutrition and increased physical activity.

The Wellspring food plan is low in calories and fat and high in protein and fiber. Students get one portion of the "dish of the day" at each meal; no seconds. Some of them doctor their dishes with artificial sweetener, ketchup or hot sauce. Although the staff encourages students to enjoy food in its natural state, they don't worry if kids experiment to make healthful foods more palatable.

The students are allowed to supplement their meals -- buffalo burgers, chicken fajitas, vegetarian chili -- with uncontrolled amounts of food such as plain yogurt, soup and salad. Students must record their calorie intake, and they are encouraged to stay within 1,200 calories a day. If they go over, they can compensate with extra activity.

For Susan Cook, as well as many other parents of Wellspring students, a live-in school where her daughter would have no choice but to eat well and exercise seemed to be the only answer. Kristen Sjostrom, 14, came to Wellspring on Jan. 21 weighing 234 pounds.

"From (age) 10 on, the weight kept creeping up, creeping up and creeping up," Cook said. Kristen's best friend died that year, and she ate to comfort herself. Cook had tried various programs to help Kristen lose weight, including gym memberships and Weight Watchers. She drove Kristen from their home in Malvern, Pa., to a dietitian in Wil­mington, Del., once a month.

Kristen lost weight, but nothing worked for long. She ate pizza, ice cream, cheeseburgers and Doritos. Her mother didn't keep junk food in the house, and she packed healthy lunches for Kristen to take to school. But Kristen usually chucked her homemade lunches and ordered pizza.

"Given a good choice and a poor choice, unfortunately, the poor choice is going to win every single time," Cook said. Kristen accepts responsibility for her choices. But Cook, who has struggled with her own weight, also blames herself.

"I'm as much at fault as the next person," she said. "I don't put a lock on the refrigerator or cabinets." Cook and Kristen's father, Steven Sjostrom, tried to get Kristen involved in physical activities, such as swimming and martial arts. She resisted.

"She's the kind of kid if you push, she pushes back," Cook said.

Cook hated seeing Kristen picked on because of her weight. She worried about her daughter's elevated blood sugar and cholesterol readings. She feared that Kristen would face discrimination as an adult, that she might have trouble obtaining insurance or landing a good job. And she wanted her to enjoy being young.

"You're only a teenager once," Cook said. "It's only going to get harder for her the older she gets." So, in order to send Kristen to Wellspring, Cook applied for the kinds of loans parents usually take out to pay for college. If Kristen continues to lose weight at her current pace, she will reach her ideal weight by mid-August. She will remain at Wellspring until Friday, then go to a two-week adventure camp and then to a Wellspring camp for the rest of the summer.

"I haven't tapped my 401(k)," Cook said. "But to get her through the summer, I am considering refinancing my house."

"I want to lose," Kristen said, "but not if it means my family has to go through all these problems." She tried to talk her mother out of going into debt to pay for her stay. But her mother has reassured Kristen that she wants to help her reach her goal weight and maintain it. As of last Monday, Kristen had lost 39 pounds.

Emotional and fiscal cost

Students at Wellspring are between 13 and 18, and several of them weigh more than 300 pounds. One weighs more than 400. Their bellies bulge over their jeans. Their thighs chafe from constant rubbing. They are fat, and they know how they got that way.

They didn't exercise.

They ate too much junk food.

Skelton hears the same stories over and over.

"Genetics loads the gun," he said. "Society pulls the trigger." The bodies of human beings developed the ability to conserve energy over millions of years in order to survive, he said. "It used to be that we lost weight in the winter when there was no food and would gain weight in the summer when we had access to food -- we stored it later in case there was a famine or drought."

The emotional cost of obesity is high, Borgman said. Fat kids and teens often suffer from low self-esteem, depression and various forms of anxiety. They face issues related to their weight every day. Some isolate themselves, afraid to face the taunts of their thin classmates. Some feel like failures, like misfits.

Kristen looked sad and anxious the day she arrived at Wellspring. She knew she needed help, but she didn't want to go to boarding school.

"It was my parents' idea," she said.

When they said their goodbyes, Kristen clutched at her mother's coat and Cook kissed her on the forehead.

"You're going to be a different person," Cook told her daughter. "You can do this."

As the days went by, Kristen made friends and started losing weight. But she fumed over the school's restrictions. "They don't let you have any privacy," she said. "The rules are stupid."

Two months into her stay, Kristen had had enough of the rules and the squabbles.

"I can't stand this place anymore," she said. "The thing is, I've lost 22 pounds. I want to stay to lose weight, but I don't want to stay to argue with people."

Kristen snapped at classmates who urged her to join a basketball game. She just wanted to sit.

"I have a short fuse with people here," she said.

Drama is a constant in a school with only 30 students and a staff that keeps them on short leashes. But the students feel safe to be themselves among peers who share their problems and staff members who understand them.

"We're all in the same boat," said Francesca "Franny" Pittarie, 15. Franny, from Auburn, Ala., had lost nearly 90 pounds by March, since attending a Wellspring summer camp and the school. She and her roommates bubbled with excitement as they helped each other primp for this year's Valentine's dance. She confidently bared her arms and shoulders in a slinky party dress.

"I wouldn't have gone to a dance at home," she said. "All the other girls in my grade are skinny."

Wellspring students develop hope when the weight starts coming off, Borgman said. Their energy levels jump, and their anxiety and depression diminish. In therapy sessions, many of them open up and talk about the frustration and pain their weight has caused them.

"In a setting where everybody has the same problems, they tend to start to relax a little bit and enjoy people's company and not expect the worst all the time," Borgman said. According to the Wellspring philosophy, losing weight can help teenagers improve their body images and energy levels, but they will still have to cope with other typical teenage problems such as trying to establish their identities, finding self-worth and making sensible plans for the future. Kristen, for instance, has vague career plans to work with horses.

The average stay at Wellspring is four to six months. Students who remain at Wellspring for at least two semesters -- nine months -- lose an average of 81 pounds, according to a study of students conducted by Wellspring Academy of California, which opened in 2004. Follow-ups done 10 months later showed that the students had, on average, retained their weight loss. Skelton said that Wellspring bases its program in behavior and recognizes the importance parents play in sustaining behavior change and weight loss.

Cook said that by sending Kristen to Wellspring, she is trying to give her tools to manage her weight for the rest of her life. She, like other parents, received an oath to follow in order to help Kristen succeed. The oath includes such promises as listening without interrupting and buying healthy foods. Cook attended a three-day family program to learn how to help Kristen stay on track, and she keeps close tabs on her daughter's progress through frequent conversations with Kristen's behavioral counselor.

Most parents wouldn't hesitate to pay for expensive medical treatment if a child needed it or to get help for a child's learning disability, Cook said.

"It's that same kind of feeling; you're going to do what it takes to help your child. It's what any parent would try and do with their kid."

n Janice Gaston can be reached at 727-7364 or at jgaston@wsjournal.com.

■ For more information on Wellspring Academy of the Carolinas, go to the Web site
www.wellspringacademies.com or call toll-free at 866-364-0808.