A Child’s Heavy Burden

Elaine sits in a tiny room of the nurse’s office at her Los Angeles high school, staring through crooked Venetian blinds at the dark, rain-filled sky. At 14, she is severely obese, plagued by joint pain and fatigue that have caused her to miss classes this year. But her physical ailments pale in comparison to the emotional turmoil she endures.

“It’s very depressing when you’re fat because you look at yourself every day, you look at your pants size and say, ‘Oh, my goodness! That’s me?’ And you feel like you don’t want to live anymore. Sometimes people don’t understand that even just calling somebody a name would make them want to kill themselves--like when somebody you look up to says, ‘Dang, you’re fat! You need to lose weight.’ ”

Heavy most of her life, Elaine (who, like other overweight teens in this story, asked that her real name not be used) endures taunts from classmates, occasional nagging from her parents and little understanding from P.E. teachers who she says deride her for not being able to keep up with others.

Although Elaine is surrounded by friends who accept her as she is, she is not at peace with herself.

“Some kids will say, ‘Look at that gorda,’ and I know that means ‘fat.’ I’m the only one sitting here that’s fat. . . . And then you feel like you want to attack them or something, beat them up. . . . I guess they do it because they’re bored or they’re heartless; they don’t care how other people feel. [Sometimes] I confront them and I’d get all pissed off, and they’d end up saying, ‘Sorry, sorry.’ ”

School counselors and nurses have recommended structured diet programs and clinics, but nothing so far has worked. There are daily temptations from fast-food restaurants just a minute’s walk from the school--McDonald’s, Burger King, Carl’s Jr.

Elaine’s painful struggles with her weight are not unique. America’s youth are getting heavier. A National Health and Nutrition Examination Survey released last week by the Centers for Disease Control and Prevention reiterated the dangerous connection--that America’s children continue to be overweight; overweight children tend to be overweight as adults; and that overweight adults are at increased risk for morbidity and mortality.

The population in general is gaining weight, so if parents aren’t watching what they eat, they’re obviously not paying much attention to what their children are consuming.

Easy access to fast foods and easy-to-prepare grocery store items laden with fat make it that much easier to pack on the pounds. More time in front of the television and computer means less time outside playing and getting exercise.

But studies and statistics tell only part of the story.

Being overweight is difficult at any age, but childhood is fraught with its own perils. Relentless teasing by schoolmates leave scars that can last a lifetime. Parents’ reasoning that obesity is just baby fat that the child will outgrow is ignoring the severity and complexity of the problem.

Kids can withdraw, isolate themselves, their emotional wounds becoming deeper and deeper. Amid the teasing, the nagging and the name-calling, their voices are almost lost. Last year an overweight 12-year-old boy in Florida hanged himself, apparently distraught over being taunted by classmates.

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Talking about sports makes 15-year-old Roberto’s face break into a wide grin.

“I love sports,” he says. “Football, tae kwon do, many sports. My favorite is swimming.”

He’d like people to know that, because “there are some who don’t understand me because they see me as a defect,” says Roberto, who stands about 5 feet, 9 inches and weighs 257 pounds. “Some people call me names, like ‘pig’ or ‘fat burger.’ I only listen and say, ‘Oh, I don’t care.’ But I do care.”

This 10th-grader, who has grown up in Central America and Los Angeles, has been heavy nearly all his life. He’s endured cruel taunts in two countries, but finds his weight to be more of an issue in Central America.

“There, there aren’t as many overweight people,” he says in Spanish through a translator, “so they look at me the way somebody here in the United States would look at someone who weighs 600 or 700 pounds.”

And it doesn’t help that the rest of his family is average weight, except for one grandfather.

“My family keeps pushing me to eat less and less, but I find that really hard,” Roberto explains, especially when he is relegated to special meals while everyone else eats whatever they want. “They don’t understand how difficult it is for me.”

Diets for the most part have failed. A few years ago he lost 50 pounds on one program that featured prepackaged food. But when he went off the program, the weight came back.

He empathizes with children fed large amounts of high-fat foods by their parents, saying, “Whenever I see parents with their children, I try to tell them not to give them a lot of fat, and don’t make them eat a lot and be overweight, because then the child will grow up and say, ‘Why did you do this to me?’ ”

Roberto isn’t sure if he’ll tackle another diet. Programs, like the one he was on, can be expensive, and his family can’t really afford it now. He’d like to see more help for kids his age.

“People should try to overcome their obstacles,” he says. “Even though it may be hard for them, they shouldn’t just stay as they are. They should try to do something to keep themselves active, to keep themselves from being so sad, otherwise they’re never going to be able to change themselves. . . . There are good and bad people, big and small, and I want people to look at me for the person I am and not just for being overweight.”

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In the peer-pressure-intense world of junior high, Sarah knows what it’s like to stand out. Heavy most of her life, she is aware of her schoolmates who wear the right clothes and seem to magically fit in.

“I get mad because I can’t wear the clothes my other friends are wearing,” says the honor student. “It’s very difficult for a lot of us to find clothes. . . . It’s all how you dress, how you look.”

Sarah’s mother confesses that she sometimes brings her daughter to maternity departments to find clothes. It’s a painful ordeal both despise.

Sarah’s mother exhausted the standard routes trying to help Sarah slim down. Highly recommended pediatricians advised Sarah to eat less and exercise more--a grossly oversimplified plan that left both mother and daughter frustrated and angry.

A solution was found in a therapist who counsels Sarah and her mother on self-esteem issues, meal planning and exercise.

So far Sarah seems happy with the program. She makes her own food choices and doesn’t feel deprived. The rest of the family is abiding by it too.

But still, she is not free from prejudice for being overweight.

Physical education classes are especially torturous: “The teachers aren’t very sympathetic, especially when they give you fails because you can’t climb the bar,” she says. “It’s so unfair. Why should emphasis be put on climbing a bar? And every year we have a mile run, and it’s really hard to do it. A lot of people, mostly the bigger people, are left behind.”

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Parents, kids and experts decry the lack of programs and professional help available at elementary, junior and senior high schools. A child cannot join a health club or sign up with Jenny Craig, and often parents cannot afford or do not want to send their child to individual or family counseling. And diet pills and fat camps may offer only temporary solutions.

But there are some fitness experts who are taking up the challenge of teaching youth the importance of good eating habits and regular exercise.

Energy2 Burn, a fitness program being used in schools across the country, was developed by the American Council on Exercise and the National Fitness Leaders Assn. last year to incorporate noncompetitive physical education classes for fourth-graders.

Volunteer fitness professionals teach the five-week class, then leave a video with the teacher to continue the program.

“We tried to pick exercises that anybody could do--like sports moves,” says Mitch Sudy, vice president of program services for ACE. “Everyone can [pretend to] dribble a basketball, but they’re not competing in basketball. They’re just mirroring those movements. . . . And we know we’re not going to change anyone’s fitness level by that and only that. But hopefully it will play a key point in motivating the kids.”

Sandy Voyne, a fourth-grade teacher at Rosewood Elementary School near West Hollywood, was thrilled to have UCLA Extension fitness instructor Ken Alan teach the program to her class recently.

“It takes a lot of energy to think,” she says. “And when they don’t have the energy level to even answer a question, everything is a lot of effort. But [after the class], it’s a whole different day. They’re self-disciplined, they’re self-directed.”

Teens are also being helped through an in-school health clinic, currently operating at Los Angeles High School and staffed by Childrens Hospital Los Angeles. Irene Rodriguez, a health educator at L.A. High School’s clinic, also counsels teens on nutrition and exercise.

“I really do think the [overweight] students really do want to find somebody who is going to help them, and they do want to lose the weight. They want to make a change in their life, and maybe they don’t have the skills to do that, maybe they have other problems going on in their life.”

Getting the family involved in the child’s weight loss is key, says psychotherapist Debbie Lux, director of the weight treatment program at Encino-Tarzana Regional Medical Center. Her approach is not to single out the child and make his or her weight the focal issue. She also believes if the family is accepting and not critical of a child’s weight, then the child will have higher self-worth and be better equipped at school.

“Having always struggled with weight issues as a kid, I personally feel for what these people are going through. . . . The isolation issue begins at home. If the parents see their child as the problem, then it affects their self-esteem and self-worth and usually leads to sneaky, destructive eating. We need to look at the whole family, and that way the child doesn’t take on this huge responsibility and blame,” she says.

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The Percentages

Percentage of children (6-11 years) and adolescents (12-17) who are overweight, 1988-’94:

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Male Children Adolescents White 13.2 11.6 Black 14.7 12.5 Mexican American 15.8 15.0

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Female Children Adolescents White 11.9 9.6 Black 17.9 16.3 Mexican American 15.8 14.0 Total* 13.7 11.5

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From Third National Health and Nutrition Examination Survey released last week by the Centers for Disease Control and Prevention.

*Total estimates include racial / ethnic groups not shown.

Percentage of children (6-11 years) and adolescents (12-17) who are overweight, 1988-’94: