Success story: Sam Feldman

Meet Sam

Sam Feldman cocks his head, remembering a kid he used to know. The boy was self-conscious about his weight, and as a result he lacked self-esteem in other areas of his life, too. He felt different from other kids. That boy was Sam before he enrolled in the six-month, behavior-based Pediatric Weight Control Program at Lucile Packard Children's Hospital Stanford. To say he changed would be a vast understatement. Sam Feldman became a new person.

"Before, I didn't always think of myself as a good person," the Palo Alto 11-year-old says. "After the program, everything changed. I felt a lot more normal and more confident, because I saw that I could do something that most kids can't." What Sam could do was take control of his own health — something even many adults can't manage. Starting at 48 percent above his ideal body mass index, or BMI, he has worked his way down to just 7.5 percent over. He says this shift was both monumental and surprisingly manageable.

 "You see a huge change in your life, but the point of the program is that it's slow-paced, and pretty simple," he says. "It's just about budgeting. Do I really want dessert tonight, or would I rather have these. French fries? And you budget your time, too — you always want to make sure you have enough time to exercise, for example." Like many kids, he and his family had tried various diets in the past. Low-fat diets. Higher protein, lower carb diets. Boot camp-type programs. But as Sam's mother, Robin, says, "These were just one piece of the big picture, and didn't really make a dent." The big picture meant assessing not just what he ate, but how he spent his time in general. "I used to come home from school and watch TV, eat a junky snack," Sam says. "Now I come home and play sports, and if I'm hungry I have a whole wheat quesadilla and some fresh fruit. The amount of exercise I got was very little. Now I do two hours a day, including half an hour of intense cardiac workout."

The essence of the program wasn't just a collection of rules he had to follow blindly — it was about seeing for himself how different patterns could make him feel better. In some cases, he felt so much better that he went above and beyond what the program asked of him. "One of our assignments was to cut out our screen time for a week. No TV, no computer, nothing with a screen at all. That was a big thing, because I used to watch TV every day," he says. "But it turned out it was really fun to turn off the screens — I got to do a lot more activities than I usually did, from reading to playing sports with my neighbors. So instead of just a week, I ended up going three months." Sam's mother had some eye-openers, too.

"The biggest surprise for me was learning about "habit foods" — all those 100-calorie packs, granola bars, frozen yogurt, things made with artificial sugar. The theory is, you get in the habit of eating those, and then it just feels natural to go to McDonald's and have a Big Mac and shake," she says. "It's not that the program doesn't let you have them, it's that you budget how much you have, and try to move down progressively." Of course changing the contents of one's pantry is just part of the solution. As Robin points out, there are sleepovers, birthday parties, holidays and trips to Grandma's to contend with — all potential wildcards when it comes to the kind of food being served.

"But the program really understands those challenges kids face, so they help them develop strategies for those situations," she says. Here Sam jumps in. "You can still have things you like. It's about moderation," he says. "Peanut butter was heaven to me, for example, but it's really high in fat. I can still have it, but now I'll have some peanut butter on toast instead of a giant peanut butter sandwich, which was my default lunch everyday. I haven't had one in over a year. I don't even know if they taste good anymore." Thomas Robinson, MD, MPH, Director of the Center for Healthy Weight, says the Pediatric Weight Control Program takes the best science about weight loss in children and makes it work with real-world families. "Decades of weight loss research have taught us what works best," he says. "The evidence is in our results. I have never heard of any other programs that come close to our participation and completion rates."

For Sam, those results came into particularly clear focus one day out on the track at his school. The year before the program, when everyone had to do the mile run, he clocked in at 13 minutes. After the program, he cut that down to an astonishing seven minutes. "I lapped the best runner in the class!" Sam says. "He does track! And I lapped him!

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Sam was thrilled to observe the physical changes the program brought about — some people didn't even recognize him afterwards, he says. But in a sense, that was beside the point. Coming to Packard each week didn't just help him change his physique, it helped him change the way he thinks. Sam says he still remembers the kid he was before: worrying about his weight, thinking about it every day, wondering what he could be doing to change it. It's that memory that makes him something of an evangelist for the program now, singing its praises to anyone considering it. "It's great to do this while you're young, because when you get older, it's harder to change your bad habits. Once the whole train is off the track, it's harder to get it back on," he says. "What you learn is self-control, and how to be a healthy person for the rest of your life. You have nothing to lose, and only something to gain."