Study aims at obese kids with diabetes

ST. LOUIS – Two years ago, Jazmyne Robinson was 14 and carrying 230 pounds on her 5-foot-2 frame.

Her menstrual cycles were irregular, she was urinating constantly and by the time she arrived home from school each day, she was exhausted and her head would be pounding.

“I would make myself some cheese fries, then go to bed until about 6 or 7,” Robinson said.

Her doctor ordered blood tests during a routine checkup. That’s when she learned she had Type 2 diabetes.

Today, Robinson, 16, of Ferguson, Mo., is 50 pounds lighter, no longer has headaches and has enough energy to run, rather than walk, laps during softball practice. She also tests her blood twice a day and takes Metformin to control her blood sugar levels.

As for the cheese fries? They’re not a staple of her diet anymore.

The dramatic changes began gradually when Robinson and her mother, Angel Allen, 38, signed up for a study at Washington University looking at the role families play in helping kids with Type 2 diabetes lose weight and, more importantly, keep it off.

“It’s easier to get people to make the initial changes and harder to get them to keep with them. We’re trying to figure out the best way to get them to make permanent lifestyle changes,” said Denise Wilfley, director of the Weight Management and Eating Disorders Program at Washington University.

Results of the diabetes study have been so promising that Wilfley has begun a similar study called COMPASS, or Comprehensive Maintenance Program to Achieve Sustained Success, with nondiabetic children. She’s looking for 120 local children, ages 7 to 11, who have a BMI greater than 85th percentile for their age and at least one overweight parent or guardian.

Finding such children shouldn’t be a problem. According to Wilfley, 37 percent of U.S. children ages 7 to 11 are overweight or obese, and about 68,000 of them live in the St. Louis area.

The first phase of the study will last 16 weeks and focus on getting the pounds off. Then the children and parents will be randomly assigned to one of three maintenance groups for 20 months. One group will attend workshops that provide state-of-the-art education such as cooking and fitness demonstrations. The other two will continue meeting with counselors who will help parents encourage their kids to be friends with physically active peers and to arrange play dates with existing friends that involve physical activity and healthy eating. One of the two later groups will meet with counselors and support groups weekly, while the other will meet twice a month.

Rob Welch, assistant professor of psychiatry at Washington University and a counselor in the diabetes study, was startled by the number of calories many of the children were eating each day.

Parents often gasped when he tallied then compared them to the 1,600 to 2,200 calories they should be eating, he said. Some kids were eating 4,000 to 5,000 calories and gaining 5 to 10 pounds in a month.

Welch estimates that Jazmyne was consuming her entire daily allotment in the cheese fries alone, then drinking several sugary colas and sometimes snacking on chicken wings and pizza.

“She wasn’t eating right,” Allen said. “We didn’t know it plays such a big part of it.”

A lot of kids eat in the absence of hunger, Welch said. “They come home tired, stressed out or there’s nothing else going on so they eat. If they were eating carrot sticks or apples that would be fine. But often the types and quantities of food in house are not very healthy.”

He believes too many parents take a hands-off approach to their child’s eating because they’re running from one activity to the next or they are stressed from working two jobs and trying to pay bills. Grabbing high-calorie fast food is easier than cooking a healthy meal.

Counselors, or interventionists as Wilfley calls them, help parents purge the home of junk food and plan meals that include more fruits, vegetables and milk products prepared in healthy ways.

Robinson now eats three balanced meals and two snacks a day. Allen, for her part, stopped frying foods and began baking, broiling and boiling meats, which they eat with salads and fresh fruit.

As a bonus, she has lost 37 pounds.

Robinson said the new way of eating was hard at first.

“But after you change you learn that there are a lot of foods that are good for you that taste good,” she said.

Mother and daughter also joined a nearby gym and began working out three times a week. Counselors work one on one with families to locate school gyms in their neighborhoods that they can get access to, and they point them toward exercise videos.

“Most kids who come in want to make changes because they’re being teased or can’t participate in sports or feel like they look different than other kids,” Wilfley said. “And their parents are motivated, because they often had to deal with weight problems and don’t want their kids to go through the same thing.”