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Motivated to Lose:
Pediatric weight loss program takes multidisciplinary approach

It had been a decade since Nick Lieto was diagnosed at age 6 with acute lymphocytic leukemia. He had been cancer-free since completing treatment in 2000. But during an annual Pediatric Long-Term Follow-Up visit at the University of Michigan Comprehensive Cancer Center in 2007, his health-care team warned him: His weight-which was then 321 pounds -- could raise his risk of recurrence as well as heart disease and diabetes.

When Cancer Center Registered Dietitian Nancy Burke suggested he try a six-month pediatric weight loss program called MPOWER -- the Michigan Pediatric Outpatient Weight Evaluation and Reduction Program -- Lieto and his parents signed on. Two years later, Lieto is 80 pounds lighter -- and has kept the weight off.

"At first, I wasn't inspired about doing the program, but they helped us to understand," Lieto said. "They weren't saying, 'You need to lose weight.' They were saying, 'We're going to help you do this.'"

MPOWER is a multidisciplinary program that combines medical evaluation, nutritional counseling, behavioral therapy and physical fitness education for weight loss designed for youths 12 to 18. For childhood cancer survivors, this approach can help address emotional issues, Burke said. Sometimes families use food as a reward or a coping tool to help children get through treatment, which can lead to unhealthy food habits later.

During the first visit, MPOWER patients undergo a physical exam and meet with specialists, including a dietitian, psychologist, social worker and exercise physiologist, said Susan Woolford, medical director of the U-M Pediatric Comprehensive Weight Management Center. Between the first and second visit, patients log their eating and exercise habits. During the second visit, the log and lab results are discussed, and the health-care team presents a 24-week weight loss plan.

The plan sets incremental goals, Woolford said. The team supports patients and families through weekly visits, which involve group sessions on developing healthy eating habits, individual counseling to help families with specific issues and group exercise classes.

For Lieto, the key to his success was his motivation and family support.

"The Lieto family all made changes to support Nick," Woolford said. "When they went to a barbecue, healthy food was available. They changed get-togethers so that they were centered around an activity, rather than food.

"It's key that the whole family participate. If the home environment doesn't change, then it's very difficult for adolescents to make changes that are necessary for them to achieve their goals."

Lieto, now a freshman at Western Michigan University, said he realizes how important his family support was -- particularly now that he''s away at college.

"It's kind of a struggle making the transition from high school," he said. "Your parents help put healthy choices in front of you. Then you go to college, and it's a complete 180: You have to make your own choices. It's definitely harder, but I've kept it up."

 

Try Nick Lieto's Grilled Potato and Veggie Foil Wraps [pdf]

 

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