Helping Teens Take Off Pounds Sensibly
Today’s Dietitian
By Kate Jackson
Vol. 6 No. 4 p. 20

America’s youths are putting on more pounds than ever before. The Centers for Disease Control and Prevention indicate that 30% of young people in the United States are overweight and 15% are obese. Clearly, the nation’s youths are losing the battle of the bulge. In a supersized-society of increasingly overweight adults, they are following their parents’ footsteps and making themselves vulnerable to the same weight-related diseases that plague the older generations, such as diabetes and heart disease. At the same time, they face fierce peer pressure to be thin and emulate their cultural role models.

On any given day, millions of teens are bombarded and transfixed by the images that represent our culture’s conception of perfection. As they tune in, for example, to MTV, they absorb the messages conveyed by the videos that set the standards of style, beauty, and ideal shape—standards that the average teen couldn’t get close to, let alone achieve. Although teens may grasp intellectually that such seemingly perfect people are either extraordinarily rare or are essentially constructed and packaged commodities, they measure themselves against these icons of cultural idealization. While they may have been raised to believe that self-worth is not gauged by beauty, media images and the attention “the beautiful people” garner tell them otherwise. Whichever way they look at it, the message remains the same: If ordinary teens are simply not good enough, overweight teens are anathema.

The consequences, for many, are shattered self-esteem, spiraling depression, and the development of eating disorders. Some will try any diet that promises rapid weight loss and will generally be doomed to fail. Others will smoke; put their faith in diet aids, drugs, or supplements; or abuse alcohol and recreational drugs to numb their feelings. Although there are numerous weight-loss programs that focus on healthy weight loss, few offer what teens need most to cope with obesity or overweight: emotional support and understanding.

TOPS (Take Off Pounds Sensibly) Club, Inc., a nonprofit, noncommercial weight-loss support group comprised largely of adults, offers promise to teens grappling with weight issues and their emotional consequences. With more than 250,000 members in 10,000 chapters in the United States and Canada, TOPS—started in 1948 by a Milwaukee homemaker, Esther S. Manz—is broadening its mission to help young people combat obesity by incorporating youth-friendly programs and incentives.

Many of the teens find their way to the program with an older relative. Some join in the adult groups and others take part in teen chapters. In either case, they find a warm and motivating environment. “It’s a place where teens can get that support without worrying about what people are going to think about them because TOPS is a very accepting atmosphere, not a judgmental place,” says Melissa Baxter, TOPS communication manager.

“They can come here and participate with others who can relate with their difficulties,” explains chiropractic physician and TOPS chapter organizer Betsy Lavin, DC. Sadly, they come with horror stories of how they’re treated by other kids; but in the group setting, they can share those stories with people who understand. “They come to this environment and know that it’s safe to talk about it.” In response, the participants not only get unconditional support, but practical strategies. “We teach them how to handle difficult situations and how to understand that their self-worth isn’t based upon the comments of their peers,” says Lavin. While other programs may offer teens diets and food plans, many lack attention to the emotional component so crucial to teens’ success.

“For teens, peer pressure is so overwhelming,” explains Lavin. Eating at fast-food restaurants, for example, is a social activity that overweight individuals may find difficult yet are pressured to take part in. In addition, there’s intense pressure to wear the current fashions, which are generally designed for those who are reed-thin. For teens, says Lavin, “there are many things stacked against them if they’re overweight.” TOPS, she indicates, helps them overcome the odds because there’s strength in numbers and comfort in support. “The biggest thing we try to teach them here is that even though they feel they don’t have any control, they do. It may not seem that they have control when they go to the cafeteria or if they have to eat all the time. But, we teach them how to make the right choices given their circumstances.” The educational sessions coupled with support emphasize the things over which individuals do have control, says Lavin, such as how to react to teasing or pressure. “We give them the self-esteem to handle those situations the best they can,” she explains.

Self-esteem, support, fun, and a certain amount of healthy competition drive teens to succeed with TOPS. “Teens are really used to blending into the background, and they’re generally very shy and inhibited,” says Lavin. “Here, it’s fun because we’ll watch them come in and they’ll be a little shy at first, but once they realize that it’s safe and that they can talk about anything they want, that they’re going to be loved and understood, and that there’s hope, they just open up—especially when the weight comes off.” For many, she says, the scale used to be a horrible thing. Some overweight teens, for example, have been humiliated when insensitive teachers force them to step on a scale in front of their classmates and announce the results. “But here, after we get them losing weight, they come and get on the scale and their eyes light up,” says Lavin, who loves the job of being weight recorder because she thrills at seeing the teens’ faces when they lose the first 10 or 20 pounds. “You just see an overweight teen become a whole new person.”

TOPS organizers have found that a certain amount of competition spurs young people to try their best. To encourage its youthful members to participate and stay active, the organization each year recognizes the best “losers” in a number of categories. Those selected are honored annually at International Recognition Days at various locations across the country.

Nutrition counseling is not overlooked as self-esteem is built, contests are won, and feelings are shared. The educational sessions also focus on healthy lifestyles and nutrition basics. “If we can get them to think about drinking water instead of [soda] pop or grilled chicken instead of a double cheeseburger, we can have an impact,” says Lavin. “So, you teach nutrition information from day one, hoping they’re going to carry it through.” The results have been encouraging. The TOPS program boasts numerous success stories, which Baxter never tires of hearing. Success may be different for each teen, measured by various criteria. “Maybe they didn’t get to go to their prom, and now they get to be crowned on stage in a long formal gown,” she says.

The TOPS program maintains booths at a number of medical and healthcare conventions, such as the American Heart Association, the American Dietetic Association, and the American Academy of Physician Assistants, not only so healthcare professionals can learn about the program and refer their patients and clients, but also so they can become acquainted with the program and start chapters linked to their own practices. Dietitians and other professionals are often interested in starting their own chapters, explains Baxter, to make sure that their patients or clients can get the extra support they need.

Having a chapter needn’t involve a great deal of time or involvement for the healthcare professional because chapters are run by volunteer leaders. To start a chapter, professionals need only contact TOPS headquarters, which will dispatch a local field staff person to provide a kit that explains the process and be there initially to answer questions and provide support for the developing chapter.

Lavin, who once struggled with her weight, started a TOPS chapter in Granite Falls, Minn., where she has her private chiropractic practice, after having benefited from the program herself and wanting to bring its rewards to her patients. “I knew that I had to lose weight myself because it was really hard to teach wellness to my patients when I was overweight myself, so I looked for a nutrition-based healthy lifestyle group that I could use for myself as well as my patients,” Lavin says. She was drawn to TOPS because it emphasized a healthy lifestyle over adherence to any specific diet. “It’s not about eating this food or not eating that food,” she explains. “It’s about changing your lifestyle and building self-esteem.” She was also attracted to the program because it was a nonprofit endeavor, something she notes her patients look upon very positively.

Lavin started the chapter in her wellness center with 10 members that grew to include more than 100 active members at one point. However, it takes only roughly four people to start a chapter. TOPS chapters, she explains, have weekly meetings at which there is an official yet confidential weigh-in for members. “You have to have that accountability to the scale, which is why group support is so effective.” The weigh-in is followed by a group meeting with a program that stresses an aspect of positive change. “We teach something about healthy living—for example, portion control—and address emotional issues—social pressures members might be facing, self-worth, or positive attitudes.” TOPS headquarters sends each chapter program ideas and supplies all the information and materials.

There’s no single facilitator at TOPS groups. “Each chapter elects a leader, co-leader, treasurer, and secretary. We like to get as many people involved as possible, so it’s a group effort when it comes to creating the programs and selecting the topics.” No special training is required. “The only training we have is that we’ve all been overweight, and we all know what it feels like,” observes Lavin.

What makes TOPS work, observes Lavin, is the unconditional support. “Anybody that walks into our group will feel instantly welcome because we’re all in the same position or we’ve been there and we know what it feels like. That’s the biggest thing, regardless of whether a member has five pounds or 205 pounds to lose. Our group is here to understand and support what they’re going through.” Groups such as these, she says, are the only place people can go where they’re not going to be judged or ridiculed about their weight. Instead, they can get a hug from somebody who knows how they feel. And, says Lavin, “they may not have had a hug in 15 or 20 years. But, this is a very open and caring environment where they feel safe.”

For more information, visit www.tops.org or call 800-932-8677. A free brochure that offers 10 healthy steps to be a lean-eating teen is available from TOPS by calling 800-932-8677.

— Kate Jackson is a staff writer for Today’s Dietitian.

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