By Michelle Grappo, MA, EdM, NCSP, Associate Member, IECA (CO)
No one is immune to the challenges of nutrition, activity, and stress management in our society. According to a 2015 report from the Centers for Disease Control and Prevention, over 30% of children and adolescents were overweight or obese in 2012. That fact is certainly reflected in the families with whom independent education consultants (IECs) work.
Parents typically contact IECs for solutions when things have reached a tipping point: when local resources have been exhausted and the child’s happiness and well-being are compromised. When I get referrals where the primary concern is weight management, I typically view the weight issue as merely the canary in the mine and approach the referral with a holistic perspective, asking:
• How is he doing in school?
• What is her social life like?
• How does he cope with difficult or challenging situations?
• Is she able to express and cope with emotions in an age appropriate manner?
Children, like any of us, may use food to cope with difficult emotions or struggle to get proper nutrition in a busy world. Teens with ADHD or other executive functioning issues may have added challenges because they struggle to manage timely or balanced meals—for example, they allow themselves to become ravenously hungry and then overeat. I become especially concerned when a child has a poor self-image, the effects of which can snowball and affect their involvement with friends or in activities they once enjoyed. The goal is for young people (and all people) to feel good about themselves and have positive relationships with their bodies, regardless of their weight.
In my practice, I have seen great success in weight management through participation in outdoor behavioral health programs, e.g., wilderness therapy or therapeutic outdoor programs. Although such programs are not designed as weight loss (or gain) settings, students typically emerge stronger, fitter, and more confident. For example, I recently had a teenage client who lost about 20 pounds in a wilderness program. That young man felt very good about his physical abilities upon program completion, and his experience laid the groundwork for a more active lifestyle after his graduation. He knew he was stronger and wanted to keep that going, and he also felt more confident and empowered when exercising, especially in group settings.
At Pacific Quest, a wilderness therapy program in Hawaii, medical director Britta Zimmer, ND, advocates a slow and sustainable approach of 2–4 pounds a week. Dr. Zimmer points out that “once students realize they have to address several areas of their life—exercise, eating well, sleep, and stress management—there is so much they can do that extends well beyond food to manage their weight.” She adds, “as they are working on these elements, they also find more energy to engage in all the pieces in their lives.”
Beneficial Program Components
Programs that effectively address weight loss include multiple domains.
Rest. Proper sleep is the cornerstone of good physical and mental health. One of the first shifts for students at wilderness programs is the regulation of circadian rhythms—in the absence of technology programs and with a group schedule, students’ rhythms begin to align with the natural world. Students fall asleep soon after the sun goes down and wake with the sunlight. Dr. Zimmer explains that “balanced cortisol rhythms in the body will lead to less insulin resistance, which results in better blood sugar control and fat metabolism.”
Physical activity. Students are physically active every day. Whether walking around the campsite, rock climbing, gardening, or hiking, students are moving. Many programs also include calisthenics or yoga. Students not only increase their caloric expenditure but also develop muscle mass and, most importantly, confidence in their physical abilities and a more positive self-image. They come to see their bodies as capable of incredible feats—and their self-efficacy grows.
Nutrition. Programs employ dieticians, nutritionists, or naturopathic doctors to ensure that food is wholesome and appropriately rationed. All programs have nutritional oversight because of licensure regulations, but some have gone an extra mile—or three. Many now serve kids organic or exclusively whole foods and place an emphasis on nutrient-dense foods as the diet cornerstone. Open Sky Wilderness in Colorado, despite the logistical challenges of being an expedition model, incorporates local meats and fresh organic produce into participant’s diets. Students learn to cook and to nutritionally balance a plate; many report that they never really understood correct portions before that experience. Proper hydration (with water, not soda) is also emphasized, and meals are social occasions and a time for connection. The relationship with food evolves in positive ways with all those changes. Dr. Zimmer adds, “In terms of food, it’s very important not to restrict or miss meals; to learn clearly whether each meal has enough protein, fiber, colored vegetables, and fruit; and to never count calories, but rather to analyze the plate—e.g., I don’t have enough protein, so I need to add an egg.”
I have also noted programs’ increased sensitivity to students’ nutritional needs. It used to be that girls were at risk of gaining weight in wilderness programs, but on a recent tour of True North Wilderness, a program in Vermont, I learned that a dietician had advised different ration portions for boys and girls. They had also looked at carbohydrate consumption and were working to incorporate more protein to better support weight management.
Skilled support. One of the most important pieces of the puzzle is well-trained adults who are always present to observe an issue if it arises and compassionately intervene. A primary goal of a therapeutic wilderness experience is to work with children to identify what’s going on for them emotionally in a developmentally appropriate way—whether it’s in a food-related or another moment of stress. Skilled therapists and guides work with students to help them express and process their emotions in healthy ways. Before admission, IECs should discuss eating and other related referral concerns with programs so that a treatment plan can incorporate those goals.
Although therapeutic programs can really shine in addressing the mechanics of weight management—such as eating, exercise, and sleep—they can also go far deeper to deal with underlying issues, such as poor stress management, depression, anxiety, and even trauma. Bullying and self-image are also issues that often arise and can be therapeutically addressed. What’s more, families are very much involved in this process with detailed parent communication and support so that the momentum behind the students’ progress can be maintained long after graduation.
Our philosophy as IECs is to try to understand and serve the “whole child.” When a child is unhappy, we want to learn from the parents and other professionals how we can support the child’s growth across the domains of life. And sometimes an outdoor therapeutic program is just the right fit.
Michelle Grappo, RNG International Educational Consultants, can be reached at [email protected]
Centers for Disease Control and Prevention. 2015, August 27. Childhood Obesity Facts. www.cdc.gov/healthyschools/obesity/facts.htm.