Sunday, June 22, 2003
Copyright © Las Vegas Review-Journal

A Family Affair

Years of bad habits weigh heavily on health

Photos by Amy Beth Bennett. WORKING TOGETHER: Registered dietician Gustafson explains to Jordan how to read food labels during a recent office visit. HITTING THE ROAD: From left, Jordan, her sisters Paula and Katie, mom Danielle and dad Kirk take an evening walk. The Ellicos, especially Danielle and Jordan, have been trying to walk for 15 minutes each day. DINNERTIME: Jordan Ellico, 12, makes up her dinner plate while sister Katie, 10, waits her turn. Danielle Ellico pours milk for her daughters. Danielle says she's trying to feed her family healthier fare, so tonight's meal consists of chicken and rice with vegetables and a salad. OFFICE VISIT: Jordan, left, and her cousin Jade Duarte, 12, chat while they exercise on treadmills at Children's Heart Center. Health professionals at the center encourage family members to participate and exercise with those enrolled in the nutrition program. KEEPING TRACK: Registered dietician Anissa Gustafson helps Jordan analyze her weekly food diary. Jordan uses different colored pens to highlight which foods are fats, proteins, carbohydrates, fruits and vegetables. WEIGHING IN: Jordan gets weighed at the Children's Heart Center. Although she hasn't lost any weight since she began the program eight weeks ago, she has stopped gaining at the rate of 3 pounds per month. FAMILY TIME: From left, Paula, Katie, Jade and Jordan dance and play in the Ellicos' family room. SUMMER FUN: Jordan, left, and Jade swim in the Ellicos' backyard pool. Jordan's mother encourages the girl to swim for exercise.

Dinnertime rarely varied at the Ellicos'. The family would gather around the TV with their plates, watching M*A*S*H reruns or football, eating bread and butter with every meal as well as dessert.

Until recently, the overweight parents didn't think much about the food they offered their kids: mounds of mashed potatoes, triple-decker sandwiches and homemade cookies for snacks, and always cakes, brownies, pies or ice cream for dessert.

Now Jordan Ellico, their 12-year-old daughter, weighs 200 pounds. Her doctors say she's twice the size she should be and consequently at risk for developing diabetes, heart disease, and bone and joint problems.

"I really didn't think Jordan would grow as large as she did," said Jordan's father, Kirk Ellico, a 45-year-old mason who also owns rental properties. He and his wife live with their three daughters and numerous pets in a ranch-style house in central Las Vegas.

"I know it was the eating, and we never really exercise. We're couch potatoes," he continued.

Health risks

Jordan, a pig-tailed, 5-foot-2-inch sixth-grader, is not alone in having a weight problem. Everyone in her family is overweight to some extent, including her two younger sisters, who along with Jordan exemplify a national trend toward obesity in childhood.

"I should have fed my family differently," said Jordan's mother, Danielle, 41. "I used to let Jordan come home from school and eat eight cookies. Now she can only have one cookie."

Danielle, a homemaker and former cake decorator at Baskin Robbins, recently began curtailing Jordan's diet after the girl's doctor said her extra pounds could cause serious health problems.

Jordan already has trouble running because of her weight. She says she loves basketball, but that the running hurts her legs. "I'm such a good shooter, but I don't want to join a team because I can't run very well," she said.

Jordan also has elevated levels of insulin, which put her at high risk for developing diabetes, said her pediatric cardiologist, Dr. William Evans.

The Ellicos first took Jordan to see Evans after two pediatricians expressed concern over the girl's health. The doctors were worried that her excessive weight was putting too much stress on her heart.

Jordan's heart works fine, for now, but Evans said she'll most likely develop heart disease as a young adult if she doesn't develop healthy eating and exercise habits. Evans enrolled Jordan in a new pediatric program, called the Risk Factor Reduction Program, that he developed along with his partner, Dr. Gary Mayman. Children enrolled in the 12-week program work with a registered dietitian and exercise physiologist to learn about diet and exercise.

Evans and Mayman started the children's program last year after noticing an alarming increase in the number of young patients suffering from heart problems and other medical issues associated with weight. Forty children are enrolled in the program, and many more are on the three-month waiting list.

"The kids we work with will probably always wrestle with their weight, but we're trying to give them the tools to deal with that and prolong their lives," Evans said. "That's why we're doing this. We think childhood obesity is a major health threat."

If Jordan doesn't shed her excess weight, Evans says, there's a good chance she'll develop what was once considered adult diabetes by her late teens or early 20s.

"Someone who gets diabetes at age 20 could face major problems like leg amputations, blindness, kidney failure and heart problems by the age of 30 or 40," he said. "Diabetes kills people slowly, and the younger you are when you get it, the more likely you'll suffer major health problems."

A decade ago, type 2 diabetes primarily attacked only middle-age or older adults, according to the Centers for Disease Control and Prevention in Atlanta. Now, overweight children as young as 5 are being diagnosed with the disease.

"When I started in the late '70s, it was unheard of to see adult diabetes in kids," said local pediatric endocrinologist Dr. Henry Artman. "Now, these kids are a significant portion of my practice. Virtually every single one of these patients is obese."

Artman says many of his patients go for years without being diagnosed because the parents don't want to acknowledge their children are fat.

Touchy subject

The Ellicos say they knew Jordan had a problem, but that it was difficult to face because weight can be a very sensitive subject for children, especially young girls.

"I always got yelled at whenever I mentioned her weight," Kirk said. "I kept telling her that she's not going to want to be that heavy in high school, but Jordan always told me to shut up."

Psychologists who specialize in eating disorders and obesity say it often takes longer for overweight parents to recognize and deal with their child's weight problem than it does for healthy-weight parents to handle their overweight kids.

"Some parents are in denial. They don't want to think about their children as obese because then they have to think about themselves as obese," said clinical psychologist Jillon Vander Wal, who specializes in eating disorders and obesity at Wayne State University in Detroit. "A lot of parents don't even know what a healthy weight is."

Both Danielle and Kirk are considered obese by the CDC, which defines obese adults as those who have a body mass index of 30 or more using a calculation based on height and weight.

Danielle, who is 5-foot-8 and weighs 260 pounds, has a BMI of 39. Kirk, who is 6 feet tall and weighs 230 pounds, has a BMI of 31.

Kirk used to weigh about 260 pounds. He recently, and unintentionally, lost weight after he sold his auto repair business, which changed his daily work routine. Instead of sitting behind a desk all day, Kirk now works outdoors laying stonework on new homes.

Danielle, a stay-at-home mom with a penchant for baking desserts and hosting neighborhood barbecues, says she knows she has a weight problem but doesn't like to talk or think about it.

"It's a very sensitive issue for me, something that makes me cry," she said. "I don't think anything could hurt my feelings more than somebody calling me fat."

She says she hopes Jordan doesn't feel the same way.

"The world is different toward fat people. Sometimes you feel humiliated and it makes me sad to think Jordan feels the way I do," she said, recalling a time when she slipped and fell on her youngest daughter in a local store and nobody would help them up.

"She was screaming and everybody just stared at us. If I had been a skinny person, people would have run over to help," she said.

Overweight children suffer from depression, fear, stress and other psychological problems much more so than healthy-weight children, pediatric specialists say.

"Children as young as kindergartners associate obesity with undesirable characteristics. They think obese kids are lazy and don't want them as a friend," Vander Wal said. "Obese children tend to not like themselves and are less likely to do well in school, gain entry into college or progress as far as they might otherwise."

Hurtful words

Jordan says she feels better about herself since she began her nutrition program, but that her weight still upsets her. She said it's hard not to cry when kids tease her and call her names like, "tubby," "fatty" and "big mama."

"People tease me, but I try to defend myself," she said. "One student started calling me fat and Big Mac, and I started crying. But then I started yelling at him really bad."

Jordan says most of her friends are very supportive and help her stick to her diet. She said some of her friends also are overweight, but that none is as heavy as she.

Some experts speculate that overweight kids aren't as isolated as they once were because they no longer are unusual. Now, instead of one obese child in an entire school, there often are several in each classroom, they say.

"I'm seeing three or four kids in each class now who can't run because of their weight," said local elementary school physical education teacher Jurgen Kraehmer. "Physical education is not a priority for our kids today, and it's really hurting them."

Kraehmer also said that many of his students often don't get any exercise outside of their physical education classes twice a week in school. Many spend their after-school time eating and watching television, or playing computer games. Jordan usually plunks down in front of the television or computer after school. She grabs a snack -- sometimes a bag of popcorn and string cheese, cookies and a tuna fish sandwich, or a couple of frozen burritos -- and settles in for the afternoon. Often she watches cartoons while lying on cushions spread on the floor. In the summer, she sometimes swims in the family pool.

"I really have to stay on her ... to get her outside because all Jordan really wants to do is watch TV or play computer games," Danielle said. "She's like me, she doesn't want to exercise and whenever I push her, there's always an argument."

Both Danielle and Kirk refer to themselves as "lazy" and question whether their children are now suffering because of it.

Experts say yes. They say children learn to either enjoy exercise or disdain it from their parents. If parents don't adopt healthy habits, how can they expect their children to?

"Parents are not exercising, they are eating more fast food and larger portions, and they are transmitting those behaviors directly to their children," Vander Wal said. "It's very rare to see a heavy child in a thin family because the kids are big because their parents are big."

Technological advances and changes in the food industry have made it easier for Americans to be sedentary and consume too many calories, according to the CDC.

Americans now can choose from a wide variety of prepackaged foods in grocery stores or quick meals at drive-through windows. Although the foods are convenient for busy families, they also tend to be packed with fat and too many calories, according to the CDC Web site. People who regularly choose these calorie-dense foods eventually will begin to gain weight, especially if they don't get enough exercise.

Elevators, escalators, remote controls and dishwashers also contribute to the obesity epidemic, according to the CDC. Americans don't have to physically move as much as they used to in order to clean their home, change a channel or walk through an airport or mall.

Making changes

The Ellicos are trying to change their sedentary habits. Instead of remaining on the couch after dinner, the family walks for at least 15 minutes most nights of the week. The nightly walks are part of Jordan's pediatric program at Children's Heart Center.

"We walk but we wait until the sun goes down because we feel fat out there," Danielle said. "But this is good for us. We haven't ever really exercised before and it's a really hard habit to develop, but we're trying."

Kirk said he's proud of his daughter and tries to join her on the walks as much as he can. He says he knows the program must be working because Jordan now sometimes refuses to eat foods she loves, something she never did before.

Danielle blames her family's weight problems on her love for cooking and her desire to please everyone by regularly providing junk food. She said she was poor growing up and food was scarce, so she never wanted her own children to feel deprived.

"For Easter every year I would usually hide 200 eggs in the yard filled with chocolate and candy," Danielle said. "Not anymore. They all ... moaned, but this year they each only got one chocolate rabbit and money in the eggs instead."

Jordan's registered dietitian, Anissa Gustafson, said it's important to remember that people don't have to stop eating the foods they like, but simply keep an eye on the portion sizes.

"Her portion sizes were really pretty large when she first came to me," Gustafson said of Jordan's eating habits. "She was also inactive and drinking a lot of sodas."

The foods Jordan has been choosing to eat at school haven't helped, either. Jordan usually buys mozzarella sticks, french fries with cheese or chicken strips for lunch at school. She rarely eats any fresh fruits or vegetables with lunch, but is trying to remember to bring an apple to school each day.

Before meeting with Gustafson, Danielle said, she only served vegetables twice a week because everybody complained. Now she tries to fit them into every dinner.

Kirk said he doesn't mind the vegetables, but misses the desserts and snacks. He denies it, but Danielle said her husband restocked the house with candy and sweets after she had tossed all the junk food.

"It's killing me," he said. "I'm really missing those brownies and cakes."

Jordan says she misses sweets, too, but has learned that she can occasionally indulge in a cookie or a brownie, just not handfuls of them.

"I'm trying to stick to the diet, but sometimes it's hard," she said. "I had six pieces of bread yesterday, and I'm used to sometimes eating four sandwiches a day."

TV trouble

Besides consuming large portion sizes, Gustafson said, many overweight families share another bad habit: eating in front of the television. Many pediatric experts say children and adults who eat while watching television consume more calories and are more likely to be overweight or obese.

The Ellicos always eat dinner while watching television because Kirk refuses to turn off the set. Kirk sits on the couch and channel surfs, Danielle dines in a rocking chair, while the girls gather around a table nearby.

Kirk says he's "addicted to television" and doesn't think turning off the TV would make any difference in his daughter's weight. He said he wants family meal times to be "low key" and not a formal, stuffy occasion.

"I won't turn it off and I won't make everybody sit down at the table," he said. "We're all still in the same room. What's the difference?"

The difference, according to Dr. William Cochran, chairman of gastroenterology and nutrition for the American Academy of Pediatrics, could be measured in terms of pounds of excessive fat.

"Kids eat faster, they eat more and they consume more foods with fat and salt when they watch TV," he said. "Eating becomes a secondary thing to the television, and you don't really pay attention to whether you are hungry or not."

Jordan says she wishes her father would turn off the television. She said she knows her dad is proud of her, but that it would help if he were more supportive.

"I want him to be more involved," she said. "Sometimes it makes me mad. He says it's his house and he can do what he wants."

Changing family habits takes time and can be frustrating, but the Ellicos are making progress, Gustafson said. After eight weeks on the program Jordan hasn't lost any weight, but she is no longer gaining at the rate she once was.

"Success is not based on pounds on the scale because you are so much more than that," Gustafson said to Jordan. "You are successful because you go on walks now and you eat things you never used to. This whole thing is a process, not an event that occurs at one time."

Jordan says she feels better, her clothes aren't so tight and that friends have noticed she even looks better. She says she hopes to lose 10 pounds this summer and also get her younger sister, Katie, 10, involved in the program.

"Katie is close behind me and I worry about her," Jordan said. "She's going to be like me someday if she isn't careful, and I really don't want her to be like me. I don't want her to feel like I do."