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Weight Loss Confidential
by Anne M. Fletcher, M.S., R.D.
foreword by Holly Wyatt, M.D.

"Regardless of how they may appear on the outside and how content they might seem to be, the majority of overweight teens deal with a lot of emotional anguish. It will almost always be hidden, but it's there." — Taylor S., from Weight Loss Confidential

"There are millions of reasons to lose weight. Find one, go with it, stick with it, and believe in yourself. It took years for me to find the inspiration, but when I finally got it, there was no stopping me. If you want it enough, you will lose weight." — Aaron T., from Weight Loss Confidential

"I became motivated to do something about my weight because I started to hate looking in the mirror. I wanted more confidence, didn't like not being able to wear fashionable clothes, and wanted to run faster. Some of my peers made fun of me. I stay motivated to keep off 45 pounds by just thinking about how much happier I am now." — Erin D., from Weight Loss Confidential

About the Book

Can teenagers lose excess pounds in a healthy way? How can parents support their teens without sabotaging their success? Who better to answer these questions than the teens and parents who have "been there" — and succeeded?

For her award-winning bestseller, Thin for Life, nationally known author and registered dietitian Anne Fletcher went straight to the experts: hundreds of regular people who had lost weight and kept it off. Now, for her new book, Weight Loss Confidential: How Teens Lose Weight and Keep It Off — and What They Wish Parents Knew, she's uncovered the success strategies of more than 100 formerly overweight teens from across the United States and Canada. Their average weight loss is 58 pounds, and some of them lost as much as 75 to 100 pounds.

Many of the teens overcame "heavy" odds — a number of them had been overweight for a long time and most had at least one overweight parent. Their motivations to change were diverse: wanting to look better, improve their health, feel better about themselves, attract the opposite sex, and end the teasing and ridicule. Through their clear voices and poignant experiences, Fletcher informs both parents and teens about what works and what doesn't work for long-term weight management.

The teens in Weight Loss Confidential are a varied and inspiring group:

• Joyelle T. gained more than 80 pounds in eighth grade (bringing her weight up to more than 200 pounds). With the help of a weight-loss program and through healthy eating and exercise, she lost 55 pounds in tenth grade. She also inspired her father to lose more than 100 extra pounds, and now they are planning a bike trip together.

• Tyler D. was 5 feet 4 inches tall and weighed 185 pounds in seventh grade when he got fed up with being overweight and getting teased about it. He joined the middle school football and track teams, lost 20 pounds (and grew 9 inches), and is currently a healthy, active college student.

• Shanisha B. at age 12 was 5 feet 7 inches tall and weighed 210 pounds. She wanted to be able to run, walk, and play without stopping frequently to rest. She joined a comprehensive weight program, had tons of support from her mother, and lost 40 pounds.

• Jorgey W. says that before she lost more than 100 pounds at age 13, "every day [I] would come home crying." She remembers being chased around the playground with her pursuers yelling, "Run, Fatso, run," and was harassed on the Internet and by phone because of her weight.

• Anne Fletcher's own son, Wes G., weighed 270 pounds and stood 6 feet 1 inch in eleventh grade. During his senior year in high school, he decided he wanted to look good when he went to college. He lost 65 pounds by keeping track of everything he ate in a daily planner, weighing himself once a week, and playing pickup basketball.

In fact, it was Wes's weight loss that inspired this book. He lost the weight after meeting another teen who had slimmed down. That's when Fletcher realized that teens listen more readily to their peers than to their parents — even if their parents, like Fletcher, are weight experts.

In Weight Loss Confidential, teens and their parents explain how families can help: what works, what won't work, and, perhaps most importantly, what may actually backfire by making a teen rebel and gain even more weight. Tom C.'s mother says, "We should not have told him he looked good when he did not. He eventually resented us for lying to him." Parents also understood that, as Richie C.'s mother says, "Telling Richie not to eat something was counterproductive. I'd have to say to myself, 'Don't be the food police.'" One of the keys to success is to create a healthy home food environment for the entire family. As Sid J.'s mother points out, "If a child is constantly relying on someone who says 'Don't eat this' or 'Don't eat that,' it doesn't work. At some point, he has to begin to own his own eating habits. This happens when you give them choices."

Fletcher's research challenges myths about teen weight loss and addresses both practical and controversial aspects of weight management for young people — from dieting and dealing with body image to the role parents play in the process. Her findings are bolstered by the latest studies and advice from leading experts in the field.

Everyone's talking about our national weight problem. Finally, in Weight Loss Confidential, we have solutions from people who have "been there," solutions that will actually work. In a society where one out of every three children and adolescents, ages 2 through 19, is overweight or at risk for being overweight — and the numbers keep growing — we can't afford not to hear what the teens in this book have to say.

About the Author

The award-winning health and medical journalist and registered dietitian Anne M. Fletcher is frequently sought out for her knowledge about weight management, behavior change, and addiction. Her most recent book, Weight Loss Confidential: How Teens Lose Weight and Keep It Off — and What They Wish Parents Knew, was published by Houghton Mifflin in January 2007.

Fletcher is the author of the national bestseller Thin for Life: 10 Keys to Success from People Who Have Lost Weight and Kept It Off. The book won a National Health Information Award and was nominated for a Julia Child writing award. Fletcher's 2001 book, Sober for Good: New Solutions for Drinking Problems — Advice from Those Who Have Succeeded was also a national bestseller and received several distinguished awards.

Fletcher is the 2006 recipient of the American Dietetic Association's Media Excellence Award for consistent nutrition reporting, coverage of issues with balance and perspective, scientific accuracy, broad audience reach, and creativity in presentation. As the former assistant director of an obesity treatment program, she provided counseling to hundreds of clients with weight problems. Previously, Fletcher was the executive editor and chief writer of the Tufts University Health & Nutrition Letter and a contributing editor for Prevention magazine. She holds a bachelor of science degree in nutrition from Cornell University and a master of science degree from Drexel University. Fletcher, her husband, and three children live in Minnesota.

Fletcher's extensive media experience includes appearances on Today, The View, The Phil Donahue Show, Good Morning America, The Early Show, and National Public Radio's Talk of the Nation. Her articles have appeared in Vogue, Good Housekeeping, Parenting, Reader's Digest, Redbook, Better Homes & Gardens, Cooking Light, American Psychologist, and the Journal of the American Dietetic Association.

A Conversation with Anne M. Fletcher

You've written three books about adults who lost weight and kept it off. What prompted you decide to write a book about teens who lost weight?

I actually got the idea years ago, when my overweight teenage son came home from camp and excitedly told me about a boy he'd met who had lost 40 pounds. It occurred to me that a great model for a book would be "teens helping other teens" with weight management. My son lost more than 60 pounds when he was 18 and, when he'd kept it off for a few years, I decided it was time to write the book.

I was also troubled by the skyrocketing numbers of overweight kids in our country and around the world and thought it was time to offer some solutions.

How did you go about reaching out to the 100+ teens we meet in Weight Loss Confidential's pages? Was it difficult to convince those teens to participate?

I turned to schools, health clubs, weight programs, friends, relatives, and colleagues, all across the United States, even in other countries, to find formerly overweight teens who had lost weight in healthy ways. I worked hard to find kids from diverse racial and ethnic backgrounds — teens who could say, "I lost weight and you can do it, too."

Once I found the teens, I had to convince them to complete an eight-page questionnaire. It wasn't at all difficult to get the profiled teens to tell their stories because they're proud of what they've accomplished and want to reach out to others.

How heavy were the teens before they started losing weight, and where are they now?

I included only teens who had been truly overweight, not kids who lost 5 or 10 pounds to look better. Before losing, nearly 9 out of 10 teens met the medical definition of "overweight" (60 of them were very overweight), and the others were "at risk of overweight." After losing, to be part of the book, the teens had to be at what they considered a "comfortable" weight for about a year or more. And they had to have lost weight in a sensible way. The teens' average weight loss was 58 pounds, and the average length of time they successfully managed their weight was just over three years.

So are most of these teens now what we'd consider "thin"?

All of the teens are at a weight that makes them happier and healthier than they were before losing. And most of them are at a weight considered healthy for their age. But they are not all "thin" by societal standards. One of the most important goals of the book is to help kids set a realistic weight-loss goal and to show them you can be successful without looking like a skinny celebrity. As Sandra D. says, "If you don't have an ideal-size body, it doesn't mean you're not an ideal person." Their stories show that success is not just what the scale says.

A lot of kids today are overweight — what made your teens decide to turn things around?

For most, it was a combination of things: they wanted to look better and feel better about themselves; they were concerned about their health; and they wanted to have better relationships with their peers. Many of them were sick of being teased because of their weight. Some of their stories would break your heart — this isn't a society that's kind to overweight people, and kids can be especially cruel. But the teens in my book rose above the cruelty and turned things around.

What did you learn from the parents you interviewed?

First, they made it clear that kids need to know that they're loved unconditionally, regardless of their weight. Both the parents and the teens also stressed that the initiative for weight loss has to come from the teen — if the teen is not ready or isn't motivated, nagging, preaching, and complaining will only backfire. Mick J. told me, "My desire to finally lose weight was internal. Before that, my mom nagging me just made things worse." Parents also emphasized the importance of providing healthful foods, not having a lot of high-calorie foods around, and being role models for healthy eating and exercise. Once the teen makes a decision to slim down, parents stressed the need for giving them lots of support and praise, no matter how small the changes are.

Was it difficult to be unflinchingly honest when writing about your experiences with your son, Wes?

It's never easy to reveal personal information, especially when it involves your own child. But with my son's permission, I chose to talk about the issue because I wanted readers to know that my son and I have "been there." I shared the personal side because it shows that even if parents do what they think are the "right" things to raise a healthy-weight child, he may still become overweight because of a biological predisposition and/or our environment — one that sets us up to eat too much and exercise too little. My son's story shows that if you give overweight children the tools to succeed, they may eventually do it.

How did the teens lose the weight? Were there any common threads?

The most striking theme was that there is no one way to do it — teens have to find what's right for them as individuals. About half of the teens lost weight on their own and the other half had help from a professional or a program. To help readers find the best way for a teen to slim down, I share in-depth stories of kids who lost weight in different ways and offer detailed guidelines about choosing a weight-loss program. The book also offers a "shopper's guide" to weight programs, helpful Web sites, and other resources for healthy weight management.

If you had to pick the one most important strategy that led to the success of these teens, what would it be?

Without hesitation, I'd say exercise. In fact, exercise (or becoming more physically active) was the number one response when I asked the teens for their most important weight-loss strategies and for the most important way to keep the weight off. I was actually surprised to see how dedicated these teens were to exercise; strength training and running were the most common forms of activity. Less than a quarter of them were involved in team sports, so kids don't have to become "jocks" to be fit. The teens offer strategies for overcoming self-consciousness about exercising, getting started, and making physical activity fun.

What are some other themes that jumped out at you?

A big theme was giving up or cutting back on soda, and many teens said that drinking more water is one of their strategies. They share their strategies for staying motivated and for cutting the fat, downsizing portions, snacking smarter, shifting to healthier carbs, making better restaurant choices, and managing emotions without eating. Most of them are not meal-skippers, and they don't deprive themselves of treats.

What's the most important piece of advice you can offer to teens who are struggling with their weight? To the parents of such teens?

Know that you can succeed, because I found more than 100 teens who did it. Don't give up, because it usually takes time and at least several attempts to reach a healthier weight. Teens have to do it for themselves — parents need to provide support and healthy foods, but ultimately they have to let teens take the lead in finding a way to lose weight and keep it off. The teens in Weight Loss Confidential pave the way for that to happen.

10 Things Teens Wish Parents Knew about Weight Loss

1. "Don't tell me my weight is okay." If your teen is overweight and says he wants to slim down, listen to his concerns and offer to help find some solutions. Don't minimize the problem.

2. "Get off my back." Don't nag, preach, criticize, or try to coerce your teen into losing; talk to her like a friend, not a disciplinarian.

3. "Let ME be in charge." It's up to the teen to decide if, how, and when she wants to lose.

4. "Don't be a food cop." Comments like "You've had enough" and "You don't need that bowl of ice cream" will backfire.

5. "Be there when I'm ready." Support your teen's choices and praise his efforts: help find affordable ways to exercise or a program he'd like to attend. Be a role model for healthy eating and exercise.

6. "Help me out, don't single me out." Create a healthy home food climate - for the entire family, not just the overweight teen. Provide kids with healthy, appealing food choices without making them feel deprived.

7. "Love me no matter what." Let your teen know she's loved whatever her weight is and whether or not she succeeds at slimming down.

8. "Be patient." Understand that losing weight takes time, effort, patience, and often multiple attempts.

9. "Help me be realistic." After losing weight, your teen may not be "thin," but she'll be healthier and happier.

10. "Believe in me." Send the message that you know your teen can succeed and that you'll be there if he needs you.

In Their Own Words

"If a teen is really concerned with losing weight and has good reason to believe he's overweight, don't tell him he's just fine the way he is." —Taylor S.

"Parents need to understand that teens can't lose weight alone—they need support and encouragement." — McKenzie K.

"Teenagers need to be talked to like a friend. The last person they want to listen to is a disciplinarian parent laying down the law about 'this is why you need to lose weight.'" — John A.

"Don't make overweight teens feel singled out at the dinner table, like by having meals that are different from everyone else's. Use your child as an opportunity for the whole family to eat better." — Aaron T.

"Be supportive of their choices. If they mess up, don't get angry. Make sure to talk to them about what they're going through because it's hard and parents are easier to talk to about weight than friends are most of the time." — Emily B.

"I never would have started exercising if my mom hadn't been working out for my entire life. She makes time every day to exercise, and she's a very busy woman, so I knew I could fit it into my schedule too." — Kristy C.

"Parents need to understand that having tons of junk food around is practically sabotage." — Mary N.

"If tempting foods are around, you feel like your family's not supporting your ambitions. When you're home, you want to relax and not have to worry about being tempted." — Felicia S.

"Don't plan a teen's diet for him/her. If he wants to try the grapefruit diet and the parent spends all day researching the South Beach diet and persuades the teen to try that, chances are the kid won't stick with it. Let your child learn what works and what doesn't on his own." — Kyle B.

"Many different things make a person worthwhile. If you're not an ideal-sized body, it doesn't mean you're not an ideal person." — Sandra D.

Weight Loss Confidential Shatters Myths about Teen Weight Loss

Weight Loss Confidential by Anne M. Fletcher, M.S., R.D., challenges the prevailing thinking on teen weight loss, including many beliefs commonly held by professionals in the field:

Misconception: Teens who diet invariably fall prey to fads and have unhealthy eating habits.

WLC: The more than 100 teens whom Fletcher interviewed lost a significant amount of weight without going to extremes: their average weight loss was 58 pounds, and three quarters of them lost 30 pounds or more. Many said they followed diets, but they were healthy diets.

Misconception: Teens who have tried and failed to lose weight many times won't succeed.

WLC: 7 out of 10 teens lost and gained weight multiple times before finally succeeding.

Misconception: The methods used by adults to lose weight are inappropriate for teens.

WLC: A number of experts steer teens away from counting fat grams and calories, keeping food records, and working out, believing these things might lead to an unhealthy obsession with weight and food. Many of the teens Fletcher interviewed used these techniques, and their attitudes about weight and food were healthy.

Misconception: Teens are rebellious by nature, so efforts to help them will backfire.

WLC: A strong majority of the teens indicated their families' support was important to their success.

Misconception: Overweight teens from overweight families are unlikely to overcome the odds and lose weight.

WLC: Most of the teens said at least one parent was overweight.

Misconception: Teens who have been overweight since they were very young don't have much hope of losing weight permanently.

WLC: The average age at which the teens reported becoming overweight was 9 1/2.

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