After Juliana hit 168 pounds at a height of 5′ 4″, I went looking for a kids weight control program. I found one at Lucile Packard Children’s Hospital at Stanford University. It was near my house, and started at the end of January. It was expensive and not covered by insurance, but I wanted help. Juliana was in the habit of asking my permission to eat things–usually sweets or seconds. I never said no, but would try to guide her choices–”I wouldnt have the cookie because we are going to a party later and you’ll probably want something there.” I wanted to cut myself out as the middleman. I wanted her to be in charge and empowered to control her own intake. The Packard program is designed to do that. Juliana met with the Packard staff, learned about the program, and we both agreed to try it together.
The Packard program is based on the standard calories in/ calories out model. Kids are taught to switch to lower calorie foods, control their portion sizes, and increase their physical activity level. Children are thereby supposed to burn more calories than they consume and lose weight. The Packard program first ramps down on higher calorie foods. Then it ramps up on physical activity.
Foods are evaluated for their caloric density, that is calories over grams of weight: c/g. Foods with caloric density over a certain threshold are red. Below a lower threshold are yellow, and below the lowest threshold are green.
Green foods are things you may eat in virtually unlimited quantities. It’s a short list, and includes things like broccoli, romaine lettuce, and spinach. Yellow foods are go-slow foods–usually still healthy, but watch your portion size. Whole wheat bread, pasta, chicken, starchy vegetables like sweet potatoes, eggs. Red foods are junk foods, like soda or candy, or fast food, but also meats if they aren’t low in fat, full fat cheese, and nut butters.
Eating more than two servings per meal of a yellow food also makes the third portion into a red, to try to control for meal size. The kids were taught the visual cue of a serving being equal to what would fit in the palm your hand.
Some of the kids started out eating 100 or more red foods per week. They had fast food, soda, and juice regularly. Juliana topped out at 35, the week she was on a trip with her school and had no control over her food. Even so, we reduced the number of reds she ate. We eliminated maple syrup on her whole wheat French toast, substituting applesauce. She cut out the 100 calorie fudge bars she liked for dessert. I started cooking with almost no oil–a teaspoon for six servings was a “yellow”, more than that a red. I started making mostly vegetarian bean soups and stews, carefully using my teaspoon of oil to sauté garlic and onion. In a few weeks, she was down to eating only 4 or 5 reds a week. (The Packard program didn’t recommend even trying to go below 18 reds per week, because they wanted goals to be challenging but doable—they didn’t think 18 reds or fewer was doable enough).
After six weeks, the Packard program starts to ramp up on exercise. Different activities have different point values, and you try to increase your exercise points while you decrease your red foods. Juliana had always exercised, but she began to do even more.
Did she lose weight? Yes, she lost 6 pounds in 10 weeks. I didn’t find that rate of weight loss very impressive, considering how few reds she was eating and how much she exercised. Then she stalled, gaining back half a pound at the weekly weigh-in. And meanwhile, she was almost always hungry, despite eating every few hours. I would pick her up from school, and before she said hello, she would gasp, “do you have a snack?”
The Packard program confirmed for me what I had been saying to anyone I thought could help–compared to the other overweight and obese kids in the program, her eating habits had been super healthy, and now were even healthier, and she exercised. If the Packard program was going to work for her, shouldn’t she be steadily dropping weight eating only 4 reds a week and exercising a minimum of 30 minutes a day at a medium intensity? But she wasn’t. She was also having a hard time because she was frequently hungry. I went looking for something better.