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Cracking mysteries of eating habits

A pilot support group focuses on shedding pounds by tracking behavior and changing how we eat.

By SAUNDRA AMRHEIN, Times Staff Writer
© St. Petersburg Times
published January 27, 2002


NEW PORT RICHEY -- Maryann Kane does it in bed. Giovanni Renella does it when he's bored. And Jon Folsom can't help but do it when it involves French or Italian.

For all of them, eating has consumed their lives, putting excess pounds on their bodies and threatening their health.

That's what brings them shuffling into a spare room in the New Port Richey Public Library one night a week for a support group. They come here hoping to change their habits after most other programs have failed them.

"I've lost the motivation," says Renella, now more than 400 pounds and to the point that he must sleep on his knees to avoid putting weight on his heart and lungs. His legs are turning black from the inability of his veins to pump blood back to his heart.

The three join about 13 others to make up a pilot support group run by the Pasco County Health Department to tackle obesity through behavior -- not just what you eat, but when, how and why.

The class is part of a larger, state-funded Chronic Disease Intervention Program in the county. It comes at a time when Florida and other local governments seek to tackle the national and state epidemic of obesity and its significant role in larger health problems, like cardiovascular disease.

Obesity is a factor not only of weight, but one's weight in proportion to height and body fat.

At the start of the group meetings, each member must climb onto a scale. Some flash shy grins; others crack jokes or banter advice.

"You know what's good? Putting vegetables in a blender and doing puree," Renella offers.

"That's baby food!" Kane calls out from the front row of chairs.

Pasco's approach focuses as much on the mind as the stomach.

On a recent night, the fifth of 16 classes, group members watch a video providing tips on behavior changes.

When heading out to shop, eat before you leave the house, a woman tells them; make a list and bring only enough money for the food on the list. Shop as much as possible on the perimeter of the store, where the fruits and vegetables tend to sit.

Eat slowly, the woman says. It takes 20 minutes for the brain to realize the stomach is full. Establish habits of calling friends for emotional support instead of eating.

Other tips: box half a restaurant meal as soon as it arrives; eat your food on smaller plates so it looks like you have more; keep a food diary and join activities, like a class, during part of the day you eat the most.

Renella, 34, has struggled with his weight since breaking his leg playing ice hockey in 1990. Three months in a cast left him inactive and sent him sliding down a steep slope of calories that slapped 160 pounds on his frame.

With circulation problems in his legs, he finds it hard to exercise. He developed bad habits, such as eating sandwiches and chips while bored, that he's now trying to break with the help of the class.

"Maybe if your own story isn't that great (for overcoming the problem), maybe Jon's story will motivate me," Renella says after class about Folsom, 70.

Folsom lost 60 pounds before joining the class by eating better, swimming and riding a stationary bike. But on his own he can't lose anymore. He joined the group to shed another 20 pounds and reach 230 pounds.

"You really do need to understand you're not in this by yourself," Folsom says.

He blames his previous weight gain on age, a slower metabolism and his wife's great cooking. During class he suggests to his classmates ways of being more disciplined, like eating a meal in one place instead of carrying snacks all over the house.

Both Folsom and Kane, 64, are diabetics. Their weight exacerbates their diabetic conditions.

"I've been told the last four years I have to lose weight to control diabetes," Kane said after class.

She started gaining pounds more than 30 years ago when she developed rheumatic fever and was bed-ridden. After deaths in the family, she turned to food to relieve stress.

Through it all, she was bombarded with messages to eat and eat some more.

"You turn on the TV and look how much is about food," she said.

But like other group members who said they'd tried to lose weight through diets and other programs, Kane said classes on diabetes and blood sugar controls have not helped her lose weight. Only recently through the unjudgmental guidance of the support group and its focus on behavior has she seen a difference.

"It's relieving to find out what i was doing wrong," Kane said.

What she did wrong was eating and snacking in bed instead of planning a meal at a table where she can concentrate on portions and then take a walk afterward.

"It's a total life change," said health educator Megan Carmichael, who runs the class and tries to push members toward exercise and eating properly and away from the yo-yo experience of diets.

"We don't want them to diet," she said. "So many problems happen with obesity and being overweight. If we could just get some of the people focused on their behavior and eating habits and why they are eating and if they are hungry, I don't think people would have a problem losing weight."

* * *

The class is part of the county's Chronic Disease Intervention Program, which also includes diabetes self-management.

The county's program is one of 17 community intervention projects funded by the state Department of Health in 21 counties to target heart disease, said Jennie Hefelfinger, chief for the Bureau of Chronic Disease Prevention in the Florida Department of Health.

Some of the statewide programs focus on diabetes, nutrition or tobacco use, while others like the one in Pasco also are including weight control classes.

"The leading cause of death in Florida is heart disease," Hefelfinger said. "This program is intended to bring some awareness to the community and promote some behavior changes."

Obesity contributes to other serious health problems, she said, including strokes, osteoarthritis, gallbladder disease, and a "frightening" rise among children nationwide diagnosed with adult diabetes, which is related to weight, nutrition and lack of exercise.

The past 20 years -- in an era of super-sized portions, vending machines and promotion of high-calorie foods -- obesity has become an epidemic, according to a report released last fall by the state Health Department called "The Obesity Epidemic in Florida."

Since 1986, the prevalence of obesity in Florida adults has doubled to 18.5 percent. About 38 percent of Florida adults are overweight, an increase of almost 18 percent in that time. Florida's numbers closely mirror the nation's increase, the study shows.

As for children, health experts at an obesity conference in London on Monday said there is a direct link between television viewing and the prevalence of obesity among youngsters. They quoted studies showing that as much as 25 percent of children's food intake occurs while they are watching television.

Obesity in adolescents in the United States trebled between 1980 and 1994 and doubled in younger children, experts said.

Obesity is a worldwide epidemic and becoming an increasing problem even in developing countries, they said.

Last year, Florida became one of 12 states in the nation to receive funds from the Centers for Disease Control and Prevention to attack the obesity problem, according to the Department of Health.

A task force will be assembled in February to devise a state plan on how to use the $345,000 grant to prevent obesity, Hefelfinger said.

"We're really changing focus . . . to how the behaviors change the outcome" of health problems, she said. "It's long-term behavior change, and you have to work in the community to change the mindset . . . .

"It's really quite serious."

-- For information about future classes, call Carmichael at 869-3900, ext. 162.

-- Information from Reuters was used in this report.

-- Saundra Amrhein can be reached in west Pasco at 869-6244, or toll-free at 1-800-333-7505, ext. 6244. Her e-mail address is amrhein@sptimes.com.

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