The Last One’s Chosen

By Dan Barrett

It is sadly an all-too-familiar story: the stigma of being picked last. We all seem to relate to it. Whether at school, on the playground, or even within our own families, everyone can think of one time in which they felt inadequate or abandoned. For one group of adolescents, however, such times rarely can be linked to specific instances or events. For severely obese adolescents, the pain and stigma of being left out of normal childhood activities is a burden they must carry each day, one that can be as weighty as the extra pounds they carry.

Dr. Allen Browne is a pediatric surgeon who has seen the rise of obesity in adolescents first hand, and, "being from surgery, "he says, "I wanted to think of a way to make things better. "It was this commitment to the health of his young patients that led Browne and his then colleagues at the University of Illinois Medical Center, at Chicago, to start the New Hope project for pediatric and adolescent weight management.

What he and his colleagues realized was that, for treating childhood obesity, there was no easy fix. It required working with families and kids about eating and drinking and getting them to understand the things that make them eat and drink. "A lot of diets you see on television simply don’t work," Browne says. "When kids try them, and they don’t work, they become even more stigmatized."

One thing Browne and his colleagues focused on was activity. Severely obese kids cannot exercise in the "classic" sense of the word, but they need to get their hearts and lungs going. Ironically, obese adolescents are far from weak. "They carry sometimes 200 extra pounds around," Browne adds. "The problem is that they get out of breath very easily. We saw physical therapy as a good way to design activities that are within their capabilities." To this end, one of Browne’s colleagues at U of I began a small program that put kids into the pool for recreation.

Browne is a SCUBA diver. In 2007, he attended the Our World Underwater dive show in Chicago. It was there where he came into contact with Diveheart.

"I saw in the association of the U of I’s New Hope project with Diveheart the marriage of a couple of different concepts. These kids are disabled, they are handicapped. Likewise, the water is friendly place for them as well. They don’t carry the extra weight around in the water. Being able to go in the water, and tackle the equipment is something they can take with them."

Browne also saw in the diving the opportunity to get obese adolescents involved in an activity that is better tolerated by their bodies, an activity that is fun, challenging, and opens their brains to new opportunities of things they can do.

There is probably no one who understands the challenges faced by the obese children more acutely than Browne’s wife Nancy. A pediatric nurse practitioner, she’s worked closely with the New Hope project for years. One day, while talking to a mother of one her patients, she thought of a short, very poignant title to describe their plight: The Last Ones Chosen. While as a society we can feel proud of teaching our children to be accepting of many types of individuals, the obese always will seem subject to some form of discrimination. It may be at school, it may be on the playground, or, as Browne points out, it can even be with insurance coverage.

"We have the chance to fix an entire life," Browne says. "We’ve learned a lot abut which surgical procedures work best. But you need to work them into a weight-management program. Kids need a life. What solution you chose needs to fit into someone’s life."

At Diveheart, we can throw the phrase ‘changing a life’ around very loosely. We work it into what we say so often that we forget about how powerful an idea it really is. What Browne and others in the medical field should make us realize, however, is that we are engaged in a mission that goes beyond any singular event in the life of an individual. In his quest to treat his obese patients, to make their entire lives better, Dr. Allen Browne, the surgeon, had to admit to himself that “surgery was only part of the answer.” He now sees the problem as requiring, what he calls, a dose of four pills: nutrition, activity, behavior, and surgery. Perhaps we too at Diveheart should remember that diving is only one of the pills we can offer anyone who comes to us in the hopes of, maybe for only one time in their lives, not being the One Last Chosen.