How much does the SHAPEDOWN Program Cost?
Each participant must pay a non-refundable enrollment fee before the program begins. Fees may be reimbursable from medical spending accounts.

The initial assessment, follow-up appointment, and program sessions will be billed to your mental health insurance provider. Participants are responsible for co-payment and any portion of the program not covered by insurance. Thanks to generous support from University of Iowa Health Care Departments of Family Medicine, Pediatrics, Psychiatry and the Children's Miracle Network, participants are only expected to cover approximately 10 percent of the program's actual cost of the program.

Limited scholarships are available to cover part of the enrollment fee. Contact us at 319-384-7900 for specific fee information.

Is the SHAPEDOWN Program a weight-loss diet for adolescents?
The Shape Down program will NOT put your teen and your family on a diet - it is a unique program that offers the support needed to develop new eating and fitness skills and overcome the barriers to making better food choices.

The SHAPEDOWN program offers an individual evaluation by a counselor and a dietitian certified in child and adolescent weight management to identify the reasons for your teen's excess weight. Families participating in the SHAPEDOWN program must attend group support and educational sessions concurrent with teen session. Parent sessions are led by specialists in adolescent development. Parents will be asked to commit to work toward their own behavior change goals.

How can the SHAPEDOWN Program help my overweight teenager?
We know eating and activity patterns that begin in childhood and progress through the teen years can have long-term health effects.

Medical problems associated with overweight:

• Type II Diabetes
• High blood pressure
• High cholesterol
• Severe asthma
• Joint and bone problems
• Snoring
• Polycystic Ovarian Syndrome for females

Emotional and psychological problems associated with overweight:

• Adjustment difficulties
• Social Anxiety
• Generalized Anxiety
• Depression

We aim to teach skills that will help your teen work toward developing the internal cues to regulate eating and help resolve weight problems.

The SHAPEDOWN program is designed to help families turn from chronic dieting and food restriction and turn to better eating and increased activity.

How do you know if your teen's weight is adversely affecting health?
Anxiety, depression, and adjustment difficulties are the most common problems associated with over-weight. However, as a teen becomes 50 or 100 pounds overweight or more, there is an increased chance of:

• high blood lipids
• glucose intolerance leading to diabetes
• increase in fat in the liver
• gall stones

Less common is high blood pressure, sleep apnea, and orthopedic complications. It is not clear whether the excess fat alone or the behaviors that lead to excess fat are responsible for the health issues.

What is available for younger children?
PHIT, a weight management program for elementary aged children and parents is offered. If interested, contact Kim Turner, RN at 319-356-8705 at the Center for Developmental Disabilities

What will SHAPEDOWN do for me?
For Children and Teens -
SHAPEDOWN will help you take care of your health and happiness. You will learn to create an active, full life so that food and television are less important. You will talk about your feelings and needs so that you will feel safer and happier. You will learn strategies so kids stop teasing and so you feel better about your body. SHAPEDOWN brings out the best in you!
For Parents -
SHAPEDOWN will help you feel better about your parenting and about your child. You will let go of guilt, fear and frustration about your child's weight as you put into practice positive changes in your family's lifestyle and communication. In many cases, changes from SHAPEDOWN are profound. Parents are amazed at their teen's new happiness and vitality and at the richness of their family life.

Is SHAPEDOWN Right For Me?
Not necessarily. That's why care begins with a biopsychosocial assessment by your SHAPEDOWN Provider (adolescents can receive a full computerized Y.E.S. assessment). Through it you learn all the areas you are already healthy in and the things to focus on to get the best results with your weight. The right care for you may involve SHAPEDOWN, in a group or individually, and/or other kinds of treatment.

Should all kids be thin?
No. Children come in all sizes and shapes that are perfectly normal. The goal in SHAPEDOWN is for the teen to gradually attain their genetic body build, which ranges from willowy to rounded. What if the weight is genetic?

The goal of those with simple genetic obesity is to accept their genetic body build, to develop healthful habits and to avoid the dieting psychology, all of which are addressed in SHAPEDOWN.

Is SHAPEDOWN Safe
Weight loss for children and teens can be hazardous. Rapid weight loss or strict diets can affect the growth and development, promote binge eating, slow metabolism and result in weight gain. SHAPEDOWN is safe. It encourages a gradual, safe weight loss or the maintenance of weight as the child grows.

Is SHAPEDOWN Effective?
Yes. Controlled studies have shown that when families participate in SHAPEDOWN, there is significant improvement in weight, self-esteem, depression, diet and exercise habits and weight management knowledge. However, progress varies depending on how open to change the teen and family are.

How Long Does It Take?
SHAPEDOWN: Just for Teens at UI Hospitals and Clinics is offered in a group format. Group programs include an intensive, 10-week schedule with meetings of about 2 hours weekly to give families basic SHAPEDOWN training. UI Hospitals and Clinics anticipates offering ADVANCED SHAPEDOWN, a nurturing support program that deepens and extends their progress. ADVANCED SHAPEDOWN meets weekly or biweekly for 20 weeks or more. Teens enjoy the SHAPEDOWN groups. Parents receive support from other parents and cooperate toward their child's progress.

Who Teaches SHAPEDOWN?
The University of Iowa Children's Hospital Shapedown: Just for Teens is taught by a registered dietitian, licensed psychologist an Advanced Practice mental health nurse and a certified fitness instructor/personal trainer from the University of Iowa's Recreation Services program. All SHAPEDOWN Providers, in addition to their own professional training, complete 46 hours of clinical education in child and adolescent obesity from the University of California, San Francisco.

How Does SHAPEDOWN Work?
SHAPEDOWN builds on the strength of the family. It gently and effectively supports families in creating an active lifestyle and a healthy but not depriving diet. Parents tune up their nurturing skills to curb their teen's emotional overeating and sharpen their limit setting skills to prompt their child toward a healthier lifestyle. The teen accepts more responsibility for diet and activity and feels happier and safer. Food becomes less important, activity more exciting and the teen's weight begins to normalize.

What Other Therapies Are Involved?
SHAPEDOWN not only helps families target changes in nutrition and activity but focuses on common underlying factors that fuel a child's excessive appetite for food and inactive pursuits. Although exercise physiology, nutrition and behavioral techniques are used, the power in SHAPEDOWN comes from its sensitive, entertaining and practical use of family therapy and psychoeducational techniques.

Is There A Diet?
No. Diets typically cause children to feel deprived and, as a consequence, to overeat. Instead, SHAPEDOWN supports gradually adopting a moderate food intake that provides essential nutrients based on the Recommended Dietary Allowances and the National Cholesterol Education Program Guidelines.

What About Exercise?
SHAPEDOWN The University of Iowa Children's Hospital Shapedown: Just for Teens includes group exercise. The goal is to increase overall fitness, including endurance, flexibility and strength. Overweight teens may find it difficult to sustain individual exercise so our program includes group exercise in a safe, supportive environment. Shapedown also asks families to develop a more active lifestyle and replace television viewing and other inactive pursuits with chores, interest, sports and projects.

What Else Is Addressed?
A wide range of strategies help the teen and parent take care of their emotional and physical health. For example, children learn techniques that effectively stop peer teasing. Parents free themselves from the weightism of our society. Families learn communication techniques to resolve conflicts.

Is SHAPEDOWN right for us?
SHAPEDOWN caters to diversity. Ethnic, cultural and economic differences are reflected in the program as are a range of family types, such as single parents and blended families.

Does SHAPEDOWN treat parents too?
In SHAPEDOWN, the whole family changes so parents often see weight loss and sustainable improvements in their diet, activity, blood pressure and serum cholesterol. However, overweight parents need a comprehensive assessment from their own health care provider to determine the best form of care for them.

Which parent should attend?
If both parents reside in the area, both parents should attend. Also, step-parents, aunts and friends or anyone who takes a parenting role, is encouraged to participate. If one parent is more removed from a child, their presence may be even more important. Questions about your particular situation should be discussed with your SHAPEDOWN Provider.

Research has shown repeatedly that without a family approach, all treatments - diet, exercise, behavioral approaches - are ineffective. It is only by building on the strength of the family that child obesity programs have their long lasting, beneficial effect on weight.

What if parents don't want to eat healthy and exercise? Then SHAPEDOWN is not right for the teen. The SHAPEDOWN philosophy is that parents should not ask of their child anything they are not willing to do themselves. However, the SHAPEDOWN lifestyle changes are gentle and flexible and fit into the priorities and capabilities of most parents.

Here are some facts about child and adolescent obesity:

• 27 percent of children and 21 percent of teens are obese, an increase of 54 percent in the last 20 years.
• Overweight in young people is diverse in cause and consequence and benefits from an individual assessment to develop an individualized care plan.
• 50 percent to 70 percent of the obese young will be obese adults. Family weight problems, severe obesity and the person's age increase risk that the obesity will persist into adulthood.
• The medical consequences of obesity vary. However, obese children and teens have an increased prevalence of hypertension, respiratory problems, hyperlipidemia, bone and joint difficulties, hyperinsulinemia, and irregular periods.
• The psychosocial disadvantages of overweight in the young include peer teasing, scholastic discrimination, low self-esteem and negative body image.
• Weight difficulties in children and adolescents are highly treatable when a family-based approach is used. Studies have shown that if the treatment includes parents and focuses on the family's lifestyle and communication, weight loss is maintained, on the average, even at five and ten year follow-up.