Controlling her weight is a constant struggle for 13-year-old Noelle. The bright and articulate 8th grader says she's tried several diets but none have worked for her. Noelle is determined to lose weight, that's why she's starting a lifestyle beahvior program at The Cleveland Clinic:
NOELLE: "I really want to do it because next year I start high school and I've been like this all my life, and I'm really ready for a change... and it's just kind of hard though staying with a diet, and I think it's harder for teenagers because you have the pressure of all your friends."
Dieting during the teen years presents its own set of pressures says Dr. Ian Dresner at Akron Children's Hospital... especially for obese teens:
DRESNER: "Everybody knows about the fast food environment, and everybody knows about eating at school. Everybody knows about the kinds of choices that kids would rather make that also becomes more difficult as they get into the adolescent years because adolescents don't want to be different and to be on a special diet makes it very difficult and they don't want to be in the sick role."
Not wanting to be different is part of what's motivating Noelle to change her lifestyle now. She says eating out with her friends presents some problems:
NOELLE: " Like during your teen years its really hard to fit in anyway, with everybody... But on top of it when you're overweight and you have to eat differently than everybody else, it's a hundred times harder because you just look so much different."
Dr. Gerard Benez is the director of the program Noelle is enrolled in and a pediatric psychologist at The Cleveland Clinic:
BENEZ: "Clearly one's physical appearance and body image is critical at this stage for all kids. And it's especiallly a problem for adolescents who are dealing with problems like overweight and obesity."
Benez says societal changes have made it difficult for the Millennial generation to maintain a healthy diet and lifestyle. They have more temptations than their parents had:
BENEZ: "They're not eating at home as much. Adolescents are out with friends, and they like to congregate with friends, outside of homes, and the kinds of foods they like to eat and the places they like to eat in don't serve the most healthy sorts of meals, and so that's a big issue. Adolescents as a whole aren't that physically active compared to the way they used to be when they were younger kids."
Benez points to the example of a lack of school physical education. The National Association for Sports and Physical Education reports that America's children are receiving fewer phys-ed classes than their parents did. Sally Phillips is a registered dietician at Akron Children's Hospital and she points to the lack of exercise. She says America's modern suburbs are designed for the automobile:
PHILLIPS: "We have people that live in allotments where you can walk within the allotment but it would be impossible safety wise to walk to school, to walk to the library, to walk to a field. And so that you can have in a way some of the same kind of problems you would have in a densely urban environment where you might have access to places but you wouldn't feel as safe to go to them. And so I think there's a problem in people using their own body as a mode of transportation as opposed to a vehicle."
Phillips says marketers also influence the way the Millennial generation eats by supersizing portions:
PHILLIPS: "The best example I can think of is soda pop. When I was a child, you would put ten cents into a pop machine and you would get a six ounce bottle which they now sell as antiques. And it is now impossible to get six ounces of pop anywhere and the interesting thing is that people didn't stand there and put in three dimes until they got 18 ounces, which is what many pop machines now are, 18 and 20 ounces."
Money also matters when it comes to healthy food choices says Dr. Ellen Rome, head of adolescent medicine at The Cleveland Clinic:
ROME: "Obesity is a bit of a higher risk if you're less wealthy, because the cheapest foods are the fast foods. If you can feed a family of four with a box of mac and cheese for 79 cents, that's not as healthy a meal as the fruit, the fresh vegetables, a healthy salad, a nice piece of salmon and some rice pilaf. That's a more expensive meal. So we can certainly have better eating and exercise opportunities if we have more money."
Schools are offering more ala carte items like french fries, pizza, and ice cream and it's easier for teens to select those foods because they are convenient and that's what the majority of their friends eat...
Down the hallyway from Canton McKinley High School's lunch room, health teacher Holly Flouke is teaching a group of about 20 students about the nutritional value of foods. The class is an elective and most of the students say they're taking it because it's considered an easy class. But they are learning about healthy food choices...
Catherine is 17 and says health is important to her, which is part of the reason why she took the nutrition class:
CATHERINE: " Health to me is working out, eating good, and like... eating healthy foods and not like eating out all the time and fast food and stuff."
According to the online magazine Entrepreneur.com, the average American eats out four times a week. The Millennial generation spends about $100 a week on whatever they want. Therefore, they are considered prime targets for restaurants and food chains. The students in Flouke's nutrition class say they eat out a couple of times a week and according to 17-year-old Wade, it's predominantly a social experience:
WADE: "Yeah, we go to Friday's after the game. We just go there to like hang out and just whatever sounds good I guess..."
MC: "So Fridays and Saturdays aren't necessarily about what you're eating?"
WADE: "No, it's just to hang out with everybody."
When it comes to eating at home, most of the students say they are largely self-sufficient:
CATHERINE: "We have five people in my house and we all have different schedules and....most of the time I'm at work or something, so by the time I come home, she might have cooked and then... it'll be cold and I won't want it."
TIM: "My mom, she'll cook like a dinner... like every night. She's a home mom so she cooks dinner for all of us. The family usually sits down sometimes, but then if we don't we just like get a meal from the cupboard or I cook something to eat. And it's just like you either eat what my mom cooks and puts on the table or you get something that you want."
But it's the independence of this generation and the hectic family schedules that can contribute to weight gain. That's why Dr. Gerard Benez says more and more intervention lifestyle programs seek to target the whole family:
BENEZ: "Those kids who lose the most weight in some structured intervention program are the ones whose parents themselves lose the most weight in the program."
There are many programs being developed around Ohio to try to combat the obesity epidemic that impacts almost a quarter of Ohio's teenagers. And for Noelle, working with her peers makes her chances at success all the more likely:
NOELLE: " Just meeting people in the program that are like me and have the same problems that I do, and being able to talk with them, it's kids that are exactly like you."
Doctors warn that obesity can cause chronic problems like type 2 diabetes, sleep apnea, high blood pressure and heart attacks.