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Experts Dispute Wellspring's Approach

Tuesday, May 20, 2008

Wellspring's California school, opened in 2004 with 15 students, currently has about 95 and includes a college program. Enrollment at the North Carolina campus is capped at 50, and usually about two dozen students as young as 11 are in residence. Many are from the South.

Teenagers take classes in academics as well as nutrition and eat a strictly regulated diet that hovers around 1,200 calories per day and contains fewer than 12 grams of fat. They must accumulate a daily minimum of 10,000 steps on a pedometer (the equivalent of walking about five miles) and participate in intensive behavior therapy.

Privileges such as telephone use and trips home are contingent on moving up a five-level system based largely on effort, weight loss and compliance. Cellphones, DVD players and computer use except under supervision for schoolwork (forget Facebook) are banned.

Misbehaving students can be temporarily shipped to a disciplinary program run by Wellspring's parent company, which operates a burgeoning network of boot camps and treatment programs for troubled youths.

The primary goal, said Wellspring clinical director Daniel Kirschenbaum, a professor of psychiatry at Northwestern University, is to create a "healthy obsession" with weight that will endure long after a student leaves. Kirschenbaum, who devised the boarding school program, said students are taught that in order to become an "LTWC" (long-term weight controller), they must maintain the lifelong discipline of an elite athlete.

"This is like training for the Olympics," said Kirschenbaum, who said he has maintained a 30-pound weight loss for more than 35 years.

But other obesity experts question the wisdom and sustainability of Wellspring's rigid, total-immersion, extremely low-fat approach, as well as its claims of unparalleled success.

"I've known Dan Kirschenbaum for 25 years, and I think he's done a good job of taking the best of science and marrying it with the best of practice," said Thomas Wadden, director of the Center for Weight and Eating Disorders at the University of Pennsylvania.

Wadden applauded the school's use of cognitive behavior therapy and self-monitoring, which have been found to be effective in maintaining weight loss. But Wellspring's results have not been subjected to rigorous scientific scrutiny, so there is no way to tell whether the program works, Wadden said. "It's an interesting idea, but the answer is going to be in the data."

Pediatric endocrinologist David Ludwig, director of the obesity program at Children's Hospital in Boston, said he fears that a stint at Wellspring might leave some students in worse shape.

"For some people, rapid weight loss is motivating and inspiring," said Ludwig, an associate professor at Harvard Medical School.

For others, dramatic weight loss can be "a traumatic experience," particularly if food has been used to self-medicate or as a kind of body armor to cope with sexual abuse or other trauma.

While some people thrive in authoritarian environments, he added, others find them oppressive and rebel.

Ludwig said he is particularly worried about the effect on vulnerable teenagers who regain weight after their families have sacrificed so much financially to send them to Wellspring.

"The sense of failure that can set in afterward" could inflict long-term damage, he said.

Kirschenbaum disagrees. In his view, Wellspring may plant the seed of future success in the same way many smokers make multiple attempts to quit before doing so.

"What this program does," he says, "is show them the yellow brick road."

-- Sandra G. Boodman

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