The Academy of the Sierras (AOS) is for students with serious weight problems. The main thing I learned during my visit was that AOS has just as many students with serious clinical problems as any other Therapeutic Boarding School. The stories from students and staff discussions about various treatments and student progress, as well as my observations of student behaviors, indicated a full complement of students with bi-polar, obsessive-compulsive, clinical depression and other serious disorders in addition to obesity.
I emphasize this point because prior to my visit, I had heard of some consultants and programs steering prospective students with a dual diagnoses of obesity and clinical problems away from AOS. The perception was that the child needed an RTC more than an obesity school. AOS Clinical Director, Molly Carmel, explained that the program must treat any underlying clinical disorder, which is prevalent in most obese children, before the child can successfully achieve permanent weight loss. She bases this claim on several years of experience in both her private clinical practice in New York and her work with obese students at AOS. Consequently, AOS provides a strong clinical treatment component to its students as well as medication management when needed, which includes individual therapy as needed. Each child participates in a cognitive group therapy session twice a week with the cornerstone focusing on setting weight loss goals, and emotional and rational tools to accomplish these goals. Taking a page from the Positive Peer Culture theories, these are heavily peer driven groups.
AOS helps children with obesity as well as serious mental health problems, but it is not for the child who is acting out. All AOS students choose to attend, with the main resistance issues arising from a fear of change or another failure. AOS will not accept students delivered by an escort service, which in part allows the school to screen out the highly resistant or acting-out child. Before arriving at AOS, most students suffer silently, endure bullying (or bully others), skip school to avoid teasing, fail at every diet attempt and often have an improperly diagnosed disorder. Parents typically consider enrollment when their children adamantly refuse to attend school.
The overriding goal of the school is to help students learn how to reach a normal weight range and how to maintain that healthy weight. To accomplish this goal, AOS helps the students' acquire and implement permanent behavioral changes that will support their ability to maintain a healthy weight. The program also focuses on providing emotional growth experiences to foster the self discipline and responsibility needed to maintain a permanent healthy weight, and academics that not only provide the students with badly needed successes in standard academics, but also the nutritional knowledge to develop sensible eating and exercise habits.
The 68-acre campus looks well groomed with a variety of birds and animals (including some mellow pet dogs) adding to the peaceful atmosphere. AOS provides students with plenty of opportunities to care for and build relationships with a variety of animals, including emus, a smaller version of an ostrich, and even some turtles living in the Administration building Atrium. With horses also on the campus, the school plans to develop a fully credentialed equine therapy program.
Depending on the individual needs and situation of each student, the typical stay is seven to eight months with the absolute minimum being three months. With rolling admissions, AOS accepts new students year round and while most graduate from the program and return to their home school, about 15 percent obtain a high school diploma from AOS.
In a series of student presentations, I had the privilege of seeing one male student's report that explained some of the cultural causes of our obesity epidemic. These causes included, a tendency for larger food portions, especially with fast foods (like super-sizing your order), heavy marketing designed to make the viewer hungry, a higher tendency to eat out in restaurants, searching for easy weight control solutions and diets and biology. He explained that our bodies evolved during humanity's hunter-gatherer demand for considerable and constant physical activity, and our bodies still need exercise to maintain a healthy weight balance. He also referred to a biological fact that once developed fat cells remain forever, just waiting to fill up again on a surplus of food.
The AOS program operates on a three-part solution. First, students self-monitor their diet while developing a habit of eating about 10 fat grams a day to reach their goal of low fat consumption. Each student receives a book containing the amount of fat grams and calories for common serving sizes of virtually every food (including fast food) available.
The second part is to incorporate a daily exercise regimen into each student's regular list of habits. These daily activities may include biking, swimming, running, various sports, yoga, etc. The idea is for each student to find specific activities that interest him or her, and learn how to do them right. Each student receives a pedometer to clip onto their hip that counts the number of steps they take each day with the goal being at least 10,000 steps in a typical day. (During my visit, I clipped one on and only got to 5,000, which clearly demonstrated just how active these students are in any given day).
The third part is nutrition education. This includes classes in practical cooking nutrition, as well as how to read and interpret store labels and restaurant menus. For example, as one part of the academic component, I sat in on a culinary class where students were learning how to cook tasty, nutritious and low fat meals. The students seemed to enjoy the lesson, and the prepared food tasted good, which surprised me because I've never cared for spaghetti squash. One of the on-going assignments is for each student to develop a long list of menus to take with them for use back home.
AOS designs the program to teach three basic skills: low fat eating, self-monitoring and daily exercise. The students initially learn to use these three skills in the controlled school environment, but the focus is then on how to convert these three skills into life long habits. Recognizing how easy it would be for students to revert to old eating and exercise habits after returning home, a portion of the tuition covers six months of after-care work. The staff continues to help the students maintain those three skills when they return home and face all of society's temptations.
The school philosophy is that even if the subject matter is weight control, the school is really about is changing attitudes, because they feel that is the only way create a plan of permanent weight control.
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