Electronic Fall 2022 | Issue 52

An Exercise in Treating the Person, not the Disease

By: Christian Alfonso, M4, UIC-Rockford

There is a moment of acknowledging an uncomfortable truth when making the decision to embark on a “lifestyle change”; an acknowledgement of the fact that some aspect of your being has been unnourished, unfulfilled, or unsatisfied and that you have been complicit in making that choice time and time again. It can be difficult. So difficult, in fact, that many people avoid that moment for as long as they can. For those who take that first step, the journey does not get much easier. Questions layer and fold in upon themselves. Answers feel as intangible or unobtainable as the Sun.

The journey of lifestyle change begins for many with an immediate presentation of any number of barriers, and often, a sense of hopelessness. Dr. Katrina Nguyen was critically aware of this when she began to expand her role as a pediatric gastroenterologist. There was a “recognition that there are barriers in developing a healthy lifestyle”, whether it is not knowing where to begin regarding healthier eating, or even a sincere lack of understanding that one is eating unhealthy food.

We inherit much of our understanding of the world and our place in it. Nutrition, habits, and perceptions are as inheritable as heart disease. The question of what is normal vs. what is normalized is also of seminal importance in perceptions of health.

Perhaps one might consider that everyone in their family being overweight is just a “normal” part of their baseline physiology, nature, or genetics. However, one may also consider that their diet is “normal” simply because it is all they have ever known. Dr. Nguyen believed that none of these issues were going to be addressed in an office setting.

What started as an AAEP grant in 2012, became a non-profit called Faithful 2 Fitness (F2F), which offers a free 12-week fitness program to families bi-annually. F2F is the only one of its kind in Rockford, in that it allows families to participate together regardless of age or ability. We meet every Saturday for a 1-hour class led by certified volunteer fitness instructors and incorporate imaginative and communicative nutrition and meal-prep lessons led by a licensed volunteer dietician.

I have been involved with F2F for two years now and it has been an incredible experience. I noticed that there was an almost overwhelming sense of trepidation or shyness in many of the participants at the beginning of every cycle - a sense of self-doubt, introversion, or even sadness. It was clear that many were also struggling with issues of self-image, depression, and social anxiety. In discussing this with Dr. Nguyen, I later found out many children had faced extreme bullying at school due to their weight and appearance or were referred to the program by their endocrinologist for type 2 diabetes and weight management.

One of these children, Jadon, was 12 years old, diagnosed with type 2 diabetes, and placed on ever escalating doses of insulin prior to enrolling in the program, with his mother Ivette, two years ago. He is now Insulin-free and his last A1c was 6.3%. In fact, they will be giving a speech at this year’s Walk with Me 5K event at the end of August.

After our regular exercise class on August 13th, Dr. Nguyen asked them to give a dry run of the speech to the class in preparation of the event. What transpired was an incredibly beautiful and powerful moment of sincerity and emotional vulnerability. Ivette spoke of how she and Jadon developed type 2 diabetes over the course of 2020 quarantine, how their diet, lifestyle, and mental health slowly decayed, and manifested as a disease. She spoke of the pain of watching her son have to inject himself and take so many medications at such a young age. She spoke of the sense of community and support she felt with F2F, the motivation she received from being there with her son and the sense of not feeling judged while she was there.

When it was Jadon’s turn to speak, he spoke of similar things, but highlighted the “lifestyle changes” they had made as well as the effect his physical health has had on his mental health. It was an absolutely perfect and emotional moment of self-realization and empowerment.

While they directly outlined their story for us, it is indirectly observable in many of the families that participate; the weight of their burdens, emotional and physical, are lighter at the end of the program. It has been one of the most incredible and rewarding experiences to observe and participate in.

What I find most fascinating is that mental health was never a primary or even secondary outcome Dr. Nguyen was looking to address in creating this program. It was entirely a passion-project aimed at curtailing the ever-expanding curve of childhood obesity. And yet, Dr. Nguyen has done more for these people with community, support, and information resulting in empowerment and better decision-making than any drug ever could, something I hope to emulate or re-create by establishing my own chapter of F2F wherever I end up. I am an avid fan of history and bibliophile; I am a collector of stories. This is one story I will never forget and the reason I think we all find such fulfillment in the field of Psychiatry.