It's been more than a year since WAMU 88.5 met Rachel and her family. She's now taller, in the third grade and much more talkative! Her favorite sport is soccer. "It's really fun," says Rachel. "You get to move around a lot and sometimes you get to be with your friends."
In December 2010, the Freedman family — Rachel, her brother Stephen and her parents Lois and Bob -- had been struggling to make changes that would help Rachel lose weight. They drastically changed what they ate, went on long family walks and cut out treats like ice cream. Rachel weighed 98 pounds then, more than twice the size of an average American 6-year-old. Lois had to shop online so she could find age appropriate clothes.
"She's wearing clothes that an adolescent or tween would wear," says Lois. "So it's tight or writing on her backside. You don't want your 6-year-old in that."
Rachel says she rarely takes sandwiches to school for lunch. Now it's mostly fruits and vegetable: apples and peanut butter or carrots and ranch, she says.
Rachel also fills out what's called the 5-4-3-2-1 Progress Chart every day, where she keeps tabs on herself. "Every day I have to tick off whether I get five servings of fruits and vegetables, but I usually get a lot, lot more. Also, it says you should get four glasses of water. I need three servings of dairy, and I usually get two."
The chart calls for no more than two hours of any electronics, and at least one hour of physical activity. She gets at least 30 minutes. The checks are added up and she exchanges what she calls "sweaty points'" for a family movie or her favorite, a pedicure!
It's been a struggle. Over the summer, Rachel gained 7 pounds. Lois and Bob were devastated. But they hope she may have recently turned a corner. "Just two months ago we had our first appointment where Rachel lost weight." She lost 3 pounds and weighs 112. "Lois and I were in tears. We were so overwhelmed by four years' worth of work finally showing through."
The Freedmans have a co-pay of $250 for their doctor's visits to a specialized clinic. Every decision they make has to factor in food and exercise. But they say they'll keep trying because the main goal is that Rachel feels good, is happy and stays healthy.
More than 30 miles away, in southeast D.C. Saquonte Wilkinson and his two little brothers bask in their mother Shaquinta's attention. He's now 18 and a senior in high school. He says he's lost 15 pounds. "I'm not 315 pounds anymore. I'm almost exactly 300 pounds. I've been walking more, I've cut out soda out of my diet, I used to always have soda, candy."
Saquonte now picks the grilled chicken instead of the Big Mac at McDonald's. For a while he played on the school football team and sometimes walks a mile to school instead of taking the bus. He'd like to lose another 100 pounds and is considering bariatric surgery.
When we spoke last, his girlfriend had just broken his heart. "She was cheating on me. I found out it was because of the weight. She would say stuff like, 'You're too fat to do this' or she 'doesn't go with fat people'. The sad thing about it was when I found out about her cheating on me, it was Valentine's Day."
Now he says having a girlfriend is what makes him want to lose weight because "nowadays, girls only care about dudes, not about someone who is nice." Shaquinta says she tries to pick up tips for helping her son, such as correct portion sizes, from TV.
She's bought a stationary bike. But she blames herself a lot, saying when he was younger she didn't let him go outside to play after school because of shootings.
"Once you shield a child and say you can't go outside because of the violence in the neighborhood, what's a child to do but watch TV and eat?"
Saquonte has just moved into a residential program run by his school. His mother says the school limits portion sizes and has dinner earlier, so she's hoping Saquonte may lose weight faster. She says she worries when he gets depressed and tries to keep his spirits up.
"He's the perfect child for me. We just have to work on it."
Saquonte and his mother still need help understanding basic information about nutrition, and crave practical steps to help him lose weight. For now he's taking it one day at a time.
[Music: "Look Into the Air" by Explosions in the Sky from How Strange, Innocence]