Palo Alto mom launches app to help kids lose weight

Mobile approach to weight loss meets youth where they are

Joanna Strober's 11-year-old son had a weight problem. Looking for advice and specific weight-loss tools, she took her son to see his pediatrician, who didn't offer much besides "exercise more, eat less," Strober said.

"It's really hard to know what to do when the doctor tells you that," the Los Altos Hills mother said.

She looked into other options to help her son be healthier. There was the Stanford Pediatric Weight Control Program, a six-month-long behavioral and educational program that Strober referred to as the gold standard for children's weight loss. But it comes with a $3,500 price tag (though financial assistance is available) and its success -- since 1999, more than 80 percent of the children have achieved "age-appropriate weight reduction" -- is based on active, in-person participation. Groups of children ages 8 to 18 and their families are required to be on campus weekly for two-hour meetings, which is logistically challenging for many parents, including Strober.

But talking to Stanford staff and doing some research on weight-loss apps, Strober realized that the program's gold-standard practices could be translated into a more accessible platform that reaches kids and parents where they are. With a background in venture capital, she did what any other Silicon Valley mother would do: She founded an app company she named Kurbo.

The company, made up of a 10-member team that works out of a downtown Palo Alto house, licensed Stanford's program and turned it into a mobile version offered to 8- to 18-year-olds and their parents at no charge. The main feature of the app is a meal-tracking system: Users log what they're eating throughout the day, and the app lets them know how they're doing using a "traffic light" system. Red foods are deep-fried items, fats, sugars and carbs. Greens are fruits and vegetables; yellow is everything else, to be eaten in moderation.

When Kurbo users log what they had for breakfast -- perhaps two eggs and whole-wheat toast with butter -- the app will let them know how many red foods they can eat the rest of the day. Kid-friendly games teach about what foods fall into which traffic-light category and why; videos offer information on topics like portion size, exercise and budgeting.

"The best thing you can do for weight loss, period, is to track what you eat," Strober said. "If you pay more attention to what you eat, you're more likely to lose weight."

This doesn't mean counting calories so much as learning about what is in the food in order to establish a healthier, long-term lifestyle.

It's also about choice. Kurbo doesn't tell users what red foods they can or can't eat; that's up to them.

The app's second defining feature is a coach who serves as a third-party (read: non-parent) support system for the kids. Instead of weekly in-person meetings, the Kurbo coaches -- all of whom have established experience in children's health -- are available to both the children and parents via Skype, FaceTime, text or email at all times. Scheduled sessions usually take about 10 minutes and generally don't occur more than once a week. The coaches can view the foods and exercise time children have logged and help them to set personal goals around eating and exercise.

Esther Levy, a former elementary school teacher who worked at the Stanford pediatric program for four years before joining Kurbo as a coach, talks to kids when they get home after school, before they go to bed -- even while they're on vacation.

"It really reaches kids wherever they are and makes it as easy as possible to support them in losing weight or just being healthier," she said.

"We know that the third-party accountability is really important and taking the role of the food police away from the parents," said Strober, who said she struggled with that with her son.

"I was telling him what to eat, and I was creating a lot of problems," she said. "You're really scared (as a parent). It's not just the weight issue; it's the health issues; it's the emotional issues. There are a lot of things that happen for kids who are overweight."

Coaches aren't, however, free; consultations costs $75 per month. Strober said they plan to roll out a text-only coaching model soon that will cost less.

Kurbo coaches often serve as parents' support system, too. (One parent recently emailed Levy pictures of food labels while grocery shopping, unsure what was the most healthy choice.) But it's up to the child whether or not to allow parents to be able see the app. And after an initial session with the coach, children also choose if they want their parents to be present for future sessions.

Jordan Greene, a freshman at Carlmont High School in Belmont, said her coach helped motivate her to meet goals they set together and was someone with whom she could talk. She likes that the app is on her cell phone, and she has her coach's phone number so she can text her if she has a question or a need. (Greene's mother joked that she listens to her coach more than she does her own mother.)

And it's actually worked. Since starting with Kurbo in April, 14-year-old Greene has lost 30 pounds. She's learned about portion size for the first time with a helpful comparison: One serving is about the size of one's fist. Fond of dance, she wants to try out for her high school dance team and says she now feels less self-conscious.

Greene's mother, Michele Brenner, said her daughter's doctor suggested she try Weight Watchers a few years ago, but it wasn't the right model for someone that young. They knew about the Stanford program, but it just wasn't accessible, Brenner said, and there weren't any other programs out there for someone of her daughter's age.

But, Brenner said, it's not just that Kurbo is easy, free and accessible. The feature that sets the app apart, said Brenner and other users, is the fact that it puts the entire process -- the tracking, the education, the goal-setting, the accountability -- in the hands of the child.

"It put her in the driver's seat," Brenner said. "She was doing it because she was self-motivated to do it, not because it came from me."

Putting kids in charge of their weight loss is an approach Kurbo replicated from the Stanford program. Sam Feldman, a sophomore at Kehillah Jewish High School in Palo Alto, participated in Stanford's program when he was 9 years old and 50 pounds overweight. He joined the Kurbo team this summer as an intern, testing out the app and advising on what worked or what didn't work for him at Stanford. (Along with a youth advisory board, a group of Lucile Packard Children's Hospital pediatricians, psychologists and well-known tech experts helped develop the app and continue to provide guidance.)

Feldman -- now a slim, healthful, confident young man who plays three sports -- clearly found success through Stanford's program, and it went beyond just losing weight.

"It really changed who I was in all aspects. I didn't just lose weight," he said. "I feel like I can really accomplish anything because I saw who I was before and who I am now, and it really gives me the confidence to do anything."

Feldman was at first skeptical that a mobile app with nowhere near the same level of in-person instruction could produce such results. (Plus, it ran counter to the idea that kids who need to lose weight should be spending less time on their screens and more time outside exercising.)

But, he said, the more he thought about it, the convenience and affordability of a mobile version of Stanford's approach made sense. Instead of carrying around a journal to log what you're eating, you can pull your phone out and take a picture or make a note on the app. Kurbo coaches are available through numerous mediums at all times. He saw beta users testing the app lose 15 pounds and more.

Since launching to the public in August, thousands of people across the country have downloaded Kurbo, and coaches currently work with about 100 users, Strober said. More than 80 percent of users have reduced their Body Mass Index (BMI), a standard measure of body fat based on height and weight.

"When the kids start feeling like they're empowered to make changes, it's really cool," Strober said. "When they have a tool that helps them and then they have someone else who cares about them talking to them -- that combination, we found, is really powerful."

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2 people like this
Posted by Wife of M.D.
a resident of Palo Alto High School
on Oct 24, 2014 at 2:31 pm

How nice to read that children are succeeding with this program. There really should be some nutrition teaching in elementary school because children take it to heart (my son learned about recycling and water conservation and keeps us in line).

The current thinking about weight loss is that both exercise and calorie intake are important, but intake is more important.

PROTEIN is very important in helping to stay full. Breakfasts with protein - bacon, eggs, yogurt, meat, nuts, peanut butter, cheese - will keep them full longer than carbs and sweets like toast, bagel, donut, sweet cereal, pop tart. Oatmeal isn't high in protein but it keeps them full (we like Trader Joe's oatmeal which has less sugar).

A few tips:

- For snacks, eat Greek yogurt, which has much more protein.

Compare Yoplait regular berry, 170g: 170 calories, 1.5g fat, 5g protein
Dannon Oikos greek yogurt, blueberry, 150g: 130 calories, 0 fat, 12g PROTEIN

- Eat nuts (protein) when hungry (but don't overdo it because of fat content)

- Drink water to stay full (men should drink 13 cups of fluid/day, women should drink 9 cups of fluid/day).

- Drink water at meal time. Sweets fluids can add 200 calories! Milk has protein and calcium (and calories, but the protein and calcium are healthy).

- Protein bars aren't necessarily healthy

- Don't try to cut out everything "unhealthy". Some sweets, some fat, some splurges are okay, but keep a generally healthy diet and exercise routine. If you cut sweets, you'll realize your body adjusts and the body won't crave super sweet things like soda all the time (except on those occasional splurges).

3 people like this
Posted by Healthy Eating
a resident of Palo Verde
on Oct 24, 2014 at 2:50 pm

Best oatmeal is made from scratch without any sugar. Slice banana, berries, or apple slices if you want it to be sweet. Never buy the instant stuff. It takes very little time to make enough to feed a family in the microwave in a glass or plastic serving bowl.

Best yogurt is plain and once again if you want to sweeten it, use banana, berries or other fruit. All the flavored yogurts are loaded with sugar.

Whole grains, in bread and bagels are best. White bread, etc. is not healthy. Whole grain pasta or if you can get it with spinach, so much the better. Brown rice, never white rice.

Contrary to belief, potatoes are healthy if you don't cover them in fat. Baked potatoes or boiled with a little non fat sour cream, yogurt or cream cheese, but only a tad. Spaghetti (tomato) sauce also flavors them nicely but once again, don't overdo it.

Beans are great, but don't buy them in sauce, make your own.

Home made vegetable based soups are great too, but don't add loads of fat. You can put in some chicken or other meats to make it a more filling meal and you eat less meat in a soup than you would as a serving. Home made vegetable soups and casserole dishes do not take long to make and can be made in advance or reheat well as leftovers. Be careful with dishes like lasagna as they use so much cheese that they are full of fat. The same for pizza, make your own on a wholewheat base, loads of tomato sauce, a tad of cheese and loads of your favorite veggies.

1 person likes this
Posted by Wife of M.D.
a resident of Palo Alto High School
on Oct 24, 2014 at 3:20 pm

Your guidelines are helpful but unrealistic for most people. [Portion removed.]

1 person likes this
Posted by Healthy Eating
a resident of Palo Verde
on Oct 24, 2014 at 3:42 pm

Didn't mean to sound as condescending as you seem to think I did.

I would rather eat my sweets and fats by choice, rather than by accident.

I would rather have a scoop of icecream as my daily fat intake rather than have it by accident in something I thought was healthy such as veggie lasagna or pizza.

Likewise, I would rather have a couple of fancy chocolates as my sugar intake rather than in instant oatmeal or flavored yogurt.

I think we are both trying to give some ideas on how to eat healthy and in a busy lifestyle it is often easier than some people think to make things from scratch at home rather than stop for something on the way home or grab something to eat in the car.

My family ride bikes, walk and yes do drive too. No time for a ten mile run every day, but we try to exercise by having fun outside when we can.

6 people like this
Posted by parent
a resident of Midtown
on Oct 24, 2014 at 4:31 pm

I agree with @HealthyEating that eating wholesome foods most or all the time is not hard once you decide to make that part of your lifestyle. Also, regular exercise is not hard if you make it part of your daily routine, rather than having to find extra time for "10 mile runs".

The people that have a hard time living healthy are the ones that think health is separate from normal life.

1 person likes this
Posted by Akua Pokua Adjei
a resident of Barron Park
on Oct 25, 2014 at 2:10 pm

This is such a good way to help children lose weight

Like this comment
Posted by Scott
a resident of another community
on Oct 25, 2014 at 11:05 pm

[Post removed.]

1 person likes this
Posted by muttiallen
a resident of Adobe-Meadow
on Oct 27, 2014 at 11:21 am

muttiallen is a registered user.

Too bad this only seems to work on iOS. Lots of us have Android. Any plans for expansion?

Like this comment
Posted by Research needed
a resident of Professorville
on Oct 27, 2014 at 11:44 am

Great app and great concept but I wish the creators would do more research on healthy food choices. The low fat craze is outdated and misguided and studies have shown that consumption of healthy fats do not lead to obesity or heart disease. Saturated fats from appropriately raised and fed animals (i.e pastured, grass fed cows, lamb etc and whole milk and butter from them, pastured chickens and eggs, wild salmon etc) are good for us (protein always appears with fat in nature) and should not be eliminated (or avoided) from the diet for optimal health especially for growing kids. I know the program is Stanford based but "low fat" has been gospel for eons and most docs don't take the trouble to research whether what they're being taught is true. Eliminating processed foods from the diet is the most important thing any kid could learn to do. If they stick to foods that come to us naturally and don't over consume they'll be healthy.

Like this comment
Posted by Healthier yet
a resident of Greenmeadow
on Oct 27, 2014 at 12:07 pm

@healthy eating - your fear of fats guides your intake but I think it's misguided. You suggest eating "Greek yogurt" because it's lower fat but if that yogurt is coming from cows that were raised in confinement and fed grains, antibiotics, hormones and assorted crap, it is not healthy! Full fat plain yogurt made from milk of a cow raised on pasture and grass fed is a much better choice. Same with your ideas on lasagna and pizza - it's not the cheese you should worry about- it's the pasta and bread because those are empty carbs with no nutrition. But I do agree with your take on junk food disguised as health food. Fruit flavored yogurt (just one example) is full of sugar and other additives and is junk and it's best to be recognized as such. Read the labels and stick to stuff that's unprocessed real food. If you shop mainly in the produce aisles and the meat counters you'll be okay! And if you're eating dairy you should be very careful about the source - raw is best but after that try for organic, not homogenized- from a reputable dairy (not Horizon!). The less processing the better.

Like this comment
Posted by mathewmurdock
a resident of another community
on Mar 11, 2015 at 1:01 am

mathewmurdock is a registered user.

[Post removed.]

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