Jetting off to college brings excitement. New friendships and professional opportunities await.

But it also brings the obligation of taking care of your health without a parent’s watchful eye. Dorm buffets, sugary drinks and sleeping in all the time can lead to your clothes feeling tighter and your self-esteem feeling lower.

So what’s the scoop on the so-called freshman 15? How big of a problem is weight gain in college? How can you prevent it?

First things first: Rachel Bult, a supervisor dietitian at OSF HealthCare, says it’s more like three to 10 pounds weight gain in the first year on average, not 15. But the issue is still worth paying attention to.

“You add more calories than you intend to,” with food options in college, Bult says. “Also, stress and lack of sleep can cause increased cravings for sweets and comfort foods.”

Some tips to consider:

• Exercise portion control. Remember the saying “Are your eyes bigger than your stomach?”
   
• If you’re on a meal plan that means buffet meals every day, go to a healthier station first. Start with a salad and a vinaigrette dressing, Bult suggests. Non-starchy vegetables as your side can provide fiber. Protein like chicken, fish, beans, chickpeas and tofu will help keep you full.
   
• For exercise, find movement you enjoy. Don’t approach it as a chore. If you like pickleball, find a local league.
   
• Keep healthy snacks, not junk food, at arm’s reach.
  
  “When I was in college, I would have a protein smoothie in the morning to help fill me up,” Bult recalls. “But you could also keep fruit, string cheese, unsalted nuts or bell peppers with hummus. Just things that are healthier and quicker to grab and go.”
   
• Smartphone apps can be a short-term tool to get you on the right track, Bult says. Apps can track what you’re eating, your daily steps and more.
  
  “Those can help you understand the nutritional value of what you’re consuming,” Bult says.
   
• Talk to your primary care provider or a dietitian if you need guidance. Research what your local school, health system or social service groups offer.

Learn more

The OSF HealthCare website has healthy recipes.

Interview clips

Carla Richardson of Beverly on the southwest side of Chicago loves it when her grandson tells her, “You’re lookin’ fresh Nonnie!” She jokes, “This is what 77 looks like. But then again, I’m an old hippie.”

Richardson also credits her "fresh look” to her positive attitude and the consistent care she’s been receiving at OSF CompleteCare 55+. The clinic at 99^th and Western Avenue in Evergreen Park opened a year ago this month. It offers a new kind of primary care targeting older adults with ongoing health conditions who are looking for community, hands-on care and 24/7 access to real providers, not chatbots.

For Richardson, the vibe is great.

“They’re glad to see you. You don’t feel like you’re a patient. You feel like you’re going somewhere where someone really cares about you. They keep in touch with you, which is so important. I get texts from Taylor [Taylor Wen, PA, her OSF CompleteCare 55+provider] on MyChart, and it’s just an interaction that is rare.” 

Richardson was diagnosed four years ago with pulmonary sarcoidosis, and she has a history of pulmonary embolism and pneumonia. Plus, she has to be on blood thinners. Frustrated with her previous care, she tried OSF Complete Care 55+ shortly after it opened, and she’s been thrilled with her experience.

“My first experience with Taylor was just phenomenal. She was knowledgeable, patient, and she seemed like she cared. And going to doctors, sometimes you're just a patient number. And I didn't feel that here.”

Wen, a physician assistant, also sent Richardson to get a bone density scan where Richardson learned she had severe osteoporosis – so bad that she had to reduce the weight of her purse for fear it would break her wrist. Richardson is so grateful because she believes knowledge is power.

Staying connected to consistent care

Although she doesn’t consider herself computer savvy, Richardson says she’s learned to use OSF MyChart, and it keeps her connected to Wen.

“It’s easy to use, and it helps me monitor and keep up with my own health issues. I like the fact it reminds me when I have appointments coming up. I’m retired but I’m still busy.” 

Richardson remembers when doctors made house calls and says the care she’s getting now reminds her of that.

“When the doctor would come to your house with his bag. I know it was 100 years ago. But it’s so personal now, here. And you go to other places, and you’re waiting and waiting. And no one really seems to care.” 

The 6,300 square-foot clinic features 12 exam rooms and on-site labs. Sandy Valino Stock, DO, medical director of OSF CompleteCare 55+, says many people enjoy the option to connect digitally 24/7. Virtual visits make it easy to get answers to questions, especially after hours when symptoms aren’t severe enough for emergency care. Richardson says that kind of convenience could save her from long waits in the emergency department, only to be sent home with a quick evaluation and remedy.

Dr. Valino Stock says about half of the people who use the clinic take advantage of virtual visits, while the other half are seen in-person.

“Patients love the virtual concept because they don’t have to miss as much work. It’s just convenient for them,” Dr. Valino Stock shares. “Sometimes it’s a case where the patient comes into the clinic and their loved one wants to be tuned in, but they’re at work. So, they can be virtual during that visit, and they can be present if they need to be.” 

More than half of the clinic’s patients have high blood pressure and/or high cholesterol, one-fourth have diabetes and significant osteoarthritis, and about 10% have heart failure.

But consistent care is helping improve those conditions. For example, almost 80% of patients are now meeting blood pressure and A1c targets, up from 34% and 58% respectively.

The clinic has also seen success in increasing completion rates for screenings such as mammograms, bone density tests and colonoscopies. These preventive steps are often overlooked, but they play a key role in long-term health.

GLP1 medication management is available

As people age, weight management can also become more difficult as metabolism naturally slows. Dr. Valino Stock explains that metabolism typically declines by 1% to 2% each year after age 20. At CompleteCare 55+, more than half of patients are overweight or meet obesity criteria. This is important because extra weight on the body leads to most of the medical conditions being treated.

GLP-1 medications such as Mounjaro or Ozempic are, as Dr. Valino Stock put it, “magical” in helping people lose weight. But the GLP-1 journey requires regular check-ins and medication management.

“We see them monthly for the most part as they’re getting started on these GLP-1s. So, patients have better success at getting healthier, whether it’s controlling their blood sugars or lowering their weight and doing it in a healthy manner where they can maintain their muscle and minimize the side effects.” 

Many who enroll in OSF CompleteCare 55+ are women in pre-menopause and menopause. The outlook for Hormone Replacement Therapy (HRT) for menopause has fundamentally shifted in the past 10 years. Following major reviews, experts now recognize that for most healthy women under 60 or within 10 years of the onset of menopause, the benefits of HRT far outweigh the risks.

“If no contraindications, we can help women sleep better, have a little bit more energy, feel themselves and just continue life because life is very busy. So, if we can help a woman get a good night’s sleep, everything changes for that woman.” 

Beyond direct medical care, digital health care navigators at a “Connect Bar” in the lobby also help with insurance issues, coordinating appointments with specialists and navigating OSF MyChart and other tools to monitor their health. Events such as Tech Tuesday also allow for group sessions to address technology challenges.

Navigators also connect people with resources to address social needs such as transportation to appointments or senior centers or food insecurity. Through educational events with speakers on health topics and partnerships with local organizations, clinic leaders continue to learn more about the needs of the people they're serving.

Additionally, regular outreach efforts keep providers connected. For example, at the OSF CompleteCare 55+ clinic, any community member can access free blood pressure screenings from 10 a.m.-noon every first and third Tuesday of the month.

Learn more here about OSF CompleteCare 55+ primary care.

Video clips with Carla Richardson

Video clips with Dr. Sandy Valino Stock

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November, December and January bring bountiful holiday meals.

While it’s tempting to chow down, experts are cautioning about how overindulgence can make you feel mentally and physically crummy in the moment, plus open the door to long-term unhealthy eating habits.

Have the right mindset

Andrew Zasada, MD, provides emergency department care at OSF HealthCare. He says avoiding stuffing yourself starts before you sit down for the meal.

“If you come to the meal hungry, you tend to try to make up for not having breakfast. You load your plate up, which is going to cause you to overeat,” Dr. Zasada says. “Instead, have a light snack an hour or two before you sit down to the meal.

“Put the food in one room and sit down in another room to eat. That necessitates you going there rather than having food available for another fill.”

The meal itself

Enjoy holiday meals, Dr. Zasada says. It’s not a race.

Grab a smaller plate, and take smaller portions of each item. Pretend you’re filling the plate up for a child. You wouldn’t take five rolls and two big slabs of meat for a youngster, so don’t do it for your adult self.

Other tips: Chew slowly. Between bites, put your utensil down, take a drink of water and talk to someone. This allows your stomach to fill up and tell your brain that you’re full.

When you finish eating, leave the table, and go to another room. Staying next to the food increases the temptation to keep nibbling.

If you can’t help it

Dr. Zasada says despite our best efforts, sometimes you overeat during holiday meals. Maybe you don’t want to offend your aunt by not having a slice of her famous pie.

If that happens, Dr. Zasada says there are two pitfalls to avoid: Drinking alcohol and lying down right after the meal.

“That opens up the sphincters of your stomach, slows down digestion and increases the chance for heartburn,” Dr. Zasada says.

Try tea or coffee after a meal instead of alcohol. But if you must indulge in a spirit, Dr. Zasada says to wait at least 90 minutes so your stomach can partially empty.

Instead of lying down for that post-meal nap, sit upright, talk to people or play a game. If the weather is nice, go for a walk.

A word on more serious eating issues

Holiday meals may be difficult for people who suffer from eating disorders, such as binge eating (eating a lot in one sitting and feeling you can’t stop), anorexia nervosa (an unwarranted fear of being overweight which leads to things like starvation) or bulimia nervosa (taking unhealthy steps to avoid weight gain like purging your food).

Dr. Zasada says, in the moment, you should have someone you trust who can help you through the holiday meal and check in with you later. Long term, he says these are serious issues that should be talked about with a health care provider.

“Repeated bulimia will damage your teeth. It’s corrosive. You lose electrolytes when you vomit,” Dr. Zasada says. “You become sick. If you do this repeatedly, you will lose weight in an unhealthy way. You will possibly dehydrate. You will start losing muscle mass.

“It’s just not a good thing.”

Bottom line: Don’t get discouraged

Dr. Zasada says one day of extra eating may make you feel bad, but it isn’t going to derail your overall health.

“One day won’t make you fat,” he says.

Get back into your healthy eating habits the next day while enjoying those leftovers in moderation. If you feel you are struggling to maintain a healthy weight or body image, talk to your primary care provider. They may refer you to a specialist like a dietitian or mental health provider. From there, plans could include a diet and exercise regimen, medication or, in rare cases, weight loss surgery.

Interview clips

Donna Fortson has struggled with health challenges for most of her adult life.

It started with serious back issues, which turned out to be hereditary. She has rapid degeneration of her joints, discs and vertebrae, a condition her daughter now has too. Fortson has endured six back surgeries with more planned. Given her situation, it’s imperative the Rockford, Illinois, resident, doesn’t carry any extra weight.

“I've had to go through a lot of recovery,” Fortson says. “I have a lot of metal inside me, so it's hard to recover from that. I’ve been inactive. And that led me to gain a lot of weight.”

But there’s more.

Fortson also learned she has fatty liver disease and liver fibrosis. She had gastric sleeve surgery to help with weight loss. Then her gastroenterologist recommended Fortson see a dietitian to develop a plan to lose more weight and keep it off.  

Finding support 

For nearly 1½ years, Fortson has been a client of the Center for Nutrition and Weight Management at OSF HealthCare Saint Anthony Medical Center in Rockford. The road to weigh loss hasn’t been easy. But the good news is Fortson is down more than 100 pounds.

Sean Pavlick, a dietitian with OSF HealthCare, is the architect of Fortson’s weight loss program. He says the key to losing that much weight is breaking it down in portions.

“If you want to lose 100 pounds, OK, but let's take that in chunks of 20 pounds, just to keep your head in a better position,” he says. “Because there's a lot of psychology that goes into all of this, and it gets very discouraging, very fast.”

Food has always provided comfort for Fortson – through good times and bad. Doughnuts, cakes, ice cream. Sweets, she says, were her downfall.

“I have a lot of anxiety with all the stuff going on. So that's my comfort. It wasn't drugs or alcohol. That was my vice,” Fortson says. That's the reason I kept gaining weight. I had to sit around a lot. So, what else to do but sit there and eat my sorrow away?”

But once Fortson started seeing Pavlick, it was time to get serious about her health. Her back problems were one thing; the liver issues opened Fortson’s eyes to what her future could hold.

She meets Pavlick once a week. She weighs in, reviews her food diary and talks about any challenges she’s facing.

These days, Fortson has replaced sweet treats with fresh fruit and vegetables. She reads labels at the grocery store and ignores the temptations of making bad decisions. She’s sworn off soda, something she insisted she’d never do. She now drinks plenty of water.

Pavlick has seen significant changes in Fortson since their first meeting.

“I think it's a big attitude change with Donna, for sure. With a lot of patients, there's such a reluctance to change,” he says. “And any dietitian would agree, we hear it all the time, ‘Well, I'm just not going to do that. You can't get me to make those changes.’ I like to use the word incremental changes, or we say SMART goals, where it's things that you can tackle, the realistic changes. And Donna's done all those things and made the changes that are maintainable.”

Staying the course 

Recently, Fortson indulged in a small portion of cake at a birthday party. On the way home she experienced a headache that she attributes to cutting out all sugar from her diet.

Fortson and Pavlick say having people in your corner is important for anyone traveling along a weight loss journey.

“There's peaks and valleys with everyone, but I think something that Donna would say as well, it's the constant support system,” Pavlick says. “And when there is a setback, it's not a big negative thing. We try to put a positive spin on things and reinforce good attitudes.”

Fortson says she feels good these days. She’s got more energy, her blood work results are improved, and she’s feeling better about life. While she’s pleased with her progress, she knows weight loss will be a foe she battles for the rest of her life.

“I have a spring in my step, and I look forward to coming in every week and getting weighed, which is weird, because I used to hate the scale,” she says, laughing. “Now I'm like, ‘yes, I better be down.’ It's a challenge for me, but I look forward to it. I've dedicated my life to it.”

For more information about weight loss, visit the OSF HealthCare website. 


 

Donna Fortson interview clips 

Sean Pavlick interview clips 

B-roll 

College students will soon be home for summer break. They’re embarking on their independent phase, so opening up about mental health to their parents might not top the summer to-do list. It can leave parents wondering: How did the school year go? Did they make friends? Are they doing OK mentally?

Rachel Yuhas, LCPC, a psychotherapist at OSF HealthCare, says there are dos and don’ts to get the most out of a conversation with a young adult.

School stress

Yuhas says going off to college is a huge transition. The student may miss home. They may have trouble being accountable with no 8 a.m. to 3 p.m. structure they had in high school. Making friends can also be difficult. Yuhas says college students may be stressed and scared to branch out and meet people.

“They might be anxious or get into a rut of depression. They might isolate. They might sleep too much or not sleep at all,” Yuhas says.

Warning signs

Yuhas says parents should watch for drastic changes in their college student’s appearance as a possible “red flag” of a mental health concern. Some weight gain or loss in college is expected, but significant weight changes should warrant a discussion.

“This might mean they’re not taking care of themselves,” Yuhas says. “Stress might be coming on. They might be depressed. All of those things can cause issues with appetite.”

Other things to watch for:

• The young adult is spending most of their time away from others. Maybe they’re in their room sleeping all day.
   
• They drop hints about their college experience, such as “I didn’t join any new clubs this year.”
   
• The person looks messy. Maybe they used to be a snazzy dresser with groomed hair, but they stopped keeping up that appearance. Or they stopped hygiene practices like using deodorant or brushing their teeth. Parents should ask themselves: Is my child keeping up with daily tasks?

Dos and don’ts

It’s time to talk to your child about their mental health.

• Do: Ask open ended questions, and let the child fill in the blanks. For example: How did final exams go?
  
  Don’t: Ask accusatory questions like: What’s wrong with you? Or: Why aren’t you talking to us?
  
  “If you get mad at them, that makes it worse. They won’t want to open up,” Yuhas says.
   
• Do: Find the right time. Let the child get settled back in, and have a conversation over lunch a day or two later.
  
  Don’t: Bombard your student with questions the moment they get into the house.
   
• Do: Curtail your reactions and judgements. Be kind and mindful.
  
  “Instead of asking ‘Why?’, say ‘Oh my gosh. I didn’t know about this. What’s been going on? Tell me more.’,” Yuhas says.
  
  Don’t: Have knee-jerk reactions like: How could you? Or: Why did you fail that class? Or even: You know I don’t like your major. Why haven’t you dropped it yet?

Next steps

After that first conversation, Yuhas urges parents to not let the issue go.

“I encourage parents to become emotion coaches with their children,” Yuhas says. “Continue to check in. Continue to ask, ‘How are you doing?’ or ‘I saw the college had this event. Was it something you went to?’ Just stay involved in their everyday life, but don’t bombard them.”

If things aren’t improving, the conversation might turn to: I want to help you. Have you thought about talking to a therapist? Would that be a good option?

“Put the ball in their court,” Yuhas says.

“When we go off to college, it can be a huge adjustment. So we try to normalize their feelings,” Yuhas adds, outlining what she might talk to a college student about in a therapy session. “We go over ways to make friends and socialize. We go over how to manage stress, anxiety and depression. We talk about coping skills.”

For example, if a student is leaving their dormitory just for class, Yuhas may suggest going to the library to study. The student may make a friend along the way. Yuhas may suggest exercise or meditation. Or, is homework procrastination causing stress? There are ways to change those habits.

Learn more

Read more about healthy thoughts and behaviors on the OSF HealthCare website. If your stress has reached a crisis where you are thinking about harming yourself or others, talk to a trusted adult or mental health professional or go to the emergency department right away. The 988 Suicide & Crisis Lifeline is also available.

Interview clips

Related stories

Difficult, not bad: Navigating tough conversations
Big emotions, bigger solutions
I'll do it another time
Fall into self-care

The music world was stunned to learn that the recent passing of former American Idol contestant Mandisa was the result of complications from class III obesity. Mandisa, who was found in her Tennessee home in April, was 47.

Class III obesity is defined as a person who has a body mass index (BMI) of 40 or higher or a BMI of 35 or higher and experiencing obesity-related health conditions. In simple terms, BMI is a ratio of height to weight.

“We know the heavier we are, the higher risk we have for things like diabetes, like high blood pressure for acid reflux or sleep apnea, the things that actually are causing damage to our bodies,” says Nicole O’Neill, a registered dietitian with OSF HealthCare.

Obesity is a major problem in the U.S. According to the Centers for Disease Control and Prevention (CDC), it affects four out of 10 people in this country. Class III obesity is on the rise and affects 6% of adults nationwide.

Ideally, a healthy BMI range is 18.5 to 24.9. However, body fat isn’t the only factor of overall health. There’s genetics, activity level, smoking, drinking alcohol and mental health that all have an impact on the chance of developing health problems.

There are dozens of health risks associated with obesity including Type 2 diabetes, high blood pressure, heart disease and stroke.

Mandisa was transparent about her battle with mental health issues, which included turning to comfort foods during tough times. O’Neill works with clients who are going through their own struggles with weight issues and developing a healthy relationship with food.

“A lot of times it really depends on what the root cause of the actual weight gain is,” she says. “Is it someone who's stressed out and is eating their feelings? Then we have to look at that. Is it someone that has an injury and they're no longer able to exercise? In that case, we try to give them modified exercises. We're always going to look at diet though.”

O’Neill says the goal is to create a food plan that balances the calorie load. That includes coming up with well-balanced meals featuring plenty of fruits and vegetables, which have only 17 calories per ounce on average.

“Every person is so different. We have to take an individualized approach with each person,” she says. “What works for me probably isn't going to work for you or anybody else.”

In addition to working with a dietitian, O’Neill encourages clients to seek other professional help as well.

“I recommend people see a counselor because it's important. They're trained to know if you’re depressed or you're anxious. They have the tools to say ‘Alright, when you feel this way, do this instead of turning to food.’”

She adds that it’s important for people to know that it’s never too late to make healthy lifestyle changes. They can include slight lifestyle and diet modifications. And they don’t have to happen all at once.

“It can be small, incremental steps, and that's how most people do well,” O’Neill says. “Take one bottle of soda away and replace it with a glass of water. Take one cheeseburger away a week and add a salad so that they're sustainable changes that feel doable.”

People who think they could be helped by the new class of weight loss drugs should talk to their medical provider about the benefits in connection with a plan to make lifestyle changes. For more information on weight loss, visit OSF HealthCare.

Interview Clips 

In his year-long battle with cancer of the esophagus, Jim Corby encountered many nerve-wracking moments.

But when asked about it, one memory comes to mind for the retired construction worker from Alton, Illinois. One that happened far away from a doctor’s office.

On July 27, 2022, Corby was chosen to throw the ceremonial first pitch at the Alton River Dragons baseball game. Members of care team at OSF HealthCare Moeller Cancer Center in Alton, James Piephoff, MD, and Manpreet Sandhu, MD, were at his side. Also watching was a group of young women Corby coaches on the softball diamond.

“He knew if he didn’t throw a strike, he would never hear the end of it from the girls on his team,” Dr. Piephoff says.

No pressure, Jim.

Esophageal cancer: The basics

Dr. Piephoff, a radiation oncologist, says around 20,000 people in the United States are diagnosed with esophageal cancer each year. The cancer claims around 16,000 lives in the U.S. each year.

There are two types. The most common (around 70% of U.S. cases) is adenocarcinoma in the lower esophagus. The other type is squamous cell carcinoma, typically above where the airway separates into the lungs.

Both types are associated with excess smoking and drinking, something Corby found out the hard way.

“I smoked two-and-a-half to three packs of cigarettes a day,” Corby says. “The day I went in for surgery, I threw them out the window. I haven’t smoked since.”

Obesity is also a risk factor for adenocarcinoma.

“Obesity leads to increased risk of gastroesophageal reflux disease,” Dr. Piephoff explains. “It’s the acid churning up in the lower esophagus that leads to the risk of developing what’s called Barrett’s esophagus. That’s a precancerous condition.”

Screening isn’t common for cancer of the esophagus, so Dr. Piephoff says it’s important to watch for symptoms, which can mimic those of heartburn. See a doctor if symptoms won’t go away.

“Know your body. Don’t be afraid to talk to your doctors about it. Don’t try to minimize your symptoms,” Dr. Piephoff urges. “If there’s a change you notice, you need to convey that to your doctor.”

On treatment, Dr. Piephoff says he typically sees a person go through chemotherapy and radiation to shrink the cancer followed by surgery to remove the tumor. During surgery, instruments are sent down the throat and not through the chest, meaning an easier recovery for the person. Early detection could mean surgery only.

“There are some patients who are not able to have surgery because of medical conditions like a bad heart or bad lungs,” Dr. Piephoff says. “They get treated with radiation and chemotherapy without surgery.”

Immunotherapy is also a part of the treatment plan for some people. This involves changing how your immune system works so it can fight cancer, according to the American Cancer Society.

Jim’s journey

Corby says he started having pain in his midsection last year when he ate. Treatment for heartburn and acid reflux didn’t help. An ultrasound and CT scan didn’t get his doctors any closer to a solution. All the while, Corby says it hurt so much to eat, he started losing weight.

In September 2021, doctors examined Corby’s esophagus with a camera.

“The doctor came in and sat down, which I knew was not a good sign,” Corby recalls.

“That day was when my life changed,” he says.

The exam found a cancerous mass in Corby’s lower esophagus. The next few months were a whirlwind.

“It happened real fast,” Corby says.

“They got me here [to Moeller Cancer Center] to see Dr. Piephoff and Dr. Sandhu. They came up with a program to try to get me going,” Corby says. “I went through chemotherapy and radiation first. Then they sent me over to St. Louis, and in January I had surgery.”

The surgery to remove the cancer preceded a nine day stay in the hospital where Corby says he couldn’t eat or drink aside from the occasional ice cubes or water sopped from a sponge.

Sometime later – Corby can’t remember exactly when – he was back at OSF Moeller Cancer Center meeting with Dr. Sandhu.

“She said ‘Your scan came back. You’re cancer free.’” Corby says.

“I couldn’t believe it,” Corby adds. “How many times do you hear about people who have cancer who die? You hear more of that than you do cancer free.

“The odds were against me 100%, but I guess I beat the odds.”

The first pitch

Corby’s first pitch at the River Dragons game went – where else? – right down the middle of the plate, eliciting a cheer from his support system and all the fans learning his story for the first time. For Corby, it was a sigh of relief. No need to worry about razzing from his softball players.

“I got lucky,” Corby says, fighting back happy tears.

Learn more

Visit the OSF HealthCare website to learn about cancer treatment. This includes the new OSF Cancer Institute in Peoria, Illinois, which will serve the entire OSF service area will the latest treatment, education and more.

Interview clips - Dr. James Piephoff

Interview clips - Jim Corby