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This is ALL THINGS CONSIDERED from NPR News. I'm Melissa Block.

As part of our series on obesity and how it's changing life in America, NPR's Karen Grigsby Bates visited students at the Wellspring Academy of the Carolinas. Wellspring's two campuses - the other is in California - are the country's only boarding schools for obese students. We heard from Karen yesterday about her visit at the start of the school year. She recently returned to see how some of the students are faring, and all are grappling with a key question: How will they keep their weight off once they return home?

KAREN GRIGSBY BATES, BYLINE: It's been two months since the fall semester began at Wellspring, and many of the students today look radically changed from the way they did when the semester began. Bethany Gomez is still friendly and bubbly, but she is noticeably slimmer. She even looks taller, something she says a lot of people have told her.

BETHANY GOMEZ: Everyone keeps telling me, like, you look like - seriously, you look like you've skyrocketed, like, 10 inches.

BATES: Shy kids who checked in back in August have become briskly confident. Self-described couch potatoes are the first to hop up for a hike.

UNIDENTIFIED WOMAN: Come on, (unintelligible) out there.

(SOUNDBITE OF CHEERING)

UNIDENTIFIED WOMAN: Thank you.

BATES: And not only do these kids look different, they say they feel different.

JUSTIN MOORE: Like, I notice when I first went to camp, I would, like, have shortness of breath, like, running for really short distances and, like, activity was really difficult.

BATES: Fifteen-year-old Justin Moore started at a Wellspring camp this summer before transferring to school. He's lost almost 100 pounds since the summer and says, for him, feeling better is the most important part of his Wellspring experience. Justin says becoming physically active was hard at first.

MOORE: But now, I can - I'm, like, one of the most athletic people here, and I always try my hardest, and things just seem to come a lot easier.

BATES: This year's youngest student agrees.

AMENNIAH SMITH: My name is Amenniah Smith, and I'm 12 years old, and I'm from Baltimore, Maryland.

BATES: Amenniah, too, has lost a significant amount of weight. She comes from a family that enjoys traditional, big Southern meals. But Amenniah's folks are so impressed with her progress, they've instituted some changes at home to ensure her continued success.

SMITH: My family, they changed the house, the food for me. But, like, when I go over sleepovers and stuff, I'm going to start bringing my own food. But some of my friends' parents, they understand, and they're going to help me too. They've started to go on the plan with me.

BATES: Wellspring's tuition? More than $62,000 for the full year. The hope is that will get amortized as students inspire their families and others to adopt the school's very low-fat diet.

HALEY HUMPHREY: My dad's lost about 40-something pounds doing the same program.

BATES: When Haley Humphrey arrived in August, the 15-year-old was substantially larger than she is now. She's just returned from a weekend with her family in Athens, Alabama, where her father has been eating on program. They exchange weight loss tips during their weekly phone calls. Haley says her success has affected more than just her.

HUMPHREY: And it just inspires my whole family and my church. They're ready for me to come home and teach them things.

BATES: Clinical psychologist Daniel Kirschenbaum is a professor of psychiatry and behavioral sciences at Northwestern University Medical School. Dr. Kirschenbaum developed the Wellspring eating plan and agrees that an extremely low-fat diet can be hard on teens to adjust to when they come here initially.

DR. DANIEL KIRSCHENBAUM: It's challenging for them, but they're also in a good deal of pain from a psychological standpoint about living the life of an obese person.

BATES: Dr. Kirschenbaum believes too many Americans see fixing their excess weight problem as something that's optional and, he says, the physical, psychological and economic consequences can be dire if that hard work keeps getting put off.

KIRSCHENBAUM: You know, if your foot is broken and you didn't feel like wearing some kind of boot around it just because it's inconvenient, the doctor would say to you: Well, inconvenient or not, this is what's going to help you.

BATES: Because they have faster metabolisms than adults, when teens eat very low cal and maintain a high level of physical activity, the results can become astonishing in very short order. Sixteen-year-old Bethany Gomez has enjoyed the heights of considerable weight loss, but she's also suffered the disappointment of hitting a plateau. She was upset about stalling out at first, but now sees her weight loss journey as a marathon, not a sprint.

GOMEZ: It's great to say: Yeah, like, I lost 100 pounds in, you know, eight months. But it's also even better to say: I lost 100 pounds in eight months, and I kept it off for the rest of my life.

BATES: Physical activity is key. There's a minimum 10,000 steps a day, starting with a five-mile walk at 7 a.m.

ALFONSE MISSRY: The walk really helps you. The walk puts a jump-start to your metabolism and gets your body in the swing of things.

BATES: Seventeen-year-old Alfonse Missry doesn't mind the daily walk, but admits he'd tailor it a little if he could.

MISSRY: Making that walk a little later in the day wouldn't be too bad and also the hill.

BATES: Yup. Part of that walk gets steeply vertical. Out on the lawn, trainer Nicole Kaysing says her students are pushing themselves to take on new physical tasks.

NICOLE KAYSING: Over time, when they realize they can do little things they didn't think they could do, then they're a little more willing to give harder things a try.

BATES: This afternoon is a good case in point. Coach Andy Hayes has students doing a relay around the lake. With a little surprise, he's given each of them a 10-pound pumpkin to carry as they run to scramble over walls and shimmy under benches.

ANDY HAYES: This one right here, it's pumpkin push-ups.

BATES: It looks arduous, but the students are laughing, whooping and encouraging each other at every relay station.

HAYES: Go, Justin, Les.

(SOUNDBITE OF CLAPPING)

BATES: Bethany Gomez is one of the first to cross the finish line.

GOMEZ: That was so cool. You can see it.

BATES: And after she puts down her pumpkin, the former anti-exercise girl sprints off toward the relay course again because as she points out, it's going to feel so much easier without that extra 10 pounds. Karen Grigsby Bates, NPR News.

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