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did you hear the new one American Academy of Pediatrics(AAP) recommendations for the treatment of “childhood obesity”? If you haven’t, this will probably make your head spin. Before I get into specific guidelines, what they mean, and the concerns of medical professionals, I want you to think about your own childhood.
If you grew up in a larger size, focus on how doctors, family, parents, and peers treated you, and focus on your body size.
Has your doctor insisted on testing your glucose level at each visit just because of your weight, with no other indication that you might have diabetes? Did your parents force you into a weight loss program like Weight Watchers or LA Weightloss?
Have you ever been treated differently because you didn’t have the same clothes as your peers? Have you been dressed in a completely different uniform or costume than everyone else because this is the only option that fits your size?
“Obesity” as a Disease
If you do some research on how “obesity” is classified as a disease, it may surprise you. About 10 years ago, the American Medical Association (AMA) Asked the Science and Public Health Committees to decide whether to classify obesity as a disease or only as a risk factor for chronic diseases.
The committee produced a 5-page opinion that suggested that obesity should not be classified as a disease for many reasons. Reasons: if you consider humanity’s history of adapting to calorie storage during times of famine, obesity doesn’t fit the medical definition of a disease – it actually shows larger bodies are more efficient, and they worry that medicalizing obesity could harm patients. creating more stigma and ultimately resulting in useless “cures”.
At the AMA’s annual meeting in the summer of 2013, Resolution 420: “Our American Medical Association recognizes obesity as a disease state with multiple pathophysiological aspects that requires a range of interventions to advance obesity treatment and prevention.” It was passed by an overwhelming majority, ignoring the recommendations of its own committees.
Okay, now that we’re in the right mood to discuss these new AAP guidelines, let’s get to the point… and brace yourself.
What Do the New Guidelines Say?
One of the main recommendations is new guidelines Intensive behavioral and lifestyle therapy for the treatment of “childhood obesity”. This includes things like nutritional counseling, physical activity, and “behavior changes.” Ideally, this would require 26 hours of face-to-face treatment over months. One problem with this recommendation is that it will take some time for the treatment to become available, which leads us to the more relevant sections of these guidelines because they are more readily available.
The AAP now recommends weight loss medications to children 12 years and older diagnosed with “obese.” It is recommended that children aged 13 years and older with “severe obesity” undergo bariatric surgery. This includes those found at 99 percent body weight for age and sex.
Why Are These New Guidelines a Problem?
If there’s one thing we already know about these trending weight loss drugs that will now be prescribed to kids, when people stop taking these drugs, most of them gain their weight back. This means that once a child takes these drugs, they will need to take them for the rest of their life.
People who have had bariatric surgery are at risk. post-surgery eating disordercan be very dangerous due to the way the body needs nutrients after surgery. They are also at risk problems with alcohol as you age after surgery.
Medications and surgery are the sections of the guide that are most discussed by medical professionals online because they will likely be the preferred options by medical professionals as behavioral and lifestyle therapy is not currently available.
we asked @paulina.the.therapist (MHC-LP) on TikTok for perspective on these guidelines as a mental health counselor. He states, “Fat people are not a problem to be solved. Negative consequences weight stamp It is well documented, but obese people are treated as inhumane at both systemic and interpersonal levels.
“The AAP does not mention or warn pediatricians about eating disorders or disordered eating. Instead, they recommend actions with known and documented risk factors for eating disorders, with wholly inadequate mention of how weight stigma and weight controversy can increase the risk of developing an eating disorder. Our children are the most vulnerable. and among our vulnerable populations. It has been repeatedly shown that a focus on weight does not lead to positive health outcomes. Quite the contrary, but still, the anti-fat bias runs so deep throughout the medical industrial complex that such dangerous recommendations are made no matter what. It has never been about health ”
@nursingtheoryprof (PhD RN) says on TikTok: “As a self-management researcher, it bothers me that these guidelines do not address weight stigma in a meaningful way, including that the approach proposed here can make children feel stigmatized by their provider. This can lower a child’s motivation throughout their life, especially if most of the visits are focused on weight. If children feel relegated to their weight status in the eyes of their caregivers and then feel that their home life is constantly focused on weight, they will likely become discouraged and resist health behaviors as they develop through adolescence.
“What I find most important in these guidelines is that they only show a nominal commitment to the social determinants of health. All the pieces of behavior change, all families need food, safe spaces for physical activity, enrollment in extracurricular activities, etc. assumes that they have access to the same options. In fact, it is families who are least skilled at making the healthy choices that are required of them. they are also the least likely to have access to recommended medications and surgeries.”
What is being done to combat these recommendations?
Nutrition and Dietetics Including Weight (WIND) It assembles a team of health experts and advocates in the field, including weights, including Patrilie Hernandez. Instantiate the libDawn Lundin, Ragen Chastain, and others from Restore Dietetics to respond to these new guidelines.
WIND’s focus is to consider how these guidelines affect the most marginalized communities, their future impact and impact on families, and how this may shape policies for providers and insurance plans.
WIND situations, “Clinical Practice Guidelines have the potential to harm children and perpetuate the weight stigma even more. This working group is dedicated to analyzing guidelines and advocating evidence-based and weight-included approaches to child health. In the weeks and months following the release of the guidelines, the group met regularly and worked on:
- In-depth review of over 800 cited references, including analyzing a handful of studies to identify design flaws and erroneous results
- A one-stop resource for articles, podcasts and media responses to Clinical Practice Guidelines so far
- A signature letter outlining the potentially harmful consequences for children if the guidelines are applied in their current form. The letter also provides a call to action for anyone interested in advocating around this issue.”
All this will be made public Webinar hosted by WIND In the middle of summer 2023.
If you are concerned about these new guidelines for your own child, we recommend asking your pediatrician to: Negative Talk to your child about their weight.
You always have the option of telling your child’s doctor not to comment on your child’s body or talk about BMI in front of them. If the provider doesn’t accept it, it’s worth seeking out new doctor.
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