Friday, January 27, 2023

Opinion Today: How the new obesity guidelines could fail children

Is focusing on how much someone weighs the best path to health and happiness?
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By Eliza Barclay

Climate Editor, Opinion

Obesity treatment has become one of the most divisive issues in medicine. Look no further than the panoply of reactions to the American Academy of Pediatrics's new guidelines for evaluating and treating children and adolescents, released this month.

Some have called the guidelines a significant step forward because they encourage pediatricians to be aware of the harms of stigma and use a wider range of tools to help patients. One key change is that doctors are now urged to be quicker to send patients to "intensive health behavior and lifestyle treatment" programs, prescribe weight-loss medications and refer teenagers with severe obesity to a bariatric surgery center.

But in a guest essay this week, the writer Virginia Sole-Smith argues that the guidelines may fail to help, and even harm, many patients. The core problem, she says, is that the recommendations are based on the false premise that weight loss — and the interventions to achieve it, like diets, drugs and surgery — is "the best path to health and happiness." Instead, Sole-Smith says, pediatricians should move to a weight-inclusive approach, which has yielded promising results in adults in terms of physical health gains and fewer eating disorders.

"This means looking less at the number on the scale and talking more to families about their health priorities and challenges. Can they add healthy foods rather than restrict calories? Can they find ways to move their bodies that they enjoy?" Sole-Smith writes.

The debate about weight-loss medications is not limited to kids; for more, don't miss my colleague Lulu Garcia-Navarro's interview, on the "First Person" podcast, with Dr. Fatima Cody Stanford of Harvard on why she believes medication is an important new option for certain patients with obesity.

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