Where Serenity Is Found

Is there a basic drive for serenity? There must be, because so many people look for it in drugs, including food, which if not technically a drug, sure knows how to act like one. Fortunately, serenity can be found in a lot of other places.

Several theoreticians in the behavioral field have compiled lists of basic drives, some of which could easily be interpreted as identical to a drive for serenity. If there are only three drives, one of them is for achievement, and what is achievement really, but the serenity that comes from knowing that one has done one’s best, and succeeded?

What is serenity but the absence of stress? Serenity is the opposite of stress, which is the feeling that people who overdrink, overdrug, overeat, or do anything else past the threshold of addiction, are trying to escape. If there are only four basic drives — fight, flight, feeding, and sex — the satisfaction of any one of them brings the peace of mind that comes from knowing that the enemy has been routed or defeated; the enemy has been escaped from; the stomach has been fed; the body has been satisfied. Serenity all the way around.

This blog has devoted so much attention to the efforts and successes of Reeling in Serenity because it is an excellent example of the efficacy of displacement activity. When a person has been brought low by addiction, in many cases displacement is about finding a thing to occupy the person’s mind, energies, time, and spirit in more healthful and satisfactory ways.

Fly fishing is a particular example, and the people who are into it testify that it matches up with recovery in a number of ways. (The magic here is that in other recovering addicts’ stories, something else, like music, cooking, engine repair, or a newly discovered devotion to family, can step in to satisfy whatever drive the drug was erroneously taken to serve.

How exactly does this help?

As it turns out, fly fishing is therapeutic in multiple ways that a recovering addict can benefit from. For instance, 12-step programs all say “Take it one day at a time.” That is all well and good, but what, exactly, is a person supposed to do on those days — other than abstain from their substance of choice?

For a fly fisher, there is plenty to do. Teach the newbies how to cast a line or tie flies or pick out the most useful clothing and gear. Work with an organization to keep the water clean. Help to bring in donations so free lessons and group retreats can continue to be offered. In their special field of interest, a person with a passion can change a sizable chunk of the world.

One anonymous woman in recovery wrote that because fly fishing required mental focus, it became a healthy escape. Rather than worry about things she could not control, she worked on developing fishing strategies, and realized how compatible that was with her 12-step program.

Various members of Reeling in Serenity and similar organizations testify to the peace of feeling like a part of nature, of feeling grounded. They speak of healing, community, the breaking of isolation barriers, escape from the mundane routine, safety, a reset of mind and soul, a recharging of energy, and a new sense of perspective.

They speak of better sleep, decreased anxiety, and improved physical well-being; of connection, and building other people up instead of tearing them down; of feeling the river wash away, bit by bit, the residual shame and guilt left over from their times of active addiction. According to the people who know, it works equally well for the newly sober and for those who have been on the path for many years.

Your responses and feedback are welcome!

Image by Roxnstix/CC BY-ND 2.0

The Profound Healing of Serenity

Here is a brief and partial explanation of why fly fishing helps people get better:

When we are close to moving water it creates an abundance of negative ions that we can absorb into our systems by proximity. These natural stimulating environments automatically up your serotonin levels, you absorb more oxygen into the blood and our bodies can better filter toxins.

In a previous post, we learned the story of Reeling in Serenity founder Becca Sue Klein, and now let’s go a little further back to when she was Becca K. Powell, writing for DunMagazine.com. Spending time with moving water had already earned her “a reprieve from the hustle and bustle of a hectic city life and the strength to get through two cancer diagnoses.”

In that era of life, she was serving as a senior staff member for the nonprofit Chattahoochee Riverkeeper, learning the truth of the slogan #WaterIsLife, and also working with the global organization called Waterkeeper Alliance, and fly fishing. Learning this new skill was empowering and served as “free therapy,” and she wrote:

Wading out into the water with my fly rod in hand has shown me strength, peace, freedom, a way to give back, and a beautiful new family.

A related memoir

Moshe Kasher shares a truth about his youthful Comedy Store performances. Upset by bombing onstage, he would spend his half-hour trip home texting one girl after another, trying for a late date. As the veteran of several teenage rehab stints, Kasher understood that he was acting out the emotional state called “Somebody please fix me — get me out of this…” If he was almost home and nobody had answered yet, he would stop and buy a fancy doughnut. And there it is, displacement. You can’t have one thing, so you settle for another.

Nobody starts out wanting to be a junkie. Addiction is a condition that someone settles for when they don’t have what they really want. The concept of displacement can work either way; it can also be a power for good. A person can find something else in life that is better than addiction, and repurpose their drive to experience one kind of pleasure into a drive to experience another kind of pleasure.

Poetic justice

This is what makes the Reeling in Serenity experience so cherished by the participants. They are people who found something better than whatever they used to be hooked on. Anglers, more often than not, are just in it for sport, not to feed themselves, so they catch and release. They unhook the fish and let it go, similar to how their Higher Power unhooks them and frees them from addiction.

Your responses and feedback are welcome!

Source: “How Water’s Negative Ions Increase Your Positive Vibes,” TherapyHealthStudio.com, 02/25/19
Source: “One Life One River,” DunMagazine.com 07/20/18
Source: “Moshe Kasher — Episode 938,” GregFitzsimmons.com, 01/04/22
Image by Korda Team/CC BY 2.0

More About Reeling in Serenity

Why are the premises of and the results obtained by Reeling in Serenity so phenomenal? As we have seen, the organization’s mission is to support individuals who are in recovery from addiction, through the peace, healing, and community that are to be found through fly fishing in the rivers of the nation and the world. Yesterday we went over the backstory of Founder and Executive Director Becca Sue Klein. Let’s hear from some of the others responsible for this wonderful nonprofit group.

Board member Jason Causey, who has accumulated more than 10 years of sobriety, says,

When you’re out there in nature listening to the water run by and someone is teaching you how to cast a fly line and you hook that first fish, I mean there’s just nothing like it. You’ve forgotten about every bad thing that has happened to you that day or that week.

Program Director Jennifer Gilbert detailed for the group’s website how, when she entered rehab in 2017, fly fishing helped her connect to her higher power. It is her hope that every newcomer in recovery will find the same peace and joy. Outreach Director Sylvia Huron also asserts that recovery and fly fishing go hand in hand. She says she has learned that the dedication required to become a better angler and the commitment needed for leaving addiction behind are mutually intertwined, as are the support and companionship found in the group.

Communications Director Georgia Skuza confides that “the addiction gene runs deep in my family” and affirms that fly fishing has been a vital part of her life and her healing journey. William Henry, Education Program Coordinator, describes how important it is to be actively engaged with nature and writes,

That connection, that mindful presence has been essential to maintaining my sobriety since 2007. It drives me to be grateful and take care of myself, and the environment. Volunteering for Reeling in Serenity allows me to combine all my passions and give back to my sober community, without whom I would not have the life I do today.

Social Media Advisor Erik Clymore had spent his first five recovery years “bouncing around from hobby to hobby trying to find my passion in life” until he discovered fly fishing, after which “everything clicked and I dove straight in.” Since then, recovery and angling have been his dual passions. He says, “Both recovery and fly fishing provide me with a loving community, appreciation for the little things, and a profound sense of purpose.”

Marketing and PR Advisor Kim Ranalla was already into the angling lifestyle because multiple serious injuries had led her to river fishing as a way of healing. She had, coincidentally, also been affected by the ravages of addiction in loved ones, and found that Reeling in Serenity provided “a pathway for me to process my own complicated grief by helping others along their healing journey.” As a volunteer, she wrote,

The organization is significant to me after losing loved ones in my life to addiction. Addiction has touched the lives of nearly everyone, in one way or another, making it a cause that I want to be behind.

Not impressed with what the market offered, she started a thriving business called Miss Mayfly, which produces a line of fishing gear products for women of all shapes and sizes. She says,

Fly fishing is an ideal conduit for physical, mental and spiritual healing. It requires a focus that helps distract from physical pain and emotional stressors, helping us to experience a deeper level of peace and calmness.

Your responses and feedback are welcome!

Source: “How fly fishing in PA will help people recovering from substance abuse,” GoErie.com, 02/07/23
Source: “Meet Our Team,” ReelingInSerenity.org, undated
Source: “Women Who Make a Difference,” MissMayfly.com, 09/08/22
Image by US Embassy London/CC BY-ND 2.0

Reeling in Serenity

The previous post, about Reeling in Recovery, was the prologue to the recent and exciting occasion (March 13) of the nonprofit group’s name change to Reeling in Serenity. The press release issued on that date affirmed the basic tenets of the 501c3 organization:

Reeling in Serenity celebrates life free from drug and alcohol addiction by embracing nature and the spiritual connection that fly fishing has brought so many. We do this through free fly fishing retreats that are open to those who have chosen to live their personal truth — a life without alcohol and drugs. We also serve as a safe space and resource for the sober fly angler who is doing the work one day at a time.

The group can be found on Facebook and of course, has its own website, where various other declarations, affirmations, and mission statements can be found. Healing comes from spending time among healthy people, and some are guided to Reeling in Serenity by their recovery mentor or sponsor.

New members do not need any previous experience with fly fishing. The whole point is to tune in to something new that can displace the unsatisfactory result the person had received from their addiction. Even more, rewards can be reaped by volunteering their services to the organization in some capacity.

But let’s get down to cases, beginning with that of Founder and Executive Director Becca Sue Klein, for whom committing to recovery and the discovery of fishing were almost simultaneous life events. In 2019, she wrote under the pseudonym of “A Greatfull Recovering Alcoholic” about coming to the realization that fishing was the best therapy she could have wished for:

In recovery, we learn that our physical health — in addition to emotional sobriety, a spiritual connection, and good mental health — is so important to our program. And all are connected. They are like the four corners of a chair. If we lose sight of one of these elements, we topple over.

As the AA program puts it, Klein was sick and tired of being sick and tired, and desperately wanted change, but knew she could not do it on her own. Rather than someone who only wanted to stay up all night partying, she became the person who went to bed early to get up and go fishing. She recommends to others a short film called “One Cast at a Time.”

A couple of years later, Klein told journalist Kim Ranella,

Fly fishing soon replaced my daily whiskey and wine consumption. It was a reprieve from the stresses of my day-to-day life, and showed me the importance of slowing down. When I’m fly fishing, I’m not thinking about my lists of things to do, money or family struggles, or my stage IV breast cancer diagnosis. When I’m standing in a stream I’m able to live in the moment… [S]omething I could never do in my days of active addiction.

Klein had been participating in environmental work since 2007 and later connected with Casting for Recovery, a group that “brought women managing a breast cancer diagnosis out for fly fishing retreats.” Her concerns also encompassed the importance of leading women and girls to a consciousness of the importance of conservation efforts that would preserve America’s waterways for both fish and humans. This led to the founding of Reeling in Recovery in 2022.

(To be continued…)

Source: “Reeling,” DunMagazine.com, 12/05/19
Source: “Women Who Make a Difference,” MissMayfly.com, 09/08/22
Image by Intermountain Forest Service/Public Domain

Reeling in Recovery

Reeling in Recovery is a new national non-profit organization based in Georgia that helps recovering substance abusers by teaching them, at specially organized retreats, how to fish. In some cases, the participants not only add a fascinating new dimension to their own lives but take it a big important step further by joining up as volunteers. When that happens, they pass along the benefit by teaching others to fish by spreading the word, and by helping to gather the donations that keep the program going.

The non-profit has its own website, along with a presence on Facebook, Instagram, and other social media. This is about a particular kind of fishing, fly angling, the kind where a person puts on waterproof gear and stands around in a river. But there is a lot more to it! On the practical side, several skills are involved — preparing the gear, knowing how to put on the waders and boots, how to handle the rod and reel, and how to cast. Participants do not need previous experience and can proceed at their own pace. (Also recommended are the elementary online courses offered by the group United Women on the Fly.)

Georgia Skuza, Reeling in Recovery’s communications director, told a journalist,

Those in recovery talk about needing a routine, and in fly fishing there is a routine… You put your rod together, you put your reel on, you get dressed, you have your months in which it’s really good to fish and that routine and that consistency helps a lot of people stay grounded. When you’re on the water, everything else just melts away.

The program (which apparently is also known as Reeling in Serenity) works by helping former drug and alcohol abusers to maintain their sobriety, something that such individuals do not always find easy. It is a way to supplement their membership in the 12-step programs they have committed to. Former substance abusers need to associate with others on the path, but not just by sitting around in rooms sharing the stories of their previous and ongoing experiences.

Reeling in Recovery adds to that relationship with fellow addicts another whole dimension. It also benefits community members who are moved to help fellow humans struggle with addiction — often because they have lost family members and friends to the disease.

How does it work?

The nonprofit organization was founded by avid anglers, some in active recovery from alcohol or drug abuse. It holds free retreats for the participants, though they do have to pay their own way to the locations. A retreat class is limited to 10 participants and journalist Brian Whipkey explains,

[T]he participants will see fly-tying demonstrations, casting demonstrations, apparel instructions and a presentation from a nature-informed therapist who will combine recovery, nature and fly fishing and of course, go fishing… The organization attempts to supply anglers with gear or they can bring their own.

Since time immemorial, rivers have helped us humans feel our deep connection with nature. There are rivers in practically every part of the world, and corporate greed has not managed to ruin all of them quite yet. Just about any interaction with a river can be healthful, productive, engaging, and fun, a natural high whose therapeutic value is to provide an escape from everyday cares without drugs or alcohol. Tomorrow’s post will go into more detail about this!

Your responses and feedback are welcome!

Source: “How fly fishing in PA will help people recovering from substance abuse,” GoErie.com, 02/07/23
Image by Mobilus In Mobili/CC BY-SA 2.0

Guidelines, Quibbles and Quirks — Part 7

This continues the discussion of the thorny question of consent, where surgery is concerned. The American Academy of Pediatrics describes its goal as caring for the “whole child.”

On the surface, how could fault be found in that ambition? But many citizens see it as a ploy to make public schools into brainwashing centers, whose goal is “to make government-run schools, not the family or the home, the central tenet of a child’s life.” (For this discussion, let’s leave aside the incorrect use of the word “tenet,” which is a principle or a belief. A school is neither of those things, but an institution.)

Apparently, massive numbers of Americans see public schools as mind control tools, whose purpose is to sneakily convert their children into socialists or collectivists. Others suspect that the medical establishment (as supported by the schools) is being run by pharmacological interests and surgery clinics for the financial benefit of stockholders in those industries.

There are many other objections to the system of public schools. One bunch of critics says:

Two aspects of the “whole child” agenda go together. The first is the push to rely on medical intervention over lifestyle changes and counseling. The second is the willingness to take decision-making power from parents and give it to unelected, unaccountable administrators.

AAP’s report on child obesity focuses on medical interventions and school-based care. Moreover, they are careful to mention the supportive, not primary, role of parents.

When it comes to effective “whole-child” healthcare, the parents are relegated to fourth place.

In any case, and regardless of where the suspicion originates, unease over the consent factor provides a very strong argument for treating the underlying cause of a child’s problem, rather than attempting to merely eliminate the symptoms. Because mistakes can be made, and serious consequences can occur regardless of the technical legality of whatever consent has been obtained.

Dr. Danielle P. Burton wrote,

Can a thirteen-year-old truly consent to the lifelong undernourishment caused by such a radical procedure? Can they consent to the increased risk of suicide? While it is great to minimize the risk of potential future disease, it cannot be at the cost of premature death. A key factor in helping our children grow into healthy adults is making sure they live long enough to become one.

Your responses and feedback are welcome!

Source: “Forget Parents, Here’s What This “Whole Child” Ideology Really Promotes,” Heritage.org, 03/13/23
Source: “The Hidden Danger in the AAP’s New Obesity Guidelines,” PsychologyToday.com, 03/04/23
Image by Caitlin Childs/CC BY-SA 2.0

Guidelines, Quibbles and Quirks — Part 6

In the debates over the January news from the American Academy of Pediatrics, some serious points of contention exist. It is not enough that certain physical benchmarks be checked off the list to make major surgery permissible. Certain other factors need to be in place also, like the patient’s fully informed consent.

As things stand, a child who is bleeding out or drowning may be saved by anyone who is prepared to do it — even if neither parent is on the scene to sign a consent form. And certainly, the imperiled child is not offered a document and a pen. Water aspiration and rapid exsanguination are examples of life-threatening situations, where the response must be swift and decisive, so legal niceties can be put aside.

How is this different?

The argument is made that morbid obesity is also a life-threatening condition, only on a longer timescale. But does that make it acceptable for adults, even parents or legal guardians, to step in and authorize the almost-total removal of an irreplaceable major organ?

If a child is born with an orofacial cleft, parental permission is enough to proceed with reconstruction, and no one has a problem with that. Irreversible surgery on a minor child happens every day in the case of routine neonatal circumcision, for which there is much less justification than for what used to be called a harelip. However, surgery without the patient’s fully informed consent does raise some ethical questions.

Currently, law enforcement officers may capture and confine a person who intends and prepares to take their own life. Some individuals fear a nightmare scenario where the authorities could just take anyone into custody and remove most of their stomach for that person’s own good. Even among advocates of bariatric surgery for the young, many of those who theoretically approve would like to see more forethought exercised on a case-by-case basis.

How far is too far?

We mentioned Medical Students for Size Inclusivity, whose spokesperson Jessica Mui also wrote of the absurdity of expecting adolescents to “risk their lives and well-being in an attempt to make their bodies smaller”:

Weight loss surgeries take healthy, functioning organs and put them into a permanent disease state by reducing digestive hormone production, absorption of nutrients, and result in frequent complications. If we recommend these life-altering surgeries that come with a constellation of health risks for vulnerable youth as young as 13, we as medical providers are acting in direct opposition to our duty to “do no harm.”

(To be continued…)

Your responses and feedback are welcome!

Source: “Size-inclusive medicine: a response to AAP’s guidelines for the treatment of children and adolescents with obesity,” KevinMD.com, 03/01/23
Image by Photo by Jason Rosewell on Unsplash

Guidelines, Quibbles and Quirks — Part 5

Some things never change. There is very little likelihood that the United States will ever adopt the metric system for general use. Blue jeans will always be in style. And probably, the Body Mass Index will continue to be how the establishment decides whether or not a human is fat.

The BMI standard has always been controversial. Dr. Danielle P. Burton recently called it an antiquated system and explained,

BMI was never intended to be used as a measurement for health, and our current growth charts are based on data from the 1960s through the early 1990s. Are these outdated measurements truly the best measure of health?

A widely-held position is that obesity should not be determined by a lone data point, but by an array of them. Most things in life are on a spectrum, and ideal body weight is no exception. Gyms are full of living proof there is no exact cutoff point between fitness and the shame of being unacceptably big. A desperate need is felt for the culture to at least admit the possibility that size diversity and health could co-exist. When surgery is recommended, especially for kids, there is a hunger for evaluations that include the patient’s mental health status.

Stirring the pot

Meanwhile, policies uttered by the American Academy of Pediatrics at the beginning of this year focused intense attention on BMI once again. One expert who reacted is Dr. Kim Dennis, co-founder and medical officer at SunCloud Health, who says,

I think we do more harm than good when we […] say, ‘Based on the fact that your BMI is, you know, 28 or 30, you have a disease. By pushing people to get into this normal weight range, we’re only causing eating disorder behaviors.

It is no wonder that the recent news has been met with questions, concern, and outrage from practitioners and parents alike. Childhood Obesity News explored the concept of iatrogenesis. Many critics have mentioned ways in which the ideas could be dangerous for kids:

[T]he AAP released guidelines that recommend actions that are known top risk factors for eating disorders with almost no reference to how discussing weight and BMI can increase eating disorder risk. It is not helpful to reduce the number of children with obesity if they are driven toward the top risk factors for the second most deadly mental health illness.

Speaking on behalf of the grassroots advocacy organization Medical Students for Size Inclusivity, Jessica Mui noted that by focusing on the “flawed tool” of BMI, the AAP guidelines “are based on science that grossly misrepresents the complex relationship between weight and health.” To insist that weight loss is the chief measure of health is to “further stigmatize the bodies of children whose environments are likely already rampant with weight bias.” Mui adds,

The evidence remains elusive as to whether increased BMI alone is causative of increased morbidity and mortality. This outdated tool does not consider genetic, ethnic, and epigenetic variation or significant factors like poverty, racism, trauma, environment, chronic stress, and weight stigma, all of which negatively affect health outcomes in and of themselves.

When surgery is considered, a high BMI is what is known in logic as a necessary condition, but not a sufficient condition. In other words, a big number signifies that a person is obese enough to be medically qualified for bariatric surgery, but that alone is not enough. In making the recommendation, weight is just one factor, and needs to be regarded in the context of total health.

Your responses and feedback are welcome!

Source: “The Hidden Danger in the AAP’s New Obesity Guidelines,” PsychologyToday.com, 03/04/23
Source: “Eating disorder specialists ‘horrified’ by child obesity guidelines,” ScrippsNews.com, 03/07/23
Source: “The AAP’s new childhood obesity guidelines are dangerous. Here’s what to do,” Inergency.com, 03/01/23
Source: “Size-inclusive medicine: a response to AAP’s guidelines for the treatment of children and adolescents with obesity,” KevinMD.com, 03/01/23
Image by Ambuj Saxena/CC BY 2.0

AAP Guidelines — The Backlash Grows, Part 10

The childhood obesity world is still feeling the repercussions of how the American Academy of Pediatrics greeted the new year by releasing new guidelines that inspired reactions like this one from Dr. Catherine Devlin:

I am horrified, alarmed and concerned… First of all, I think that these guidelines need to just be completely thrown out.

The founder of Birch Tree Psychotherapy is not the only expert whose feeling could be described as outrage. Among other specifics, Dr. Devlin points out that the regimen demanded after bariatric surgery (and for the remainder of life) is very difficult for adults, and for children and teens, strict adherence must be closer to “a nightmare.”

Journalist Meg Hilling also consulted eating disorder specialist Nooshin Kiankhooy, whom we have previously quoted on the matter of inadequate evaluations before recommending surgery. This is not the only potential damage, says the founder of Empowering You. Kiankhooy told the reporter,

I have had some clients that have been put on diets at very, very young ages. Then they come to my office 10, 15 years later because they are put on weight loss at the age of 12, or they went to some clinic at a local hospital where they were told that carbs were bad.

Some authorities are even rehashing earlier controversies, like when the American Medical Association, a decade ago, recognized obesity as a disease, or further back when the National Institutes of Health said, “Obesity is a complex multifactorial chronic disease.”

There are reasons, like eligibility for insurance coverage, why this is good. But on the other hand, points out Dr. Kim Davis, some kids are being made to feel as if they themselves are a disease, and this is massively counterproductive.

In an interview with Pharmacy Times, Sheldon Litwin, M.D., pointed out, as so many have, that there is not much data on the use of weight-loss drugs on children and adolescents, since “we’ve only been using them really for 5 to 10 years, and the high potency ones probably about 5 years or so.” On the other hand, incretin mimetic drugs appear to be safe because they are analogs of naturally occurring hormones.

“It’s not really something exogenous, it’s just giving you a pharmacologic type of effect as opposed to a physiologic dose.” On the third hand, the same could be said of cannabinoids, which are naturally produced by the human brain, and yet many people are serving time in penal institutions for using plant-derived versions of them.

Your responses and feedback are welcome!

Source: “Eating disorder specialists ‘horrified’ by child obesity guidelines,” ScrippsNews.com, 03/07/23
Source: “Regarding Obesity as a Disease: Evolving Policies and Their Implications,” NIH.gov, 09/01/17
Source: “Expert: Risks, Benefits Must be Considered When Using Potent Anti-Obesity Drugs in Youth,” PharmacyTimes.com, 03/10/23

AAP Guidelines — The Backlash Grows, Part 9

We left off by talking about Body Mass Index and the significance thereof. In 1972, BMI had been deemed the best measurement method. In 1985, the U.S. National Institutes of Health concurred, and in 1997 the World Health Organization did too. What could be wrong with any of that? Well, apparently, BMI measurement does not distinguish between fat and muscle, which are, after all, two very different substances. Also,

BMI can also underestimate the threat for people who are “skinny fat,” as some doctors call those who tend to be fit, but have big bellies. Studies show that this belly fat can be more dangerous for health than any other kind.

The BMI measurements used for children are weighted for age, but when boys go through puberty, they add muscle at a rapid rate; girls add fat. BMI tends to miss these nuances.

And this is no small matter: More accurate methods are too costly for general use.

Jessica Mui reports that the grassroots advocacy organization Medical Students for Size Inclusivity believed that…

The AAP guidelines intensify the focus on BMI and weight loss as measures of overall health and further stigmatize the bodies of children whose environments are likely already rampant with weight bias. As a result of these guidelines, children will learn that their bodies are a pathology… The new AAP guidelines are based on science that grossly misrepresents the complex relationship between weight and health.

Mui pointed out that dieting and a poor self-image are known risk factors in the eating disorder realm, and labeled BMI measurement a “flawed tool.” Not only that, but nobody was absolutely positive that BMI alone causes greater morbidity and mortality. Furthermore,

This outdated tool does not consider genetic, ethnic, and epigenetic variation or significant factors like poverty, racism, trauma, environment, chronic stress, and weight stigma, all of which negatively affect health outcomes in and of themselves.

When surgery is considered, a high BMI is what is known in logic as a necessary condition, but not a sufficient condition. In other words, a big number signifies that a person is obese enough to be medically qualified for bariatric surgery, but that alone is not enough. This year, the recently issued guidelines were met with questions, concern, and outrage by practitioners and parents alike. We have spoken here of iatrogenesis, and this article brings up two reasons why the guidelines are dangerous for children:

The AAP released guidelines that recommend actions that are known top risk factors for eating disorders with almost no reference to how discussing weight and BMI can increase eating disorder risk. It is not helpful to reduce the number of children with obesity if they are driven toward the top risk factors for the second most deadly mental health illness.

Another source confirmed that BMI was never intended to be used as a measurement for health. Weight can be a helpful data point, but it needs to be evaluated in the context of overall health.

Your responses and feedback are welcome!

Source: “Size-inclusive medicine: a response to AAP’s guidelines for the treatment of children and adolescents with obesity,” KevinMD.com, 03/01/23
Source: “The AAP’s new childhood obesity guidelines are dangerous. Here’s what to do,” Inergency.com, 03/01/23
Source: “The Hidden Danger in the AAP’s New Obesity Guidelines,” PsychologyToday.com, 03/04/23
Image by A Quiverful of Fotos/CC BY 2.0

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Profiles: Kids Struggling with Weight

Profiles: Kids Struggling with Obesity top bottom

The Book

OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources