AAP Guidelines and Backlash, Part 2

This post is continued from the previous one. American Academy of Pediatrics Guidelines co-author Dr. Sarah Hampl, a pediatrician and weight management specialist, said, “Our kids need the medical support, understanding and resources we can provide within a treatment plan that involves the whole family.”

And that in itself is a problem. In the area of behavior “modeling,” previously known as setting a good example, not much progress seems to have been made in the past decades. Even in families where a good example is set, a very harmful condition known as Oppositional Defiant Disorder tends to crop up. In other words, anything that parents demonstrate or suggest is impossibly lame, and not to be adopted under any circumstances, just because some kids enjoy saying “No” more than anything.

An article written by Dr. Nicole McLean says,

Overweight means having BMI 85% greater than others their age and gender, while obese children are at or above 95%. BMI is an imperfect tool…

By this logic, in theory, the criterion of normalcy can continue to spiral upward toward infinity. If a child weighs 300 pounds, that’s okay as long as 15% of the other children are even heavier. Aside from the obvious problems like not being able to find cool clothes or fit into a classroom desk, obese children are at higher risk for all kinds of physical and psychological ailments like sleep apnea, heart disease, type 2 diabetes, hypertension, high cholesterol, fatty liver disease, arthritis, depression, and social malfunction.

Meanwhile, the AAP casts a rosy, optimistic glow over its recommendations:

All services for children and teens should also be carried out in a way that is mindful of patients’ culture and language preference, the guidelines say. By working with families to identify personal beliefs, risk factors, and challenges, pediatricians can provide a personalized plan for treatment.

Dr. McLean also wrote,

The new AAP guidelines call on pediatricians and other health care providers to avoid stigmatizing language when discussing weight with patients. The organization is also calling for policy changes that could help reduce racial disparities in childhood obesity, including improving access to healthy foods and treatments for groups at greatest risk.

In the actual world, where parents face increasingly difficult challenges to just keep their children housed and fed, how often does this ideal service scenario line up with reality? Some doubters speak of the expense and scarce availability of the type and duration of treatment that is recommended.

Some say that even under the best circumstances, talk therapy, especially in a family setting, is not spectacularly successful. The next post will go into more detail about the specifics. And no matter what, young people are setting out on a rough road, in challenging relationships with bodies that experience the increasing risk of serious medical conditions with every day that passes.

(To be continued…)

Your responses and feedback are welcome!

Source: “Children with obesity should get proactive treatment,” 6abc.com, 01/10/23
Image by GollyGforce/CC BY 2.0

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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:


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.

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