AAP Guidelines and Backlash, Part 8

The previous post discussed the major changes that are meant to be implemented in the treatment of childhood obesity, and which the American Academy of Pediatrics will encourage, going forward. Yet, there is more to the story, and an apparent enthusiasm in some quarters for further policy adjustments. Concerning the standard by which obesity is measured, the individual’s Body Mass Index, problems have been evident for quite some time.

Very close to the date when the AAP released its controversial new guidelines to prevent and cure childhood obesity, the Centers for Disease Control released updated growth charts. Reporting for media giant CNN, journalists Jamie Gumbrecht and Jacqueline Howard explained that those charts are…

[…] standardized tools used by health care providers to track growth from infancy through adolescence. But as obesity and severe obesity became more prevalent in the past 40 years… the charts hadn’t kept up. The newly extended percentiles incorporate more recent data and provide a way to monitor and visualize very high body mass index values.

Apparently, the extended growth charts will be used by providers who treat severely obese children, but meanwhile, the previous child and adolescent charts will not change. Has anyone interviewed a mathematician about whether the basic formulae are solid? As journalist Catherine Pearson has pointed out, reliance on the Body Mass Index standard is increasingly problematic as a measure of metabolic health, relying as it does on arbitrary number scores alone.

Not getting the message?

Are some healthcare providers misinterpreting the new guidelines, willfully or unwittingly? Are some members of the public spreading misleading or ignorant commentaries just to be contrary? Who knows? Users of social sites like Facebook and Twitter have noticed some of their fellow communicators complaining that the AAP guidance ignores the vast harm done by junk food. Another wrinkle that health professionals have noticed is the layperson’s tendency to blur the line between extra poundage and morbid obesity, which complicates the debate even more.

Time is not on our side

Regarding the previously endorsed “watchful waiting” philosophy, more and more experts point out that we do not have all the time in the world, because once obesity has taken hold of a person, the window for potential reversal is a narrow one. A typical warning comes from obesity specialist Matt Haemer of Children’s Hospital, Colorado. He mentions that despite good-faith efforts to make positive lifestyle changes, 80 to 90 percent of child obesity cases persist into adulthood.

(To be continued…)

Your responses and feedback are welcome!

Source: “Updated obesity treatment guidelines for children and teens include medications, surgery for some young people,” CNN.com, 01/11/23
Source: “New Guidelines Underscore How Complicated Childhood Obesity Is for Patients and Providers,” NYTimes.com, 01/20/23
Source: “Aggressive treatment guidelines for childhood obesity getting backlash,” WashingtonPost.com, 01/20/23
Image by Bilal Lashari/CC BY 2.0

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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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