Among others heard from on the subject is bioethicist Arthur Caplan who has called obesity one of the biggest moral challenges that contemporary America is up against. He describes both medication and surgery as “Band-Aids” in the sense of being alleged answers that provide the illusion of doing something, but which really do not accomplish much, and in fact, may even worsen the underlying problem.
Brian Castrucci, who heads a nonprofit foundation, has publicly said that more progress needs to be made, instead, with “the policies and environments that can produce better health.” Another concerned professional interviewed by Christopher Curley is pediatric endocrinologist Dr. Sissi Emperatriz Cossio:
If [patients] do not have health insurance, the costs are too high, and if they do, a great deal of paperwork is required to get the procedures approved. As with many maladies that doctors treat, the insurance approval and payment hurdles are among the chief sources of disparity of care quality between wealthier and poorer communities.
As with most issues in the USA, race and ethnicity enter into the controversy. Curley also reported that studies show how obese minority children “vastly underutilize available treatments, from drugs to counseling to surgery, because of these financial and logistical barriers. He quoted the executive report that accompanied the new guidelines:
Targeted policies are needed to purposefully address the structural racism in our society that drives the alarming and persistent disparities in childhood obesity and obesity-related comorbidities.
The AAP guidelines document itself says,
Inequalities in poverty, unemployment, and homeownership attributable to structural racism have been linked to increased obesity rates. Racism experienced in everyday life has also been associated with increased obesity prevalence. Youth with overweight and obesity have been found to be at increased risk… In adults, studies have found positive associations between self-reported discrimination and waist circumference, visceral adiposity, and BMI in both non-Latino and Latino populations.
Fatima Cody Stanford told a journalist…
[…] studies show that Black girls and boys are less likely to get treatment, compared with children of other races, despite having higher rates of the disease. Even those covered by Medicaid are less likely to be treated. “We find biases in who gets referred. If you don’t get the diagnosis, you don’t get the treatment,” she said.
Your responses and feedback are welcome!
Source: “Aggressive treatment guidelines for childhood obesity getting backlash,” WashingtonPost.com, 01/20/23
Source: “Criticism Emerges Over New AAP Guidelines for Childhood Obesity,” Healthline.com, 01/20/23
Source: “Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity,” AAP.org, February 2023
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