An AAP Guidelines Dialogue

Childhood Obesity News has been following reactions to the new American Academy of Pediatrics guidelines, which have been variously described as bold, aggressive, sweeping, revolutionary, fierce, outrageous, and even appalling. We have outlined various aspects of the recommendation themselves in several posts beginning on January 27 and up through yesterday.

Not long ago, Michael Barbaro of The New York Times conducted a conversation, now available in both podcast and transcript formats. The interviewee is Times medical reporter Gina Kolata, who first defines the parameters of the problem by stating that one in five American children, or over 14 million, are obese. The percentage value there is 20%, while back in the 1960s, that segment was only 5%. The introductory point she emphasizes is that these statistics ought to serve as a wake-up call, making it clear to America that obesity can no longer be ignored.

Try this

We tried to fix it with lower-calorie “diet” foods and drinks containing less sugar (or more artificial sweeteners, which turned out to become a whole separate issue). It was widely accepted that by adopting personal lifestyle choices to consume fewer calories and exercise more people could make obesity go away.

Then came the enormous studies carried out by the National Institutes of Health, which pointed to the possibility that it would not be so simple. Kolata says,

But the results were nothing like what the researchers were hoping for. After studying thousands of kids for years in this intervention, where they did everything that they thought was needed, there was no difference in the kids’ weights… There wasn’t an easy answer here.

Much to the dismay of many traditional thinkers, a great deal of evidence has pointed to genes. And even that concept is not straightforward. It now looks as if the blame might be assigned to many different combinations or clusters of genes — including genes that give people a tendency to engage in addictive behaviors. Interviewer Barbaro remarks,

It’s not that the environment doesn’t play a role, but it’s that genetics are an open door for the environment to walk into.

The thinking began to shift, and of course, new questions arose. Don’t people have pretty much the same genetic makeup as back in the 60s, when childhood obesity only clocked in at 5%? This is one of the matters in urgent need of resolution.

Other factors to weigh

The interviewer brought up another sore point around which much dissent has revolved: “Not everybody with obesity has health problems.” When obese individuals enjoy a high degree of health, shouldn’t we just leave them alone? Kolata replied that against people considered to be too big, there is widespread discrimination, most keenly felt by children and teens. It is often hard for them to form peer friendships, and they are likely to be bullied, even at home. Kolata says,

Teachers have lower expectations of them and give them lower grades. They often become anxious, depressed, socially isolated. It’s a big burden for a child. For many people with obesity, it is a really difficult life. You are judged, and everywhere you go, people assume it’s your fault. You’re out of control, and you’re not a virtuous person.

Your responses and feedback are welcome!

Source: “An Aggressive New Approach to Childhood Obesity,”, 01/26/23
Image by Kevin Simmons/CC BY 2.0

Leave a Reply

Your email address will not be published. Required fields are marked *

FAQs and Media Requests: Click here…

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:


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