AAP Guidelines — The Backlash Grows, Part 4

Last time, this page explored more deeply the concept of iatrogenesis as it relates to the newest American Academy of Pediatrics guidelines. Not surprisingly, in the realm of long-lasting trauma, there is more to say. A lot of it is said by a pediatrician and psychiatrist Dr. Danielle P. Burton, who is herself in recovery from an eating disorder:

Including weight loss pharmacology and bariatric surgery in the AAP obesity guidelines is premature, irresponsible, and dangerous. The dangers of these guidelines increasing suicidality and perpetuating eating disorders are much greater than the risks associated with being overweight or obese.

Dr. Burton is not happy with the AAP’s “sparse discussion of eating disorders” and goes on to say that among teens, suicide is one of the three leading causes of death, the others being accident and homicide. She wrote:

The potential of these guidelines to increase suicide risk is multifactorial. The first is a direct cause: One study, published in January of this year, found that bariatric surgery increases the risk of suicide, especially in the youngest patients.

The second cause is indirect. By promoting fatphobia, these guidelines are likely to increase the risk of adolescents developing eating disorders.

Jessica Mui reports that the organization Medical Students for Size Inclusivity has requested that the AAP rescind the guidelines and re-examine its premises. This grassroots advocacy group of medical students is also worried about potential harm because “children will learn that their bodies are a pathology rather than a variation on the normal spectrum of body shapes and sizes.” The concern here is that kids will regard normal weight gain as a personal failure, which may irrevocably harm their sense of self-worth.

And yet, it would be enormously better to concentrate on eating disorders and do everything possible to cure them early, than to decree, “This this person is obese, let’s bring out the pills or the scalpel.”

Would it not be more beneficial to get the person un-obese in some way that doesn’t pile on additional trauma? Wouldn’t it be preferable to help him or her to unlearn the false coping skills that created obesity in the first place? And incidentally, how can we find in this person’s experience a way to help little kids not ever have to go there?

Your responses and feedback are welcome!

Source: “The Hidden Danger in the AAP’s New Obesity Guidelines,” PsychologyToday.com, 03/04/23
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 Simone Lovati/CC BY-SA 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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