AAP Guidelines — The Backlash Grows, Part 10

The childhood obesity world is still feeling the repercussions of how the American Academy of Pediatrics greeted the new year by releasing new guidelines that inspired reactions like this one from Dr. Catherine Devlin:

I am horrified, alarmed and concerned… First of all, I think that these guidelines need to just be completely thrown out.

The founder of Birch Tree Psychotherapy is not the only expert whose feeling could be described as outrage. Among other specifics, Dr. Devlin points out that the regimen demanded after bariatric surgery (and for the remainder of life) is very difficult for adults, and for children and teens, strict adherence must be closer to “a nightmare.”

Journalist Meg Hilling also consulted eating disorder specialist Nooshin Kiankhooy, whom we have previously quoted on the matter of inadequate evaluations before recommending surgery. This is not the only potential damage, says the founder of Empowering You. Kiankhooy told the reporter,

I have had some clients that have been put on diets at very, very young ages. Then they come to my office 10, 15 years later because they are put on weight loss at the age of 12, or they went to some clinic at a local hospital where they were told that carbs were bad.

Some authorities are even rehashing earlier controversies, like when the American Medical Association, a decade ago, recognized obesity as a disease, or further back when the National Institutes of Health said, “Obesity is a complex multifactorial chronic disease.”

There are reasons, like eligibility for insurance coverage, why this is good. But on the other hand, points out Dr. Kim Davis, some kids are being made to feel as if they themselves are a disease, and this is massively counterproductive.

In an interview with Pharmacy Times, Sheldon Litwin, M.D., pointed out, as so many have, that there is not much data on the use of weight-loss drugs on children and adolescents, since “we’ve only been using them really for 5 to 10 years, and the high potency ones probably about 5 years or so.” On the other hand, incretin mimetic drugs appear to be safe because they are analogs of naturally occurring hormones.

“It’s not really something exogenous, it’s just giving you a pharmacologic type of effect as opposed to a physiologic dose.” On the third hand, the same could be said of cannabinoids, which are naturally produced by the human brain, and yet many people are serving time in penal institutions for using plant-derived versions of them.

Your responses and feedback are welcome!

Source: “Eating disorder specialists ‘horrified’ by child obesity guidelines,” ScrippsNews.com, 03/07/23
Source: “Regarding Obesity as a Disease: Evolving Policies and Their Implications,” NIH.gov, 09/01/17
Source: “Expert: Risks, Benefits Must be Considered When Using Potent Anti-Obesity Drugs in Youth,” PharmacyTimes.com, 03/10/23

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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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