Some Problem Areas

Author Aubrey Gordon is no fan of the recent American Academy of Pediatrics guidelines. Talking about interventions for a fat adult is fine, but the AAP seems to be recommending dietary intervention for kids as young as 2 years. On the other hand, some would question why the author has a problem with that, since it is the easiest kind of intervention to implement. At such a tender age, kids are not in a position to fight back against the healthful diet, or to travel to the store on their own, and they usually don’t have any money.

Dietary intervention with an infant is not a radical notion, but a combination of science and art which is generally deemed to be helpful. In addition, it has been well established that the sooner obesity is prevented, the less likely it is to take over a life.

Gordon is also against “weight loss drugs including injections as young as grade school and weight loss surgery and permanent body-altering and life-altering lifelong surgical procedure as young as 13…” No argument there!

Stigma rears its ugly head

Author Virginia Sole-Smith gives a capsule description of one way in which obese people are traumatized:

Providers spend less time with patients with high BMIs, and are sometimes even less willing to perform standard care, like pelvic exams at the gynecologist’s office. And in 2019, Nutter surveyed 400 Canadian doctors and found that 24% admitted they were uncomfortable having friends in larger bodies, and 18% felt disgusted when treating a patient with a high BMI.

On the other hand, one of this writer’s grievances is that according to the findings of a 2011 study, “medical students were more likely to blame people for conditions like respiratory distress if they were in a bigger body, and tended to prescribe weight-loss strategies, rather than symptom management.” However, it is objectively true that obesity can cause respiratory distress, and this is particularly hazardous when a very large patient is on the operating table. To keep that person supplied with air is an extra challenge.

The other objection is even more shaky. A very large number of complaints accuse the healthcare industry of the exact opposite — of resting content with treating symptoms (to the benefit of the pharmaceutical industry) rather than addressing the root causes of physical malfunction. This is particularly true when the patients are economically disadvantaged. Money can often buy a cure for a condition that the poor are expected to endure by taking over-the-counter pain meds.

The situation is capsulized by a quotation from the producers of a live call-in program:

Conscious and unconscious negative attitudes from health care professionals have impacted the treatment and care of people living with obesity. Patients have reported that physicians blame their weight first and treat their presenting symptoms second — if at all.

Your responses and feedback are welcome!

Source: “How Fatphobia Is Leading to Poor Care in the Pandemic,”, 01/10/21
Source: “Patients report that weight stigma has led to difficulties getting treatment, and avoidance of seeking future healthcare,”, 08/08/22
Image by John Benson/CC BY 2.0

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Profiles: Kids Struggling with Weight

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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.

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