Yes to Prevention, But Also Access to Care

In her opinion piece in El Paso Matters, Dr. Lourdes Asiain, a pediatrician with more than 20 years of experience, makes a case for insurance coverage for treatment of obesity. We’ve also emphasized multiple times the importance of access to the best tools possible, not just to treat already-existing obesity but also to prevent it.

Fat-shaming and creating stigma around childhood obesity helps no one, and is likely coming from misguided notions and ignorance. We don’t know that person’s struggle, or their family’s. It might be an unfortunate side effect of a medical condition, or a side effect of the medication a person is taking for that condition. It might be caused by the situation in the family, or at school, or anywhere.

For years, childhood obesity has often been viewed as a problem that can be solved simply by eating less and exercising more. However, pediatric obesity specialists say that understanding has changed dramatically. Today, obesity is recognized as a complex chronic disease influenced by genetics, biology, hormones, environmental factors, and lifestyle — not a lack of willpower.

Despite significant advances in treatment, many families still struggle to access effective medical care because insurance coverage remains limited. As a result, children who could benefit from evidence-based therapies are often left without the support they need until serious health complications develop.

Childhood obesity continues to affect millions of young people across the United States. In Texas alone (where the author of the opinion piece lives), approximately one in four children between the ages of 6 and 17 is living with obesity, placing the state among those with the highest childhood obesity rates in the country.

We might sound like a broken record, but it’s worth repeating. Obesity can have lifelong consequences, such as an increased risk of developing diabetes, high blood pressure, sleep apnea, and more.

The effects extend beyond physical health. Many children also experience bullying, social isolation, anxiety, depression, and lower self-esteem, which can affect academic performance and overall quality of life.

Medical organizations increasingly emphasize that obesity should be treated like other chronic diseases. Instead of assigning blame, physicians encourage families to understand the biological factors that contribute to weight gain.

Dr. Asiain writes:

We would never tell a child with asthma, diabetes or cancer to simply “try harder” to overcome their condition. Yet, children living with obesity routinely face blame, stigma and judgment rather than receiving medical care. This stigma is uniquely destructive for young people still developing their sense of identity, confidence and self-worth.

Recognizing obesity as a disease rather than a personal failure can be transformative for families. It shifts the conversation away from guilt and toward treatment, allowing children and parents to focus on managing a medical condition instead of carrying unnecessary shame.

Today’s approach to pediatric obesity, Dr. Asiain points out, is far more comprehensive than it was just a decade ago. She writes:

Fortunately, medical science has advanced. Comprehensive obesity care includes nutrition counseling, behavioral interventions, physical activity support, FDA-approved medications, and, when clinically appropriate, metabolic and bariatric surgery — supported by telehealth to reach our rural communities. These treatments are not shortcuts. They are evidence-based medical interventions for a serious, costly chronic disease.

When patients in my practice have coverage for modern obesity treatments, the results are remarkable. I see significant weight loss, normalized lipid profiles and reversal of prediabetes.

While effective treatments exist, affordability remains one of the biggest obstacles for many families. Critics argue that insurance policies often cover illnesses caused by obesity, such as diabetes or heart disease, while refusing to pay for treatments that could help prevent those conditions in the first place. This creates a frustrating situation where families may be forced to wait until a child’s health worsens before coverage becomes available.

According to Dr. Asiain:

As physicians, we should never have to tell a suffering family that an effective treatment exists but is denied to them by an insurance loophole.

Experts agree that prevention remains essential. Access to healthy foods, regular physical activity, safe neighborhoods, and nutrition education all play important roles in reducing childhood obesity rates. However, prevention alone cannot help children who are already living with obesity. Those children often require individualized medical care, just as they would for asthma, diabetes, or other chronic conditions.

In another opinion piece, Dr. Barry Ramo drives this point home (which is something we’ve been doing as well). Research shows that family-based weight management programs can improve children’s weight and body mass index (BMI). To support healthier lifestyles, the American Academy of Pediatrics recommends the “5-2-1-0” approach: eat at least five servings of fruits and vegetables daily, limit recreational screen time to two hours, get one hour of physical activity each day, and avoid sugary drinks. Together, these simple guidelines encourage better nutrition, more exercise, and healthier routines for the entire family.

Treating obesity early may reduce the risk of serious health complications later in life while helping children develop greater confidence, improved mental health, and a better overall quality of life.

Your responses and feedback are welcome!

Source: “Opinion: Children with obesity deserve access to treatment, not stigma,” El Paso Matters, 7/15/26
Source: “Family-focused plan offers simple steps to address childhood obesity,” KOAT.com, 7/15/26
Image by Yan Krukau/Pexels

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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:

Presentations

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