AAP Guidelines — The Backlash Grows, Part 5
Yesterday we mentioned Dr. Danielle P. Burton, who has more to say about the recently revised guidelines of the American Academy of Pediatrics. The document grants only “sparse discussion” to eating disorders, and Dr. Burton continues:
[The guidelines] do not mention the medical complications of eating disorders, which are numerous and far exceed the medical complications of obesity… Eating disorders represent a lethality that far outweighs that of obesity, and at a much younger age.
Does this sound crazy? Perhaps, but she cites research showing that people with anorexia are 18 times more likely to die by suicide, and those with bulimia are seven times more likely to die by suicide than other individuals of the same age and gender.
And, she says, the guidelines “fail to mention that the risk factors for developing an eating disorder are closely related to those for developing obesity.” Which in both cases seems to advance the argument for doing something more than just treating the symptoms. Whether a patient is obese or has an eating disorder or both, it’s all part of the same problem that does not appear to be handled very effectively at present.
In the field of juvenile bariatric surgery, it seems that the potential for iatrogenic or healer-caused harm is very present. Online forums supply plenty of examples, and complete articles from experienced patients sometimes appear, like the eloquently titled “I Had Weight-Loss Surgery at 17, and It Worked — but It Didn’t Address My Real Problem,” published by Slate.com. Headlines are sometimes awkward, and it is likely that the young woman’s other problems were also real. What we seem to be talking about here are basic, first-cause situations.
The author’s story
Amy Scheiner was diagnosed as obese at age eight, and by 16 was pre-diabetic. At 17, she underwent bariatric laparoscopic banding, or lap-band surgery. It was not a magic bullet. She writes,
[B]y the time I was 23, I had begun having side effects from the surgery, such as frequent vomiting, heartburn, and inability to eat. After an upper endoscopy, I found out I had gastritis, esophagitis, and gastroesophageal reflux disease… It was then I realized that the surgery that was supposed to cure my obesity problem had done a poor job of addressing the underlying issue, which comprised a tangle of mental health and environmental challenges.
Amongst all the doctors and diet experts the author met with, none had ever asked “what was wrong in my family, in my mind, or in the culture… My weight was a symptom of the dysfunction around me.” Consequently, she started therapy, but then bounced from binge-eating disorder to hyper-vigilance, excessive exercising, extreme calorie restriction, and purging. This went on until she was dangerously dehydrated and vomiting blood, and still in semi-denial. “I knew I was sick, but at least I was thin.”
As an adult, Scheiner describes how her entire young life was defined by her physical size, leading to an unhealthy obsession with weight. Although the doctors promised her that having surgery at 17 would make her happier, it did not — but only left her with “more problems to untangle as an adult.” She goes on to say,
I worry for the children who will have permanent bariatric surgeries before they really understand their relationship with food, and self-worth.
Your responses and feedback are welcome!
Source: “The Hidden Danger in the AAP’s New Obesity Guidelines,” Psychology Today, 03/04/23
Source: “I Had Weight-Loss Surgery at 17, and It Worked—but It Didn’t Address My Real Problem,” Slate.com, 02/01/23
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