This is the Weight and Healthcare newsletter! If you like what you are reading, please consider subscribing and/or sharing! I think that one of the more dangerous and disingenuous parts of the new American Academy of Pediatrics guidelines is their claims about eating disorders. These are claims that I am hearing echoed in other spaces as well, so I wanted to write about them in depth. In terms of the guidelines themselves, I wrote a deep dive about their three main recommendations around “Intensive Health Behavior and Lifestyle Treatment (IHBLT), weight loss drugs, and weight loss surgeries
A hearty HELL YES to all of this. One of the biggest problems with the "ob*sity as a disease" rhetoric is the idea that having a body of a certain size is a disease in and of itself. Having a large body can be correlated with certain health conditions (often endocrine imbalances) so it would be prudent for healthcare professionals to be on the lookout for such conditions in larger patients as revealed by lab work. However, telling fat patients that losing weight will improve their health and decrease their risk of (laundry list of health problems generally associated with growing older, such as heart conditions, hypertension and risk of developing type 2 diabetes) is about as logical as telling a man with pattern baldness that getting hair plugs will decrease his risk of developing prostate cancer. While a large body type can indicate certain underlying health problems, it isn't a health problem in and of itself.
Of course larger people also have to deal with the erroneous assumptions that we are constantly stuffing ourselves with "bad" food. Us fatties would be thin tomorrow if we'd just eat a salad, dontcha know? ;-)
Joking aside, if a person does suffer from binge eating disorder, one would think they would respond better to compassionate treatment than to shaming. Just a thought. However, not all heavy people have binge eating disorder. I would say the majority of us big folk are well-versed in restrictive eating. If you're looking at a fat person, it's very likely you're looking at someone who has participated in dieting in an attempt to reduce their size, probably more than once.
Today I did something I have been meaning to do for weeks - look at what many so-called "ob*sity experts" have to say on their social media platforms/blogs/whatevers about this whole AAP mess.
Most of them say nothing. Even the ones that I used to respect until they started worshiping at the holy altar of WLS have nothing to say about it.
One I found was such condescending garbage. They spouted how WLS is safer than ever! There are new drugs that are safer than ever! (with no citations for either, and for the drugs, safer than what? The one drug that makes you poop yourself sick, or fen/phen which they pretty much knew was dangerous from the start, or the stuff they used 50 years ago - actual speed and/or thyroid hormones?) It then went on to complain in the most condescending language that the people who are against the AAP statement "don't understand the needs of these poor suffering children and their families." Like, [censored censored censored] with a [censored], you demeaning excuse for a human being.
The majority of people who are making noises about this are Registered Dietitians - most of whom are condemning it and ripping it to shreds - and fat activists. In the end it's you and others doing the work to reveal the truths who will be saving the world from this horrific crap which is the *actual* risk to the lives of children and teenagers.
(excluding as symptoms of EDs) "Severe dietary restriction, skipping of meals, prolonged periods of starvation, or the use of self-induced vomiting, diet pills, or laxatives”
Good news, everyone! The AAP cured eating disorders!
Seriously, would *anyone* qualify as having an ED without engaging in at least *one* of these behaviors?
And, if I may put on my troll hat for a moment and ask a reductive, bad-faith question, under what conditions is it acceptable to starve a child? Under what conditions is it acceptable to mutilate a child's body?
In my state, kids under 18 can't legally get a tattoo from a licensed tattoo artist, with or without parental consent. I'd argue WLS causes more lifelong consequences than a tattoo, and isn't reversible in the bargain. oh, and let's outlaw gender-confirmation surgery for trans kids while prescribing WLS for fat ones. Being fat is a disease while being trans is a delusion.
People died from taking Phen-fen, and it took three years for the FDA to decide death was worse than being fat and took it off the market.
I read these recommendations with horror. Every one would have been forced on me as a child. It makes me sick to know that kids today will be subjected to these "treatments" for the sin of existing in their bodies.
Thank you so much for writing about this important topic. As the parent of two children with eating disorders (one recovered, the other hopefully in recovery) I know firsthand how devastating interventions as recommended by the AAP (!!!) can be.
I've seen this stat used in ED educational materials: "A child is 242 times more likely to develop an eating disorder than Type 2 diabetes." It's powerful, but I can't find the original source. Just googling it I found it here: https://www.scarymommy.com/kids-200-times-more-likely-eating-disorder-diabetes but I'm not sure if you happen to know where it comes from.
From casual reading of accounts of eating disorders, it looked to me as though restricted eating (whether chosen or enforced) was a common part of the history. I wasn't expecting that whether a child (and it was frequently children, not teenagers) was forced or not didn't seem to matter. Also, it wasn't about poverty, I don't know where that might fit, it was about not eating food that would have been available to a thinner person.
A hearty HELL YES to all of this. One of the biggest problems with the "ob*sity as a disease" rhetoric is the idea that having a body of a certain size is a disease in and of itself. Having a large body can be correlated with certain health conditions (often endocrine imbalances) so it would be prudent for healthcare professionals to be on the lookout for such conditions in larger patients as revealed by lab work. However, telling fat patients that losing weight will improve their health and decrease their risk of (laundry list of health problems generally associated with growing older, such as heart conditions, hypertension and risk of developing type 2 diabetes) is about as logical as telling a man with pattern baldness that getting hair plugs will decrease his risk of developing prostate cancer. While a large body type can indicate certain underlying health problems, it isn't a health problem in and of itself.
Of course larger people also have to deal with the erroneous assumptions that we are constantly stuffing ourselves with "bad" food. Us fatties would be thin tomorrow if we'd just eat a salad, dontcha know? ;-)
Joking aside, if a person does suffer from binge eating disorder, one would think they would respond better to compassionate treatment than to shaming. Just a thought. However, not all heavy people have binge eating disorder. I would say the majority of us big folk are well-versed in restrictive eating. If you're looking at a fat person, it's very likely you're looking at someone who has participated in dieting in an attempt to reduce their size, probably more than once.
Today I did something I have been meaning to do for weeks - look at what many so-called "ob*sity experts" have to say on their social media platforms/blogs/whatevers about this whole AAP mess.
Most of them say nothing. Even the ones that I used to respect until they started worshiping at the holy altar of WLS have nothing to say about it.
One I found was such condescending garbage. They spouted how WLS is safer than ever! There are new drugs that are safer than ever! (with no citations for either, and for the drugs, safer than what? The one drug that makes you poop yourself sick, or fen/phen which they pretty much knew was dangerous from the start, or the stuff they used 50 years ago - actual speed and/or thyroid hormones?) It then went on to complain in the most condescending language that the people who are against the AAP statement "don't understand the needs of these poor suffering children and their families." Like, [censored censored censored] with a [censored], you demeaning excuse for a human being.
The majority of people who are making noises about this are Registered Dietitians - most of whom are condemning it and ripping it to shreds - and fat activists. In the end it's you and others doing the work to reveal the truths who will be saving the world from this horrific crap which is the *actual* risk to the lives of children and teenagers.
(excluding as symptoms of EDs) "Severe dietary restriction, skipping of meals, prolonged periods of starvation, or the use of self-induced vomiting, diet pills, or laxatives”
Good news, everyone! The AAP cured eating disorders!
Seriously, would *anyone* qualify as having an ED without engaging in at least *one* of these behaviors?
And, if I may put on my troll hat for a moment and ask a reductive, bad-faith question, under what conditions is it acceptable to starve a child? Under what conditions is it acceptable to mutilate a child's body?
In my state, kids under 18 can't legally get a tattoo from a licensed tattoo artist, with or without parental consent. I'd argue WLS causes more lifelong consequences than a tattoo, and isn't reversible in the bargain. oh, and let's outlaw gender-confirmation surgery for trans kids while prescribing WLS for fat ones. Being fat is a disease while being trans is a delusion.
People died from taking Phen-fen, and it took three years for the FDA to decide death was worse than being fat and took it off the market.
I read these recommendations with horror. Every one would have been forced on me as a child. It makes me sick to know that kids today will be subjected to these "treatments" for the sin of existing in their bodies.
Thank you so much for writing about this important topic. As the parent of two children with eating disorders (one recovered, the other hopefully in recovery) I know firsthand how devastating interventions as recommended by the AAP (!!!) can be.
I've seen this stat used in ED educational materials: "A child is 242 times more likely to develop an eating disorder than Type 2 diabetes." It's powerful, but I can't find the original source. Just googling it I found it here: https://www.scarymommy.com/kids-200-times-more-likely-eating-disorder-diabetes but I'm not sure if you happen to know where it comes from.
From casual reading of accounts of eating disorders, it looked to me as though restricted eating (whether chosen or enforced) was a common part of the history. I wasn't expecting that whether a child (and it was frequently children, not teenagers) was forced or not didn't seem to matter. Also, it wasn't about poverty, I don't know where that might fit, it was about not eating food that would have been available to a thinner person.
Do you know of any research on this?