The New AAP Childhood Obesity Guidelines Are Setting Kids Up To Fail

Obesity now impacts a staggering 40%+ of Americans, including nearly 20% of our nation’s1 children and adolescents. We are obviously failing here—especially when it comes to our children. 

This Monday, the first guidance on childhood obesity in 15 years was released by the American Academy of Pediatrics2 (AAP), and it’s receiving a lot of attention. The academy is suggesting for the first time that medication can be offered to kids as young as 12, and that weight loss surgery can be offered to those as young as 13. This is a revision of the existing guidance to use a “watchful waiting" approach that delays more intensive treatment until children are older.

It's worth noting that these new recommendations on the treatment of childhood obesity were released before the academy's statement on obesity prevention, which is forthcoming. While we need to act urgently to treat the mounting childhood obesity epidemic in this country, I think the order of these two publications is telling. The medical system is taking drastic measures to "treat" the signs of an issue before fully considering its root cause.

This is nothing new. "As a physician, I was taught no nutrition and almost no lifestyle strategies to aid my patient care," integrative family physician Madiha Saeed, M.D. tells mindbodygreen in reaction to this news. "Putting more resources into weight management education, encouraging healthy behaviors, changing food policies, and providing healthier options in food deserts [is essential]. This latest recommendation is horrifying."

"There are many interventions that can be done before bariatric surgery in [the pediatric] population, including adhering to appropriate lifestyle changes from changing up diet, adding more exercise, supporting sleep and mental health," echoes board-certified family medicine physician Bindiya Gandhi, M.D.

Does all this sound like a radical change in our education system? Or is it more radical to go to medication and surgery? What do you think will cost more in the short term or long term? 

It doesn’t take a rocket scientist to determine that pharmaceuticals and surgeries will dwarf the costs of changing school curriculums to reflect our dire need to get our kids and our future generations thriving. Yes, I’m probably oversimplifying the complexity of what would be required for an overhaul of our education system, but it’s clear to me it needs one. 

This is also bigger than our education system, and goes back to what we as a nation place a financial value on. What if we subsidized vegetables, fruits, and nutrient-dense animal products, instead of just corn and soy?

It also extends to habits at home. Research shows that one's home environment embracing and implementing good nutrition5 is paramount.

"Obesity in children is not simply a child problem. It involves the entire family system, and therefore effective treatment requires a systems-level approach," Nicole Beurkens, Ph.D., C.N.S., a clinical psychologist, nutritionist, and special education teacher with almost 20 years of experience supporting children, young adults, and families, tells mindbodygreen.

"The solution to the problem is absolutely not to put a band-aid on obesity by giving a pill," says integrative pediatrician Joel "Gator" Warsh, MD. "It's to figure out why so many kids are obese and do something about it."

Childhood obesity is complex and multifactorial (genetics, lifestyle, school environment, food security, family dynamics, socioeconomics, psychological factors, and trauma all play a role) and there are no easy answers here.

But we must consider the potential ramifications of measures as drastic (and irreversible) as surgery. "While those interventions may provide benefit for some children, there are known physical and mental health risks involved with those approaches over both the short and long term of a child’s life," says Beurkens.