New childhood obesity guidance raises worries for eating disorder experts

HOUSTON – According to the American Academy of Pediatrics 2023 publication on childhood obesity treatment, “there is compelling evidence that obesity increases the risk for comorbidities and that weight loss interventions can improve comorbidities.”

Those interventions are specifically mentioned as lifestyle changes, weight loss, mediation or bariatric surgery.

This is the opposite of previous recommendations on talking about childhood obesity.

The 2016 publication said sudden weight loss can harm growing bodies.

“Even in as little as 10% weight loss, we start to see in medical changes and malnutrition happening, and so, that can be low heart rate, low blood pressure, it can be electrolyte abnormalities,” said Eating Recovery Center Pediatrician Jennifer Moore, “They may delay puberty, which means they can have bone density loss from not developing appropriately.”

Pediatrician Maneesh Kumar said obesity is a crisis, especially in Houston. He says about a third of his appointments are spent addressing food and weight-related issues. He also said that as a last resort, he would recommend weight loss surgery for adolescents.

“When nothing else works and when the benefit of surgery outweighs the risk of surgery,” Dr. Kumar said. “I think behavioral changes and addressing underlying psychosocial reasons for excessive weight gain need to be addressed for effective obesity management.”

While Dr. Moore agrees eating disorders need to be addressed with a mental health professional, she said she can’t think of one instance where she would recommend surgery or diet pills.

“I can’t, in my own experience, see how that will be helpful long-term without having just more information about how this could really affect them,” she said.

Moore believes basing decisions about weight loss surgery and diet pills on BMI alone would harm adolescents, potentially setting them up for eating disorders and health complications as a result of those. She said if you can’t speak with a counselor, reach out to your pediatrician with concerns about weight. However, she believes those conversations are least harmful to your child if they’re not in the room when you have those conversations.

FIVE TIPS FOR PARENTS FROM THE EATING RECOVERY CENTER

  • Understand the BMI itself is not a reliable indicator of health, and the bodies come in all shapes and sizes.
  • Ask her pediatrician not to discuss your child’s weight and body shape in front of them.
  • Seek out healthcare providers who treat your child as a whole and don’t make assumptions or recommendations based only on BMI and weight.
  • Support a healthy relationship with food by having family meals and avoiding your own negative self-talk about your body and dieting.
  • Watch for changes in your child, such as constant comparison to others, frequent negative comments about their body, or avoiding activities that they used to love, and seek support if you’re seeing these changes.

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