Fighting fatphobia in healthcare (Part 2): IAEDP urges AAP to revise harmful guidelines for childhood “obesity”

The AAP guidelines claim the “intensive health behavior and lifestyle treatment” they endorse “is the most effective behavioral treatment for child obesity.”⁷ All told, the "most effective treatments" include 26 or more "face-to-face, family-based, multicomponent treatment[s]" over a 3- to 12-month period.⁷

Yet, even the AAP acknowledges the breadth of this nutrition and weight management program is "challenging to deliver and not universally available.”⁷ It’s also not sustainable in the long-term and doesn’t necessarily result in improved health.¹

What this does result in is weight cycling, which is the actual cause behind so many physical health issues usually blamed on weight.² The AAP also claims the “evidence-based treatment" has no evidence of harm and can result in less disordered eating. However, evidence-based research has found this type of treatment results in the exact opposite—more disordered eating, weight gain, and health concerns.^1,3

Bariatric surgery, one of the recommended courses of "treatment" in the AAP's guidelines, can cause worse health outcomes, such as nutritional deficiencies and irreversible osteopenia and osteoporosis. Follow-up surgeries are often required to fix complications.

As for pharmacological interventions, some of the drugs recommended for weight loss are not FDA-approved for weight loss, while others have serious adverse side effects. Some medications only have modest, inconsistent, or no effectiveness, and some result in long-term regaining of total weight lost.

Adverse effects include bloating, nausea, flatulence, diarrhea, lactic acidosis, and oily stool are just a few outcomes of this type of medical treatment. Specifically, one of the drugs the AAP guidelines touts as “safe” has been known to cause severe intestinal blockages. Yet research findings on these drugs and their dangerous side effects weren’t among the sources cited.⁴

Most of the studies the AAP cited didn’t apply to children and didn’t have long-term results. This is because no long-term studies exist on the “safe” outcomes of intentional weight loss for kids as young as two, off-label use of drugs for weight loss for kids as young as 12, and bariatric surgeries for teens as young as 13.

We believe prescribing these drastic, risky, potentially dangerous, and unproven measures for children because of their weight is irresponsible and unethical.

Then, we have the equally alarming conflicts of interest that weren’t disclosed. Many of the professionals the AAP consulted with to develop the guidelines work in some capacity for pharmaceutical manufacturers of weight loss drugs or are bariatric surgery providers.⁵