Opinion Today: How the new obesity guidelines could fail children

Is focusing on how much someone weighs the best path to health and happiness? [View in browser](~/AAAAAQA~/RgRltlBRP4QoAWh0dHBzOi8vbWVzc2FnaW5nLWN1c3RvbS1uZXdzbGV0dGVycy5ueXRpbWVzLmNvbS90ZW1wbGF0ZS9vYWt2Mj9jYW1wYWlnbl9pZD0zOSZlbWM9ZWRpdF90eV8yMDIzMDEyNyZpbnN0YW5jZV9pZD04Mzc3OSZubD1vcGluaW9uLXRvZGF5JnByb2R1Y3RDb2RlPVRZJnJlZ2lfaWQ9Nzc2NzQ5NTImc2VnbWVudF9pZD0xMjM2NDQmdGU9MSZ1cmk9bnl0JTNBJTJGJTJGbmV3c2xldHRlciUyRjg3MDMwZjVlLTY5MTYtNWU5My04ZjIyLTY2ODRjNjgzYzMyNSZ1c2VyX2lkPWFhNDkxZWY3ZjFkOTY0ZTQ5NzlmYjc4NGU3NGUwMWQ3VwNueXRCCmPTUcvTYwBj0m1SG3RyaXN0cmFtYmFsZHdpbjkwQGdtYWlsLmNvbVgEAAAAAA~~)|[nytimes.com](~/AAAAAQA~/RgRltlBRP0SwaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjMwMTI3Jmluc3RhbmNlX2lkPTgzNzc5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTEyMzY0NCZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKY9NRy9NjAGPSbVIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAA)[Continue reading the main story](#a11y-skip-ad-marquee) [Marquee Ad](~/AAAAAQA~/RgRltlBRP0SYaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9MTYyMTM5JmxpPVRZJm09YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDcmcD1UWV8yMDIzMDEyNyZ0ZT0xJm5sPW9waW5pb24tdG9kYXkmZW1jPWVkaXRfdHlfMjAyMzAxMjdXA255dEIKY9NRy9NjAGPSbVIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAA) [Read more from Opinion](~/AAAAAQA~/RgRltlBRP0S_aHR0cHM6Ly93d3cubnl0aW1lcy5jb20vc2VjdGlvbi9vcGluaW9uP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjMwMTI3Jmluc3RhbmNlX2lkPTgzNzc5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTEyMzY0NCZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKY9NRy9NjAGPSbVIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAA) January 27, 2023 [Author Headshot] By Eliza Barclay Climate Editor, Opinion Obesity treatment has become one of the most divisive issues in medicine. Look no further than the panoply of reactions to the American Academy of Pediatrics’s new [guidelines](~/AAAAAQA~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~) for evaluating and treating children and adolescents, released this month. Some have called the guidelines a significant step forward because they encourage pediatricians to be aware of the harms of stigma and use a wider range of tools to help patients. One key change is that doctors are now urged to be quicker to send patients to “intensive health behavior and lifestyle treatment” programs, prescribe weight-loss medications and refer teenagers with severe obesity to a bariatric surgery center. But in a [guest essay](~/AAAAAQA~/RgRltlBRP0TxaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wMS8yNi9vcGluaW9uL2FhcC1vYmVzaXR5LWd1aWRlbGluZXMtYm1pLXdlZ292eS1vemVtcGljLmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyMzAxMjcmaW5zdGFuY2VfaWQ9ODM3Nzkmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTIzNjQ0JnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0Qgpj01HL02MAY9JtUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAA~) this week, the writer Virginia Sole-Smith argues that the guidelines may fail to help, and even harm, many patients. The core problem, she says, is that the recommendations are based on the false premise that weight loss — and the interventions to achieve it, like diets, drugs and surgery — is “the best path to health and happiness.” Instead, Sole-Smith says, pediatricians should move to a weight-inclusive approach, which has yielded promising results in adults in terms of physical health gains and fewer eating disorders. “This means looking less at the number on the scale and talking more to families about their health priorities and challenges. Can they add healthy foods rather than restrict calories? Can they find ways to move their bodies that they enjoy?” Sole-Smith writes. The debate about weight-loss medications is not limited to kids; for more, don’t miss my colleague Lulu Garcia-Navarro’s [interview](~/AAAAAQA~/RgRltlBRP0TjaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wMS8xOS9vcGluaW9uL29iZXNpdHktZGlzZWFzZS13ZWlnaHQtbG9zcy5odG1sP2NhbXBhaWduX2lkPTM5JmVtYz1lZGl0X3R5XzIwMjMwMTI3Jmluc3RhbmNlX2lkPTgzNzc5Jm5sPW9waW5pb24tdG9kYXkmcmVnaV9pZD03NzY3NDk1MiZzZWdtZW50X2lkPTEyMzY0NCZ0ZT0xJnVzZXJfaWQ9YWE0OTFlZjdmMWQ5NjRlNDk3OWZiNzg0ZTc0ZTAxZDdXA255dEIKY9NRy9NjAGPSbVIbdHJpc3RyYW1iYWxkd2luOTBAZ21haWwuY29tWAQAAAAA), on the “First Person” podcast, with Dr. Fatima Cody Stanford of Harvard on why she believes medication is an important new option for certain patients with obesity. [Read the full essay here](~/AAAAAQA~/RgRltlBRP0TxaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wMS8yNi9vcGluaW9uL2FhcC1vYmVzaXR5LWd1aWRlbGluZXMtYm1pLXdlZ292eS1vemVtcGljLmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyMzAxMjcmaW5zdGFuY2VfaWQ9ODM3Nzkmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTIzNjQ0JnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0Qgpj01HL02MAY9JtUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAA~). [[Article Image] John Provencher](~/AAAAAQA~/RgRltlBRP0TxaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wMS8yNi9vcGluaW9uL2FhcC1vYmVzaXR5LWd1aWRlbGluZXMtYm1pLXdlZ292eS1vemVtcGljLmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyMzAxMjcmaW5zdGFuY2VfaWQ9ODM3Nzkmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTIzNjQ0JnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0Qgpj01HL02MAY9JtUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAA~) [GUEST ESSAY Why the New Obesity Guidelines for Kids Terrify Me The guidelines are rooted in a premise that should have been rejected long ago: that weight loss is the best path to health and happiness. By Virginia Sole-Smith](~/AAAAAQA~/RgRltlBRP0TxaHR0cHM6Ly93d3cubnl0aW1lcy5jb20vMjAyMy8wMS8yNi9vcGluaW9uL2FhcC1vYmVzaXR5LWd1aWRlbGluZXMtYm1pLXdlZ292eS1vemVtcGljLmh0bWw_Y2FtcGFpZ25faWQ9MzkmZW1jPWVkaXRfdHlfMjAyMzAxMjcmaW5zdGFuY2VfaWQ9ODM3Nzkmbmw9b3Bpbmlvbi10b2RheSZyZWdpX2lkPTc3Njc0OTUyJnNlZ21lbnRfaWQ9MTIzNjQ0JnRlPTEmdXNlcl9pZD1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkN1cDbnl0Qgpj01HL02MAY9JtUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAA~) [Continue reading the main story](#a11y-skip-universal-0) ADVERTISEMENT [Ad](~/AAAAAQA~/RgRltlBRP0SXaHR0cHM6Ly9saXZlaW50ZW50Lm5ld3lvcmt0aW1lc2luZm8uY29tL2NsaWNrP3M9NTk3ODUmbGk9VFkmbT1hYTQ5MWVmN2YxZDk2NGU0OTc5ZmI3ODRlNzRlMDFkNyZwPVRZXzIwMjMwMTI3JnRlPTEmbmw9b3Bpbmlvbi10b2RheSZlbWM9ZWRpdF90eV8yMDIzMDEyN1cDbnl0Qgpj01HL02MAY9JtUht0cmlzdHJhbWJhbGR3aW45MEBnbWFpbC5jb21YBAAAAAA~) Here’s what we’re focusing on today: Editors’ Picks [PAUL KRUGMAN Can Anything Be Done to Assuage Rural Rage? Rural voters blame the wrong people, but their troubles are real. 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The political scientist Jessica Chen Weiss warns of escalating tensions between Washington and Beijing. 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