These new AAP guidelines will increase eating disorders in children

If you are in the eating disorder world, you have probably heard the American Academy of Pediatrics (AAP) newest guidelines for children who live in larger bodies.

If you have not heard of these new guidelines, I’m going to summarize them here, as well as provide my stance on these recommendations.

In the wise words of Marci, “Soapbox alert ahead.”

About one month ago, AAP released “Clinical practice guidelines for the evaluation and treatment of children and adolescents with obesity.” While the title utilizes stigmatizing language, the recommendations are even worse.

I have highlighted some key points from the guidelines below. The AAP:

  1. Defines obesity as a chronic disease, which should be treated with intensive and long-term care strategies.
  2. Utilizes BMI as a measure of health (see here for a summary of why this is problematic).
  3. Recommends intensive behavioral interventions that are inaccessible for most folks with marginal short-term weight loss and no proven long-term benefit.
  4. Advocates for weight loss pharmacology as a method of treatment.

Hey AAP – what happened to “do no harm”?

We’ve known for a while now that living in a larger body is not an indication of poor health. Weight loss surgery, by design, creates a state of malnutrition, which is particularly concerning for developing bodies and brains. In adults, medications and weight loss surgery are associated with higher mortality rates and have a strong potential for life long medical and psychological impacts.

advocate eating disorders in children

Our society is fixated on trying to shrink folks’ natural bodies to fit a mold. A mold that is rooted in fatphobia, racism, patriarchy, and oppression (just to name a few). Things like bariatric surgery and weight loss medications have failed the adult population. We cannot give this same advice to children who cognitively cannot fully understand what they or their parents are agreeing to.

Are you fuming with rage like me?

Upon hearing these recommendations, my first thought was “Wow, I unfortunately will never be out of a job in my lifetime.”

I feel frustrated, angry, and heartbroken that these are the recommendations for children and adolescents.

Dieting is the #1 behavioral risk factor for the development of an eating disorder and eating disorders are among the deadliest mental illnesses, second to opioid overdose.

There is about one death every 52 minutes as a direct result from an eating disorder. These recommendations will very increase these numbers. Our kids deserve better. So. Much. Better.

Where do these recommendations come from if they are so harmful? Simple. Like many recommendations in our society, they are rooted in fatphobia.

Many dietitians like me spend our days dedicated to understanding eating disorders and what we can do as clinicians to prevent them.

We have seen the damage that recommendations like this have done to adults. In my practice alone, I have countless clients whose eating disorder started because their pediatrician told them they are overweight or obese. With adding these new recommendations, I am afraid of how many more children will be predisposed to developing an eating disorder.

I am extremely passionate about my work with adolescents. I will continue to advocate for inclusive and respectful care for all youth. I am absolutely disgusted that these guidelines would impose such harmful recommendations on such a vulnerable population.

I do have spots available and am taking new clients at this time! If you know of a child, adolescent, or young adult that would benefit from nutrition counseling, please feel free to  share our contact information  and reach out to get started right away.

5 Signs Your Child May Have an Eating DisorderIf you are wondering if your child or teen has an eating disorder, please download our free guide, 5 Signs Your Child May Have an Eating Disorder, as a starting point.

~ Anita Dharwadkar
Registered Dietitian Nutritionist