Gabrielle with Renoir's Children

A New Call for Putting Children First in Childhood Obesity

A big gap just closed. At long last, we will be putting children first in childhood obesity.

Until today, efforts to reduce the impact of childhood obesity have been mostly silent on the issue of shame and blame that children and families face with obesity. But today, the American Academy of Pediatrics and the Obesity Society (TOS) are closing that gap in childhood obesity policy. In a new joint policy statement, they are committing to bring an end to fat shaming in childhood obesity.

A Huge Change

Make no mistake about it, this change is huge. Four decades have passed since Lancet first called for attention to childhood obesity. And all this time, the Academy has been largely silent on the harm of obesity stigma.

As recently as  2012, a major children’s hospital in Atlanta was shaming kids with obesity and their families in a controversial ad campaign. Elsewhere, screening programs singled out kids with obesity, but effective clinical care was mostly out of reach.

Removing a Big Barrier

Stigma hurts. It hurts kids who have to cope with obesity, arguably causing more suffering than obesity itself. The medical complications of obesity pile up over time. But bullying and social isolation cause immediate pain.

Some people mistakenly think that a little bit of stigma might motivate kids to overcome obesity. Wrong. Research is clear that kids who experience weight stigma are less likely to overcome obesity. Health outcomes are worse. Youth who think of their body weight as just about right are more likely to grow up with a healthy BMI.

Shaming parents doesn’t help, either. The shame and blame just gets passed around inside the family and lands on the children. Healthcare visits become something to dread.

The barriers to better health are simply higher when stigma clutters the landscape.

Pediatricians Can Lead

Pediatricians can help parents make healthy changes for the whole family. They can start with empathetic caring and support. They can help parents think about health and healthy family habits, instead of size and shape.

But perhaps more important, the Academy is calling pediatricians to be leaders for respectful care in their own clinics and more broadly across the health professions. Patient-centered care is a hot buzzword in medicine these days. Nowhere is it more important than in childhood obesity.

This new policy from the Academy and from TOS opens the door for tremendous progress in addressing childhood obesity. Perhaps now at long last, we can stop adding insults to injury in childhood obesity.

Click here for the policy statement published in Pediatrics. Click here for further perspective published today in Obesity. For yet more, we recommend this article in the New York Times.

Gabrielle with Renoir’s Children, painting by Pierre-Auguste Renoir / WikiArt

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November 20, 2017

3 Responses to “A New Call for Putting Children First in Childhood Obesity”

  1. November 20, 2017 at 11:03 am, John DiTraglia said:

    This is great but schizophrenic. The first thing a pediatrician needs to admit is that we have nothing to offer. If you say it’s not your fault and it’s not fair but then go on to talk about diet and screen time and exercise….. how are you not saying it IS your fault?

  2. November 20, 2017 at 1:34 pm, Ted said:

    Thanks, John, for making your points.

    When the subject is obesity, you’ll find no truthful easy answers. But pediatricians and other healthcare providers can do better than offering nothing. As I noted above, they can help parents think about health and healthy family habits, instead of size and shape.

    Easy answers to this issue usually turn out to be false.

  3. November 20, 2017 at 4:45 pm, Allen Browne said:

    Yes, I agree the the paper is schizophrenic. The awareness of stigma and bias is very important. The awareness of the effect of the stigma and bias on the children and their families is very important. What is missed is how to reduce the stigma and bias – rather than because it is bad for the patients and their families, how about because it is factually wrong. How about teaching the healthcare providers about the physiology of obesity, the homeostasis of the energy regulatory system, the set point, and how much of this is subconscious. Then the conversation with the children and their families can be based on fact and treatment of the disease can have realistic goals. There is much to offer child with obesity and their family. There are many tools to improve their health – evidence based and rooted in the physiology of the disease. But as mentioned in the IOM commentary in 2014 by Ted Kyle and Rebecca Puhl, bias and stigma is firmly in the way.