The Last Judgment

Eating Disorders and Obesity: Worthy of Attention

When the American Academy of Pediatrics released its clinical guideline for obesity, it put a spotlight on an odd kind of zero sum thinking. For people promoting this line of thought, the presumption seems to be that parents, advocates, and health professionals have to pick sides. Which is more worthy of our attention – eating disorders or obesity?

Let’s be clear. This is complete nonsense. Caring for young persons with one of these problems does not mean turning away from the medical needs of those with the other.

Promoting Fear

A key element in the messaging of resistance to medical care for obesity in young persons has been fear. Alexis Conason is a clinical psychologist promoting a “Diet-Free Revolution” with her book and website. She tells USA Today that she sees nothing but danger in offering medical care for kids with obesity:

“These guidelines set up a recipe for eating disorders to flourish.

“When we take kids in larger bodies . . . and we tell them in the medical profession that there is something wrong with their body, it can set kids on a lifetime path of difficulty around food and disordered eating.”

Unsupported Presumptions

The scenario Conason describes is one of pediatricians haranguing patients about their weight when those patients are unbothered by it. Pediatricians don’t have time to waste on such pursuits. More often than not, kids and their parents know when there’s an issue and they should be able to seek help from their pediatricians for dealing with it.

Because objective research tells us that leaving young persons without medically sound options for obesity care leads them to behaviors that indeed can cause them harm – and put them at risk for eating disorders.

The kind of neglect that causes problems includes advice from health professionals to simply lose weight without any help or professional support. In the American Academy of Pediatrics guideline, the authors explain this clearly:

Multiple studies have demonstrated that, although obesity and self-guided dieting place children at high risk for weight fluctuation and disordered eating patterns, participation in structured, supervised weight management programs decreases current and future eating disorder symptoms (including bulimic symptoms, emotional eating, binge eating, and drive for thinness) up to 6 years after treatment.”

Young Persons Who All Deserve Care

Thus, suggesting that young persons who need help with obesity should be kept from it to protect them from eating disorders doesn’t hold up to a review of the evidence. Both of these medical conditions deserve attention and competent care. They both can be quite damaging to a young person’s health. Leaving these young persons with only DIY options is a recipe for disaster.

These youth need care from professionals who understand the complex conditions of obesity and eating disorders. And health systems need to step up to provide more, not less, of this care.

Click here for the guideline and here for further perspective on these complex concerns.

The Last Judgment, painting by Hieronymus Bosch / WikiArt

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January 22, 2023