The Old Schoolhouse Ryders

Confusion of Scolding with Pediatric Obesity Care

Helen Ouyang has an exhaustive, thoughtful exploration of obesity care for children and youth today in the New York Times. She brings in the expertise and experiences of a wide range of people who understand the problem – both from life experiences and from clinical care and research. She also briefly brings in the confusion of folks who equate pediatric obesity care with scolding.

That confusion is unfortunate, but common.

A Letter from a New Jersey School

The scolding comes in the form of a letter from school. Esther is a fifth-grader who had to bring it home to her parents, advising them that she has a high BMI and that they had to take this letter to their doctor for their signature. Three levels of scolding here – the school, the parents, the doctor. Humiliation for the child.

The doctor advised that Esther’s weight gain “was not a big deal,” but told them that she could go to a pediatric medical center’s weight program if they wished. Esther took one trip there and refused to go back. She told her family that she was trying to be healthier.

Later she was diagnosed with anorexia that became life-threatening.

Confusion About Pediatric Obesity Care

Let’s be clear about this. This subplot is not a story of pediatric obesity care run amok. This anecdote is about a school system that bullies kids who might or might not have a medical problem. Sending letters home to parents, telling them that their child is too fat, should be out of bounds for schools. Research shows that it does no good and, as Esther’s experience shows, it can cause harm.

Ignorance about obesity dies hard. Too many people think obesity care is all about lectures on lifestyle and “being healthy.” These misconceptions and lectures only add to the problems that kids with obesity face.

Both Esther and the kids in Ouyang’s reporting deserve good care. But because of bias and stigma about obesity, mistreatment is all too common.

Click here for the full article by Ouyang and here for further perspective on BMI screening in schools.

Old Schoolhouse Ryders, painting by George Luks / WikiArt

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November 1, 2023