Reason and Emotion in Obesity Care for Young Persons

Children in the StreetBoth reason and emotion play a role in obesity care for young persons. Feelings about this subject are strong. The experience of living with obesity is intense for families, children, and youth. Recent reporting makes this clear. Equally clear is reporting and new data that tell us we’re not coping with it very well.

Severe obesity continues to grow in young persons. And they suffer for lack of care.

A Dismaying Rise

Today in Pediatrics, a new study confirms that severe obesity is rising among the young children (ages 2-5) from lower income families enrolled in the WIC (Women, Infants, and Children) program. These data contrast with earlier reassurances that changes in the WIC program might have blunted the rise in obesity between 2010 and 2016. Maybe those changes had a short-term effect. Or maybe the data are noisy. Either way, this is a problem that is not going away.

“We are dismayed at seeing these findings,” says Heidi Blanck of the U.S. Centers for Disease Control and Prevention.

These Kids Don’t Get Effective Care

Writing in the New York Times, Gina Kolata goes straight to the heart of an even more dismaying problem. Highly effective care for severe obesity in young persons is possible, but these kids don’t often get it. Medicines for obesity in kids are new and pediatricians say they’re reluctant to prescribe now because they have not often prescribed them in the past.

We don’t so we won’t is the sentiment that comes through from pediatricians in private practice.

Ann, an 18-year old from New York, told Kolata that she struggled with this throughout childhood, with her mother taking her from doctor to doctor. The response was always the same, she said. “It was always that I wasn’t eating well.”

Finally, Ann saw an obesity medicine specialist who has prescribed life-changing therapy for her. She has lost weight, resolved medical issues with pre-diabetes and high cholesterol, and pushed away from the stigma she had felt for so long.

“I feel better not just physically but mentally,” she said.

Sympathetic and Sober Insight

In New York Magazine today, Lisa Miller has crafted a very compelling portrait of a girl from rural Missouri growing up with severe obesity from her very earliest days of childhood. Miller’s account of Maggie Ervie and her parents does something that is sadly rare in the sensational reporting about Ozempic and similar medicines.

She tells the human story of a young person and her medical condition that popular culture often distorts grossly. Where much of the discourse about obesity in youth is moralistic or condescending, Miller deftly delivers sympathetic and sober insight.

This piece only misses the mark in misrepresenting the Obesity Action Coalition and its mission to empower people living with obesity. But that’s more an annoying side note than a primary focus in this fine story. (Miller connected with the Ervies at the OAC conference in September.)

Withholding Care

The real point here is the human impact of severe obesity and the suffering that withholding care can cause. We can and we will do better. Trends are already pointing in that direction.

It is frustratingly slow progress.

Click here for the new study in Pediatrics and here for a commentary that goes with it. For Kolata’s report click here. For Miller’s compelling portrait of Maggie Ervie, click here.

Children in the Street, painting by Edvard Munch / WikiArt

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December 18, 2023