Are We Panicking Without Cause?
Let's be careful when we read new recommendations
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It’s easy to read a headline and panic. That’s what happened this past week as parents struggled to understand the new American Academy of Pediatrics recommendations on obesity.
The new policy statement says a lot about obesity in this country, and the complexities of the issue on a policy, community, and practitioner level. It details the shockingly increasing numbers around obesity among children, and the known complications of this chronic condition.
But while acknowledging the genetic and inherited components, the social implications like bias, teasing and bullying, the part of the article that parents have honed in on are the practitioner recommendations.
For the treatment of children with obesity (defined as being at or above the 95th percentile vs. overweight which is defined as being at or above 85th percentile, but less than 95th), the AAP recommends “vigorous behaviors interventions” for those age 2 or above, the consideration of medication for those age 12 or above, and the inclusion of a surgical consideration at age 13 or above. There is thought that these new, and considerably tougher, recommendations will serve to pressure insurers to take a preventive approach to many of the long term health concerns linked to obesity, such as type 2 diabetes, high blood pressure or certain cancers, and cover earlier and more aggressive treatment options. This would undoubtedly help in the fight for prevention, and the focus on early intervention and treatment options.
Critics of this new statement cite anti-fat bias, reporting that these recommendations further villainize issues around weight and cement the idea that health and happiness is associated with being thin. They also argue that BMI is one data point, often inaccurate in growing children experiencing puberty, and overly important in these recommendations. But they also recommend a focus on the origin of weight issues, on asking families about their priorities and challenges, and doing more of what my dear friend Tina Payne Bryson would call, “chasing the why.” Obesity, they argue, is much more complicated than the weight on a scale.
What I am hearing from the parents I work with is an increase in anxiety around the intensity of these new recommendations, and the urge to mistakenly apply that intensity to children who are NOT within the definition of obesity as outlined by the AAP. Nothing in this recommendation is saying to starve your child, weigh them constantly, shame them for their eating, or rush to medication. Nothing in these recommendations is remotely relevant to a family with a child who is perceived as a little round or even a lot round. It is a place to start a conversation, to consider, and to bring our calmest and most sensible selves. When we translate news into how it impacts us in unrelated circumstances, it can really pull at unnecessary threads. As parents, we often panic without cause. Thanks to effective headlines and splashy media coverage, we react before we take a breath.
The Take-Aways:
Though much more prevalent than ever (1 of 6 children nationwide), most of our children do not qualify for the type of intervention recommended here. But there is an opportunity for all of us to bring our thoughtfulness and curiosity to the ways in which we can assess our own children’s needs when it comes to staying healthy. Perhaps it means checking in on our habits, family history, priorities for ourselves and our children. Perhaps it is being more conscious in how we treat our bodies, more attuned to how we feel, more in touch with how our systems are running. For each of us, there will be a different need, a different answer, a different treatment plan.
General Recommendations to Support Healthy Eating Habits
Reduce screen time. Studies show that mindless eating can cause us to eat past feeling full and increase obesity (movie popcorn anyone?).
Increase physical activity. Moving is important for so many aspects of our children’s development, including learning and physical health. Let’s all commit to doing more of it.
Eat meals together. Research tells us that when we eat together, we tend to make healthier choices (no more kids menu) and encourage each other's efforts.
Spend time together as a family. Connection is an important way to learn about each other, spend time talking about thoughts and feelings, and manage some of the stressors that may contribute to obesity.
Prioritize healthy sleep schedules. The link between sleep and being overweight is not fully understood, but well documented. Getting enough sleep every night can help avoid obesity by allowing children to be able to make healthier choices during the day, and do more physical activity.
Ask for help. Your child’s physician should be on the same team - working towards the health and wellness of your family. If you need resources, suggestions, support or information about food, try reaching out. There are also tons of national organizations dedicated to helping children around both healthy food choices and physical exercise. Look up one in your area and get started.
Warmly,
