A guest columnist published an op-ed in The New York Times on Thursday about how the new American Academy of Pediatrics guidelines on treating childhood obesity have left her terrified. And she should be terrified.
The comprehensive overhaul of recommendations for treating kids with obesity includes a cocktail of pharmaceuticals and bariatric surgery, an operation that should be the last resort for even the most severe cases.
But Virginia Sole-Smith, the author of “Fat Talk: Parenting in the Age of Diet Culture,” which comes out in April, is terrified for all the wrong reasons. According to Sole-Smith, the medical community’s remaining stigmas against excessive weight are problematic.
“The guidelines are rooted in a premise that should have been rejected long ago: that weight loss is the best path to health and happiness,” Sole-Smith wrote. “The academy’s guidelines are the latest sally in the war on obesity that health care providers, public health officials and the general public have waged to shrink our bodies for over 40 years. The approach hasn’t worked; Americans, including kids, are not getting thinner.”
She’s right that the kids are not all right. But she’s dangerously wrong to claim Americans should raise the white flag on the issue. On the contrary, Americans should be alarmed that the population’s obesity epidemic has swollen to such epic proportions that 1 in 5 children is clinically obese. Americans should be disturbed that by even the “healthy” diet standards their government recommends, their food is still leaving them and their neighbors not just fatter but sicker, with 88 percent of adults suffering from some form of metabolic dysfunction.
Even worse, Americans should be terrified that the health care industry’s answer to childhood obesity is to drug the kids with a magic medication and offer high-risk surgery, making them lifelong medical cash cows before they’re even 18. After all, big food and Big Pharma are way more interested in treating a nation that’s chronically fat, sick, and depressed with Band-Aid fixes than offering real solutions to the nation’s health crises — everyone knows solutions and cures don’t generate the same profits as a lifetime of compliance with expensive medication regimens.
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“Significant weight shifts in children can signal an underlying health condition like diabetes or an eating disorder, or food insecurity,” Sole-Smith wrote, all of which can be mitigated by the proper administration of real food. She went on, however, to scapegoat genetics: “Some kids are also just genetically predisposed to be bigger,” she added in paratheses, linking to academic literature trapped behind a paywall.
Genetics can’t explain the contemporary obesity epidemic that’s strangling the country, however. In his 2021 book “Metabolical,” Dr. Robert Lustig, a pediatric neuroendocrinologist and professor at the University of California San Francisco who has published six books on health and nutrition, explained how genetics alone can’t be blamed for the nation’s runaway obesity epidemic.
“There are thirty-nine genes that determine risk here,” Lustig began. “Only two,” he said, “have any real clinical import, and are only found in about 16 percent of the obese population, never mind the general population.”
If you had every other obesity risk gene, it would only explain ten kilograms or twenty-two pounds of weight, hardly enough to explain the population rise in obesity. Genetics are important, but not the biggest reason for obesity.
In other words, a handful of kids might be predisposed to extra weight by their genetics, but it’s their overall environment to blame, and it’s up to them and their parents to control the outcomes.
Sole-Smith’s solution to childhood obesity, however, is to recalibrate objective standards of health. In keeping with the modern “body positivity” movement and the left’s habit of redefining truth and terms to fit their perception of reality, the Times guest columnist thinks we would all be healthier if we just stopped calling obesity and other health detriments unhealthy.
“What should the obesity guidelines say instead? Stop classifying kids and their health by body size altogether,” she wrote.
It’s true that doctors ought to take a more nuanced approach to individual health care, but dismissing metrics such as the body mass index (BMI) risks forgoing data that are critical to analyzing large populations. BMI isn’t perfect, but it gives doctors a good barometer of where the country is — and when nearly 20 percent of children aged 2-19 find themselves categorically obese on the scale, something is dangerously wrong.