Last month, the American Academy of Pediatrics released new guidelines for the evaluation and treatment of children and adolescents with obesity. These recommendations included instructions for doctors to refer children under the age of two to “intensive health behavior and lifestyle treatment” programs if their BMI is deemed too high. They also include guidelines for prescribing weight-loss drugs like Wegovy and Ozempic (and in severe cases, even referrals for bariatric surgery) for children 12 years of age and older.
Is it true that approximately 14.7 million children in the United States are obese? Absolutely, and this is a real health issue that warrants a response from the medical establishment. But the increased medicalization of children’s bodies suggested by the AAP’s new guidelines may cause them to be sucked into a cycle of binge-watching that is rarely sustainable, not alone in the worry of permanent weight loss (and more importantly, the ability to deeply damage a child’s self-esteem). keeps). As Virginia Soule-Smith wrote in a recent The New York Times op-ed, a “pure weight-based medical model trains doctors to view a child’s BMI as ‘normal’ as a priority, rather than viewing that number as a data point. It hopes to focus providers and patients on weight loss. That thinness will fix everything else.”
Weight loss was a Penelope-Shroud-like goal I pursued from ages 11 to 27, learning to skip dessert and save my indulgences for trips to the kitchen when everyone in my house was asleep. I would swallow whole slices of white bread and suck icing out of a tube alone by the light of the fridge, not knowing that my secretive and shame-filled behavior around food had a name (but I didn’t know that anyone wanted to know about it. It). I didn’t exceed my recommended BMI (a measure of health, however, it’s consistently called into question) until my mid-twenties, but the presence of the eating disorder I still live with was known long before that. I spent years restricting, hiding, and never allowing myself to fully enjoy food, and I think my ED was able to thrive in secret for so long because I trusted on some level – without needing anyone to tell me, much to my doctor. Low – that fat was the worst thing I could have.
I am fat now, as I write this, and have been for years. I consider quitting dieting to be one of my proudest accomplishments, but there are still days when I look at my body in the mirror and hear that old voice in my head urging me to weigh myself every day, to go on long, punishing runs. Instead of the cold morning air I’ve come to favor gentler workouts, count my nuts, pinch my belly fat, and beat myself up until I’m thin again. Never mind that the lowest number on the scale as an adult corresponds to a time in my life where I was constantly chain-smoking, crying at night, and feeling completely alone in the world. I was small, and was not smallness the goal, the prize?
