Responding to the American Association of Pediatrics’ (AAP) Clinical Practice Guidelines

TW: Disordered eating

Weight loss doesn’t equate to or define one’s well-being. 

Health requires a multi-faceted approach, including how we think about and practice meaningful, sustainable self-care in our lives. 

I know and believe these things now. I share how to build and shift our mindsets on my podcast and in presentations. 

Yet as a 17-year-old aspiring professional dancer, I didn’t. I began to notice my body wasn’t built like a ballerina and started limiting my food intake. My body was growing and evolving naturally. As I was watching my weight tick down — my first loss — I was gaining a distorted view of eating.

So when I first heard about the American Academy of Pediatrics (AAP)’s new Clinical Practice Guidelines (CPG), my reaction went to that 17-year-old girl. I felt horror.

AAP authors zeroed in on targeting and treating childhood obesity rather than improving health access and reducing anti-fat stigma. The guidelines frame weight loss as a medical necessity and sometimes, one requiring bariatric surgery or medications. 

I’m not a medical doctor. However, I have seen and experienced how an early fixation on weight — pressured and encouraged by adults — creates trauma. This fixation can increase risks for eating disorders and other rampant, harmful behaviors. And it perpetuates weight stigma in our healthcare systems, families, and communities. If doctors would adopt and use these guidelines as is, there would be detrimental effects on our kids, teens, and future generations. 

Others (fortunately!) shared my horror. Weight Inclusive Nutrition and Dietetics (WIND) gathered a group of healthcare providers, educators, researchers, and advocates to voice our concerns to the American Association of Pediatrics. I was grateful for the opportunity to join this collaborative response. 

Our grassroots advocacy team sought to understand AAP’s recommendations. We combed and indexed the 800+ studies cited as evidence in the CPG on evaluating and treating children and adolescents with obesity. In sifting through evidence, we identified trends in the index and later, wrote up in-depth analysis on a select number of studies. Then, we wrote and edited a response letter summarizing these findings. Together, we channeled our initial outrage into action. 

A special thank you to Patrilie Hernandez, who served as our fearless project leader. It was a joy to collaborate with you and get to know advocates pushing for greater inclusivity and accessibility in this space. 

(Stay tuned for a future podcast with Patrilie. We’ll talk more about her background and the behind-the-scenes work of this response.)

I encourage you to take a look at the WIND toolkit and sign the letter asking AAP to reconsider, rescind, or at the least revise their CPG to incorporate more weight-inclusive guidance and reflect a more holistic perspective of well-being. 

See the full toolkit and sign the letter to the American Association of Pediatrics.

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