The 2023 American Academy of Pediatrics guidelines are crucial for:
-highlighting the imperative to address childhood obesity, and legitimizing it as a chronic disease with comorbidities
-emphasizing disparities, social determinants of health, and dangers of stigmatization
– recommending comprehensive lifestyle therapy as first-line treatment
-citing common obesogenic medications
But the guidelines fail to:
-prioritize prevention (these guidelines are forthcoming, but the sequence reflects an attitude that got us here in the first place)
-give more than a nod to the policy changes needed to address our obesogenic environment
-recommend any specific dietary programs beyond the 5 servings of fruits and vegetables and 0 sugar-sweetened beverages per day (eg, no mention that >90% of American kids are deficient in fiber, or that processed meat is a Group 1 Carcinogen)
-adequately represent the risks associated with weight loss meds, and especially bariatric surgery, for children