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Living in a diet and weight-obsessed culture is challenging. This is even more difficult when your doctor, someone of high authority on the topic of health, is weight-focused and advises you, your child, or your teen to go on a diet.


I really do believe doctors mean well when they do this, but, their well-meaning efforts can be VERY harmful.


This is why I am happy to say that, after nearly 10 years, the American Academy of Pediatrics (AAP) has finally come out with an updated clinical report on obesity and eating disorder prevention which includes more current research about the adverse effects of dieting.


You may be thinking: so, if diets are harmful, does that mean we should idly sit by and let the “obesity problem” continue to grow?

“Obesity” in the U.S


It seems like we are constantly fed terrifying information about the growing “obesity” rates in children and adolescents. We are frequently told about how “harmful” obesity is and how worried we should be about long-term health effects.

BUT, this is all a bunch of B.S. This “obesity problem” is not really a problem. 

Linda Bacon, an incredible researcher, has challenged the broadly accepted notions about weight and health, and has found so many of the long-held beliefs are actually wrong and not scientifically sound. 

For example, the idea that obesity leads to early death is incorrect. The scientific data actually shows:

  • “Overweight” people, on average, live the longest!
  • Those who are considered moderately “obese” actually tend to live the same amount of time as those who are in a “normal” and “recommended” weight range.

The real problem in our country is weight stigma and fat phobia.

The topic of “obesity” and the misinformation, stigmas, and problems related to this term need to be addressed in a separate blog post… so, stay tuned! Until then, check out Linda Bacon’s work.

As the focus on the “problem” and prevention of obesity has been quite high over the past couple decades, the prevalence of eating disorders in children and adolescents has continued to increase.

This is a major problem.

Eating disorders are the 3rd most common chronic condition in adolescents, with anorexia being noted as the mental disorder with the highest mortality rate.

We’ve been taught that diets are the answer to the “obesity problem,” but they are NOT

A study looking at teens seeking treatment for eating disorders found that 36.7% of them originally weighed more than most of their peers (higher than the 85th percentile for their age and sex, to be exact). It is not uncommon for eating disorders to start with an “overweight” teen trying to “eat healthy.”

Imagine a teen being told they were overweight for their age and being encouraged to avoid “bad” foods by their doctor. This teen may innocently begin restricting their food intake and skipping meals which may develop into behaviors like over-exercising or using extreme weight loss methods. As they lose weight, their doctor and others may begin praising them for becoming “healthy” after originally being told they were overweight.

Without realizing it, the doctor is reinforcing disordered patterns and overlooking the signs of a potential eating disorder.


Research has shown that the earlier the intervention and diagnosis of an eating disorder, the better the outcomes.

Unfortunately, many doctors overlook eating disorder symptoms when the patient is not severely underweight. Regardless of whether or not a patient is within a “normal” weight range, disordered eating behaviors cause great physical and psychological harm on an individual and need to be recognized as soon as possible.

The image many people picture when they think of an eating disorder is that of an emaciated white girl. But eating disorders do not discriminate; eating disorders can occur in any gender, race, or socioeconomic status. AND, eating disorders don’t always include extreme thinness. Size is not a good measure of sickness or wellness.

By only focusing on weight, doctors may miss out on eating disorder symptoms such as preoccupation with food and body, body image distortion, and social isolation.

american_academy_pediatrics_obesity_eating_disorder_preventionWhat I hope doctors are learning about dieting

Dieting, defined as “caloric restriction with the goal of weight loss,” has been shown to be a risk factor for both eating disorders and weight gain.

Several studies cited by the American Academy of Pediatrics have shown dieting in children and teens was associated with:

  • Double the risk of becoming overweight
  • Higher rates of binge-eating

Additionally, 14-15 year olds who strictly dieted and skipped meals were 18 times more likely to develop an eating disorder than the non-dieters, and those who only moderately dieted had 5 times the risk of developing an eating disorder.


There is a way to address health concerns without focusing on weight and “obesity” prevention, AND without increasing the risk for eating disorders

We don’t need obesity prevention, we need eating disorder prevention.


Instead of focusing on weight and dieting, doctors can help the patient by helping the family as a whole.
They can:

  • Teach parents how to be healthy role models (in regards to food, body, and physical activity)
  • Educate parents on what kinds of foods to have readily accessible in the home
  • Suggest things like more family meals and less screen time

computer_screen_timeWhat YOU can do

  • Print out and take the latest clinical report from AAP with you to your next doctor visit
  • Intervene as soon as you notice your child or teen’s doctor heading down the wrong road, especially with any weight-focused conversations and recommendations of dieting
  • Refer to my previous blog, “Five Ways to Help Your Teen Have Healthy Body Image
  • Stay tuned for future blog posts about specific tips included in the AAP report





Need extra support? Contact me to start with a free 15-minute phone consultation.

Emily Rich therapist in Seattle

Disclaimer: This blog is the opinion of an individual and is not to be construed as professional advice or a professional relationship between the reader and the writer. If you are seeking mental health advice contact a therapist in your area. If you are experiencing an emergency, head to your nearest emergency room or call 911.
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  1. Hi. We are in this situation right now. Our daughters Dr. Has advised a nutritionist and weight loss immediately. Since our son died almost 3 years ago we have…

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This blog is the opinion of an individual and is not to be construed as professional advice or a professional relationship between the reader and the writer. If you are seeking mental health advice contact a therapist in your area. If you are experiencing an emergency, head to your nearest emergency room or call 911.