Hi Reader,

My little guy just turned 4, which means we have a well-child check up coming up soon. You may have heard about the new Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity from the American Academy of Pediatrics. Previously, the 2016 version of the guidelines was clearly against putting kids on diets and took a much broader, contextual view at raising kids with healthy relationships with food.

Now, though, the AAP recommends "prescribed treatment plans" with nutrition and lifestyle interventions in kids as young as 2 and weight loss drugs and surgery starting for kids as young as 12. These guidelines, just from a logical standpoint—which is to say, I am not a researcher or a scientist, but I can read—make very little sense. They actually spell out all of the ways research shows us that diet and exercise interventions don't actually lead to long lasting weight loss. They explain that body size is complex and due to many factors including genetics. And then, they somehow conclude that we simply must do more of what we already know doesn't work. They double down on anti-fat bias.

And because I am unsure of how exactly this information is distilled to pediatricians around the country, or our own doctor's personal views on the subject, I approach our check-ups with a very small amount of preparation to spare my child from these conversations. Because I firmly believe that no child should ever hear a person in a position of power say that there is a problem with their body.

Here's what we're doing to prepare for the appointment:

1. We will send a message the day before the appointment to the provider mentioning that we're coming in and that we request to not discuss weight or BMI during the appointment in front of the child. If there is a concern, they are welcome to message us after the appointment. (This helps to set expectations with the provider and is a non-confrontational way to approach the topic.)
2. I will write on a post it "Please do not discuss BMI or weight during this appointment" that I will hand to the doctor when they walk into the office. Our charts are electronic, so this is one way I can be assured that the provider will see it before we get into anything. The power dynamics with people in authority often make it difficult to speak up (for me anyway), so this method helps me communicate easily and respectfully.
3. If weight loss, weight gain, or BMI come up, I plan to interrupt and ask that we save that discussion for after the appointment. I may also ask "Has he stayed on his own growth curve? Can we talk about milestones that are important for his age that are unrelated to body size?"

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No child should ever be made to feel like their body is the wrong size. Kids are very literal and that quickly can turn into a feeling of "I am wrong". (I am speaking from experience here.) It's also factually impossible to predict the future of any person's health based on their current body size. And no child should ever be put onto a diet because other people are bullying them, as The Daily podcast concluded last week. (The problem is the OTHER PEOPLE being bullies.) That they are doing something wrong simply by being themselves. Check-ups are often too brief and often lack a lot of context in conversations. The simple steps I outlined above, which we've been doing for years already because BMI talk at the doctor isn't new, are one way that I can control some of what my kids hear about their bodies.

There is a lot wrong with the AAP guidelines—in all honesty, I haven't said much about them because I have been SO livid and not all that coherent in my response to them. As someone who had a 15 year eating disorder that started when I was a teenager, due, at least in part to similar "recommendations" about diet and exercise as the ones in these new guidelines, I have taken this all very personally.

I also KNOW that I can take these simple steps to protect my kids in medical settings.

My son is straight sized. He is small for his age. I will still do this for his check-up to help normalize the request and, one can dream, make it safer for families with kids in larger bodies—particularly Black and Brown families who may not feel safe bringing this up—to ask for the same humane treatment.

For further reading on why all of this matters, including why the guidelines are discriminatory and are likely to cause even more eating disorders and weight stigma (and the related worsening of medical care), you can read:

​Burnt Toast: The Human Cost of Anti-Fat Bias​

​Why the New Obesity Guidelines for Kids Terrify Me​

​Diet-Free Well Child Visits from Anna Lutz, RD​

​The New APP Guidelines with Katja Rowell, MD​

​Statement on the Guidelines from the Academy for Eating Disorders​

This link was incorrect on Sunday, so here it is again! Learn how to make mirepoix—which is a mix of onion, celery, and carrot typically used to start soups and sauces—and store it in the fridge or freezer when you have time, then grab it for easier cooking in the moment.

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This cozy Macaroni Soup is an easy and flavorful family meal—and so nourishing with tomato, beef, and loads of veggies. I love to make this with elbows, but other small pasta shapes such as wagon wheels would work well, too.

​FLUFFY CHOCOLATE MUFFINS​

Fluffy, tender, and just sweet enough, these easy Chocolate Muffins are a favorite breakfast and snack to share with the kids.

​EASY 9 MONTH OLD MEALS​

Make it easier to feed your 9-12 month old baby meals with this cheat sheet of nutritious ideas.

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​QUICK TORTILLA PIZZAS​

Make quick work of the next kids meal with this super easy Tortilla Pizza recipe. You only need three basic ingredients!

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