More obesity insanity from NPR, presented with minimal commentary

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Two mothers — Jen McLellan in Albuquerque, N.M., and Grace, of Bethesda, Md. — haven't met, but they share a common childhood trauma: Both came of age in the 1980s and '90s feeling burdened by shame and stigma over their body size. Both tried every known diet plan and pill available at the time, only to have doctor after doctor admonish them to restrict calories and exercise still more.

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Since then, scientific understanding of obesity has transformed; doctors now consider it a disease driven by genetics, the brain and other organs, as well as by environmental or psychosocial factors. Studies have also confirmed what both women suspected all along: Diets usually do not result in long-term weight loss because food and exercise account for only some part of the puzzle.

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Grace's eldest daughter had been active in sports, but around age 8 — with no changes in how she'd been eating — she started rapidly and inexplicably gaining weight, as Grace herself had. Her increasing size and decreasing mobility started affecting her moods and caused distress.

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Bariatric surgery's track record in teens is longer and has proved effective, though it comes with some risk of complications, malnutrition and weight regain. Either way, neither medication nor surgery is a quick fix, and both are expensive and require serious commitment to big lifestyle changes in nutrition and activity in order to work.

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"Obesity in and of itself is a disease," says Stanford, a Harvard Medical School obesity specialist. "If we recognize obesity as the chronic disease that it is, then we have to treat that disease, not just as an impact on other diseases."

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Jen McLellan, the Albuquerque mother, says endorsing treatments that reduce body size makes weight stigma worse. She thinks parents instead should model acceptance of different body sizes, rather than urging kids to conform to a smaller ideal. "We shouldn't be changing their bodies because of bullying so they fit a mold that is acceptable by society," she says.

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Many advocates in the growing fat acceptance movement share McLellan's point of view. For instance, the Association for Size Diversity and Health issued a statement condemning the AAP's treatment guidelines, writing that they "worsen medical fatphobia and ultimately degrade the quality of healthcare" for kids.

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