Childhood Obesity Guidelines Newsletter: Good Medicine or Too Extreme?

Childhood Obesity Guidelines: Good Medicine or Too Extreme?


Dr. Julia Nordgren

Pediatric Lipid Specialist at Palo Alto Medical Foundation; Attending Physician at the Stanford Weight Clinic



Dr. Janna Gewirtz O’Brien

Pediatrician and Assistant Professor

at the University of Minnesota Medical School



John Donvan

Host and Moderator-in-Chief



This week:

  • New episode: Are the latest guidelines for treating childhood obesity just right or do they go too far?
  • A closer look at the use of weight-loss drugs as a solution
  • Your Sunday reading list



Obesity is a complex disease and a national health emergency. For National Nutrition Month, we wanted to take a closer look at how our youngest patients are being treated for this condition, particularly since current guidelines from the American Academy of Pediatrics are driving fierce debate among pediatricians.

We found two esteemed (and impassioned) pediatricians – Dr. Julia Nordgren and Dr. Janna Gewirtz O’Brien – who share common ground in having children’s and adolescent’s health and well-being as a top priority. However, Dr. Nordgren says the 2023 guidelines are “good medicine” and Dr. Gewirtz O’Brien says they are “too extreme.”

The Guidelines By the Numbers:

  • 1 in 5 children and teens are affected by obesity in the U.S.
  • At age 12, the guidelines say that patients should be offered weight loss medications.
  • Those 13 or older, with severe obesity should be evaluated for bariatric surgery, alongside the lifestyle and behavioral interventions suggested by the guidelines.
  • 67,000 pediatricians are members of the American Academy of Pediatrics — many of whom will keep these guidelines in mind as they treat their patients.

So, do the guidelines help the medical community chart a clear path forward for treating obesity in children, particularly when considering the long-term health impacts of the disease including higher risk for diabetes, heart disease, and mental health issues like anxiety and depression? Or are the guidelines too aggressive, risking unintended health consequences including eating disorders and lowered self-esteem?

Listen to this debate now on Apple Podcasts and YouTube and decide for yourself, and as always, let us know what you think.


A Rise in Rx for the Obesity Epidemic


Childhood Obesity Guidelines: Good Medicine or Too Extreme?


Good Medicine: Dr. Julia Nordgren

“Obesity is a multifactorial, chronic, relapsing disease. It has genetic underpinnings. It has environmental and societal inputs… I have been taking care of kids with obesity for two decades and finally, dawn is breaking on a new era of obesity management for children and adolescents. This new beginning was really ushered in by the [American Academy of Pediatrics] with these practice guidelines. These are long overdue guidelines. They understand the science behind obesity, the complications and the complexities of caring for these patients, and what treatments might actually help these kids get better.”


Too Extreme: Dr. Janna Gewirtz O’Brien

“These guidelines too aggressive… Think about the kids and teenagers you know in your lives. Their bodies are changing. They’re figuring out who they are. They’re navigating a complex world that’s full of messages telling them what they should and shouldn’t look like, hearing online and offline that their bodies are a problem and that thin bodies are an ideal… Recommending intensive and potentially harmful interventions for up to one in five children and adolescents is dangerous. If implemented, they can cause serious harm to children and adolescents in the short and the long term.”




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