Monte Nido & Affiliates, as one of the leading and most tenured eating disorder treatment platforms in the United States, has witnessed families being repeatedly advised that their child needs to lose weight. With first-hand knowledge of the medical and mental health damage that can occur in these instances, we believe strongly that the American Academy of Pediatrics (AAP) guidelines – particularly around weight loss medications and bariatric surgery for children under the age of 14 – are harmful. As experts in the field, we advocate for revision of the AAP “Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity”.
Each year thousands of children and teens are evaluated for eating disorder treatment at one of the company’s Monte Nido, Walden, Rosewood and Clementine programs. The AAP guidelines include minimal directives around screening and referring to treatment for eating disorders. This increases the likelihood of harmful and unnecessary surgical options being recommended to families of children and adolescents with disordered eating. The guidelines reference weight stigma, which directly intersects with social justice considerations that impact marginalized communities. At Monte Nido & Affiliates, we have seen how medical approaches that shame individuals in larger bodies, especially those in marginalized communities, worsen trauma and other mental health symptoms. In revising the guidelines, we ask that AAP consult with us, other eating disorder professionals, and families and individuals with lived experiences in larger bodies.
We align with the Academy of Eating Disorders (AED) approach when addressing the AAP’s guidelines and continue to partner with colleagues at other leading eating disorder treatment organizations and advocacy organizations to actively engage the AAP and other experts on this matter. Directives on eating disorder screening and safe weight-inclusive considerations should be reflected in the guidelines.