In early January, the American Academy of Pediatrics published new guidelines promoting expensive weight loss drugs and stomach rerouting surgery for obese children and adolescents, claiming they are “safe and effective.” Not only are active living and clean eating safer, cheaper, and healthier options in the long run, but these promoted extreme treatments could also severely damage childhood development. These drugs and surgeries mostly benefit the AAP’s members and donors who can use these guidelines to squeeze more money out of vulnerable families.
To induce the most rapid weight loss possible, the AAP recommends several medical treatments for children that could permanently harm their physical and mental development. Among them is a drug called orlistat, a pill that stops fat nutrient absorption in the digestive system by preventing the release of fat-processing enzymes and costs $803 per month. Another, semaglutide, is a regular injection that reduces appetite by mimicking hormones and slowing digestion and costs $1,627 per month. The most concerning recommendation is bariatric surgery, an invasive procedure that reroutes and removes portions of the digestive tract to reduce appetite and nutrient absorption, and it costs $23,000.
If these options sound dangerous for children, that’s because they are. Vitamins A, D, and E — critical to growth, bone development, and the immune system — are fat-soluble nutrients, so administering orlistat to children could significantly hamper their health and development. Semaglutide, which mimics the body’s hormones, carries a serious risk notice from the Food and Drug Administration of cancer in the thyroid, the organ where most hormones are regulated. Bariatric surgery is perhaps the most dangerous of all: By removing part of the digestive tract to reduce nutrient absorption, the surgery can result in malnourishment and low blood sugar, permanently stunting a child’s physical growth and brain development.
Why would the AAP advise such drastic courses of action when basic diet and exercise are the safest options for children? Look no further than the AAP’s list of top donors, mostly comprised of both ultra-processed-food manufacturers — whose products make children sick and obese — and pharmaceutical companies that sell expensive medications to cure them. The most telling names among them include GlaxoSmithKline, manufacturer of orlistat, and Novo Nordisk, manufacturer of semaglutide.
Several others among the top 10 donors listed on the AAP website are Rickitt-Mead Johnson Nutrition and Abbott Nutrition, the leading producers of baby formula. In the United States, baby formula is made from highly processed corn, not milk, and makes our children 14 percentage points, or 74 percent, more likely to be overweight or obese compared to those exclusively fed breast milk. The government provides such baby formula to the 43 percent of our families poor enough to qualify for public assistance, which explains part of why children from impoverished families are more than twice as likely to be obese. Regardless, it’s significant to note that joining the AAP’s top 10 donors list are Sanofi and Novo Nordisk, two of the three companies supplying the United States with insulin to treat diabetes, which often accompanies obesity.
Because the government subsidizes health care costs for poor families, and poor kids are statistically more likely to be obese, these expensive drugs and surgeries will disproportionately end up on the taxpayer’s tab. Indeed, as the number of unhealthy, poor Americans grows, so does the rationale to expand the size and scope of the federal government, which provided the AAP with $35 million last year, or one-third of its funding. This symbiotic relationship creates, resolves, and pays for the greatest health crisis facing Americans today.
Although the AAP promotes a pro-youth mission statement, its true motivations hide in the fine print. The organization’s stated purpose is “to attain optimal physical, mental, and social health and well-being for all infants, children, adolescents and young adults. To accomplish this, AAP shall support the professional needs of its members” [emphasis my own]. The vaguely defined “professional needs” of the organization’s members covers a multitude of unfavorable motives, but the implications are clear: Doctors, not children, come first. Donors who produce these drugs drive and benefit from AAP recommendations that result in financial benefits for AAP members.
Although direct cash payments to doctors for writing prescriptions are illegal, “consulting” fees, even for pediatricians, are not, and doctors tend to prescribe more of a drug if the pharmaceutical company kicks back to them. Think also of the number of fees generated by allowing children to get bariatric surgery — at $23,000 a pop on average and two surgeries per day, a pediatric bariatric surgery specialist could be making nearly $50,000 per day, minus their staff, overhead, and, of course, their AAP dues.
While this isn’t to call pediatricians greedy or undeserving, the academy that represents them does not have children’s best interests at heart. Rather than blindly listening to the AAP, parents and doctors alike should carefully consider the organization’s functional and financial motivations in promoting radical, expensive treatments for our children.
