On May 13th, our team met with congressional staffers to discuss the growing epidemic of childhood obesity and the urgent need for effective management. We were joined by a panel of medical professionals who shared their expertise on prevention strategies, the role of GLP-1 agonist medications, and the use of bariatric surgery in treating obesity. We also heard from a patient advocate who powerfully shared her personal journey—from childhood struggles to accessing effective obesity care—highlighting the bias and stigma she has faced along the way. 

To better understand childhood obesity and why treatment matters, let’s take a closer look at some common myths—and the facts that debunk them. 

Myth #1: Obesity is a Lifestyle Choice 

Many Americans believe obesity is simply the result of poor lifestyle choices or a lack of willpower. Unfortunately, this misconception is widespread—even among healthcare providers—who may attribute weight gain to personal responsibility or failure to follow treatment plans. 

But the reality is far more complex. Obesity is not simply a matter of “calories in versus calories out.” Scientific evidence shows that factors like genetics, gut bacteria, hormones, sleep patterns, medications, prenatal influences, and psychological stress all play a significant role in weight regulation. 

Most individuals living with obesity understand that it’s a serious disease with major health consequences. The false belief that obesity is a personal failing contributes to harmful bias, stigma, and discrimination, leading to lower quality of life and barriers to care.  

Myth #2: Obesity is a Condition, Not a Disease 

Obesity has been formally recognized as a disease by major medical organizations, including the World Health Organization (WHO), National Institutes of Health (NIH), and American Medical Association (AMA). 

Obesity meets the criteria for a disease because it involves abnormal fat cell function—known as adiposopathy, or “sick fat.” This condition increases the risk of serious health problems like type 2 diabetes, high blood pressure, high cholesterol, and fatty liver disease. While BMI isn’t a perfect measure of health, it does correlate with disease risk, even in children. 

Lifestyle change remains the foundation of obesity treatment but recognizing obesity as a disease encourages the medical community to research, develop, and provide more effective therapies.  

Myth #3: Diet and Exercise Alone Will Reverse Severe Obesity 

Many still believe that diet and exercise are enough to treat obesity, and they’re often skeptical of medications or surgery. However, research shows that for individuals with severe obesity, lifestyle interventions alone rarely result in significant, sustained weight loss. 

When weight loss occurs, the body’s natural feedback mechanisms—such as hormone shifts and increased appetite—often lead to weight regain. 

Fortunately, new treatments are available. In the past five years, several medications have been FDA-approved for obesity treatment in adolescents aged 12 and older. This includes two GLP-1 receptor agonists, namely liraglutide and semaglutide, as well as the combination drug, phentermine-topiramate.  Clinical trials have shown these medications lead to clinically significant reduction in BMI when combined with lifestyle changes. Unfortunately, a significant barrier to these medications is access due to lack of insurance coverage. 

Healthcare providers should become familiar with these medications to better support patients in achieving meaningful, sustainable weight loss. 

Bariatric surgery is another important tool for adolescents with severe obesity—typically recommended for those with a BMI over 35 and related health problems (such as diabetes), or a BMI over 40 regardless of complications. These recommendations are supported by the American Academy of Pediatrics and other medical societies. 

Surgery is never a first step. It’s considered only after intensive lifestyle interventions have been tried and when the patient and family are ready. In some cases, patients may turn to surgery simply because they cannot access or afford medications that could help. 

When bariatric surgery is appropriate, we screen patients carefully, ensure long-term follow-up, and see excellent outcomes—such as remission of diabetes, improvement in fatty liver disease, and a better quality of life. The safety profile for adolescent bariatric surgery is comparable to that in adults. 

Just as we approach complex conditions like cancer or inflammatory bowel disease with a combination of therapies, we are learning that effective obesity care often requires a personalized, comprehensive plan that integrates medical and surgical options.  

Myth #4: My Child Will “Outgrow” Obesity 

Many parents and even some healthcare providers believe that childhood obesity is temporary—just “baby fat” that kids will outgrow. However, data tell a different story. 

Only about one in five children with overweight or obesity will achieve a healthy BMI by middle school. And more than 75% of adolescents with obesity will continue to have obesity as adults. 

This is why prevention efforts are critical. We need to focus on creating environments that support healthy eating, increase access to nutritious foods, and address rapid weight gain in early childhood before it becomes a lifelong struggle.  

In Summary:
Obesity is a complex, chronic disease that requires a compassionate, evidence-based approach. Our recent conversations with policymakers are just the beginning. We invite our community—patients, families, healthcare providers, and advocates—to join us in pushing for greater access to care, improved treatment options, and a future where no child is left behind in the fight against obesity.