Retreat Planning is a Whole New World . . .
Just wow. All of the little details (and costs!) I never thought of.
Let’s just say I can see why most people don’t hold retreats. YET – I still want to do one! (I also would totally GO to a retreat. Like one of these. Unfortunately the 2023 dates do not work for me, but I’ll be eagerly awaiting what they will be offering in 2024.)
Anyway, I am confident BLP LIVE will happen! Just ironing out final details. I think I finally nailed down venue and am taking a last site visit tonight (!).
Very interesting podcast ep:
Maintenance Phase shared their take on the AAP Guidelines on Obesity.
I think their reactions were valid, and as a provider smack in the center of this subject matter, I’m really glad I listened. On one hand, I do think it is nice that we have more options we are able to offer to children in cases when parents + kids want to try them. The guidelines make me feel safe recommending medications when parents/kids specifically ask about wanting to try them. I can then review the evidence and the offerings plus potential side effects and let them decide.
But — I absolutely do not think we should be outright stating, “Since your child’s BMI is over X, guidelines suggest we should start them on medication.” And the guidelines sort of suggest that is what I am ‘supposed’ to do.
I also liked the MP perspective and reminder on how meaningful the physician encounters can be to young, vulnerable patients. Even when it feels routine on my end, I know my words (and actions, and suggestions, and body language) have power. I would never want my words to cause anyone long-term harm.
Finally, like the MP hosts, I also hate the emphasis on weight as a surrogate end point for health, and the lack of discussion (and probably knowledge) about long term outcomes of these treatments.
This is more medical than I usually get on this site, but this was more my reaction to hearing the podcast so I figured I would share.
And in OTHER OTHER NEWS:
I tried Hoka Clifton 8s. (100% influenced by HRG). I liked them! They put my foot at a very different angle than my usual ACIS Gel Nimbus and I think the variation is going to be good for me long term. They are light but also VERY cushy.
(I do wear super shoes — Nike AlphaFly — but for races and I will start wearing them for ‘workouts’, but currently I am doing more base building and not very many workout-type efforts!)
I appreciate that you talked about your thoughts on the AAP obesity guidelines. I mean the NYT daily did a podcast on the topic so it’s something many have heard about. The focus on BMI is so interesting to me. In our case, our kids, especially the oldest, is on the very low end of the BMI. But I appreciate that our doctor’s assessment of his health/weight is very nuanced. His weight was such an area of focus for the first 6 months of his life – I am glad that is no longer the case as those were some of my most stressful months of parenting… the weight checks were absolutely awful and many tears were cried (by me). But because he’s underweight, his weight is only one small factor in the assessment of his health. If he was overweight, I imagine more emphasis would be put on that one number in assessing his health…
Those Hokas are cute! I run in hokas but a different model. I love them! Prior to switching to Hokas, I ran in Mizuno Wave Riders and needed to wear orthotics. A running store employee suggested I try Hokas and they’ve been great and I was able to ditch my orthotics, which were falling apart!
I have so many thoughts on this topic as well. I am not a medical professional, but I have two girls who are two years apart (same parents). My older daughter (9) is definitely on the short and “chubby” side. She has always had this body type, from like 3 months old. She is very sporty and active, but she also does not have the worlds greatest eating habits (we are working on it, but she’s also 9, so what 9 year old does?) My second daughter (6) is really wispy and thin. She’s tall with long legs. She’s always been teeny-tiny. She is the less active of the two, but probably does eat a little better (enjoys fruit and yogurt as a snack and doesn’t gravitate toward high calorie foods). I struggle with how much to try and direct their eating habits, because I tend to lean toward . . . eat less for my older daughter and . . . whatever you want to do for my younger daughter. All within reason, of course — I push real foods for both of them ahead of sweets, but I find myself being more of a watchdog for my older daughter and it feels unfair.
Also, I was 100% my older daughter growing up. I’m now a very fit and active adult, but tend toward the stockier side. I had skinny sisters growing up (now, I’m adulthood, I’m probably the thinnest of all of us due to activity levels). So I know how it feels to have parents directing food choices for me and not for thin siblings. I know that thinness does not equal health and I don’t want to hurt her feelings or worse. But, I also don’t want my older daughter to end up in a place that she can’t return from when we have an opportunity to influence habits and behavior now. It’s such a struggle!
My heart goes out to my pediatrics colleagues with those guidelines. I treat adults in this space, but they come to me voluntarily and we talk about how overall health metrics and NOT BMI should guide our decision making. I have listened to a few podcasts on this topic, I liked the Puberty Podcast. It is a tough topic. Luckily guidelines are just that, and not law.
I’m glad you brought up the obesity guidelines. As someone who got an ED (and still struggles with body image at age 40) as a result of the emphasis put on my weight in elementary school, I would have been devastated if even more discussions and actions regarding my weight had been done at a young age. Hopefully physicians will find a balance between helping kids/teens and making sure it doesn’t cause long term psychological issues.
I had the same reaction. Comments made by my pediatrician about my weight at around ten years old set off a tail spin of disordered eating and body image issues for many years. I hope there can be a tremendous amount of thoughtfulness and sensitivity when sifting through and using these guidelines.
I plan to get one of those shoes too. how do you like Hoka vs. nike?
Totally different shoes for different purposes! Hoka are not super shoes they are cushy recovery shoes.
I see. will try nike fly then.
I started wearing the Hokas in the middle of training for my last marathon (Boston 2022). My first few training runs, I strongly disliked (I’ve always been a Nike Pegasus or a Brooks wearer). Then, a flip switched and I loved them. Now, when I put on a non-Hoka shoe, the toe drop from the heel feels so off and injury-inducing. I’ve been very happy with the Hokas ever since. I’m now wearing a light version for fast workouts and a sturdier version for long runs.
Thanks for the link to that podcast – it was an interesting listen. I think they made lots of good points but I also think that the AAP had an incredibly hard job to do in writing these. I work in medicine but not in a space that will be affected by these guidelines and I certainly don’t envy you and others in your position! Some tough choices and conversations, for sure.
I almost got a pair of Hokas but settled on Altras instead. The zero drop definitely forced me to change my stride – that’s for sure! I really liked the Hokas, too. I’ve always preferred the extra cushion, though I know it’s not for everyone. Glad you’re liking them!!