I never imagined I would be the one composing this article.

As a board-certified pediatrician and internist with expertise in nutrition and integrative medicine, our family consumes a good amount of kale, blueberries, and salmon. We seldom keep a notable quantity of junk food at home. Fast food is an exception, and she never even sampled juice during her toddler years. Yet, my child’s BMI has remained in the obesity category for years.

She wasn’t particularly troubled by her weight until fourth and fifth grade, when a few especially unkind classmates began to comment on her size in ways that anyone who has experienced fat shaming would recognize. Over these two years, I have witnessed her self-esteem take hit after hit. She increasingly felt inferior and socially undesirable, retreating deeper into herself, finding less joy and connection in the outside world.

Annual check-ups have not been sufficient to halt the momentum of weight gain or its psychological effects. I have seen compassionate physicians and dietitians recommend the obvious, but those recommendations often fell flat. I have grappled with my own struggles when my child’s desire for food, mixed with a strong internal food reward system, led to excessive eating. I have contended with my own ingrained thoughts, beliefs, and preferences about food and body image, attempting to counter the damaging messages from diet culture and a society fixated on appearance.

I advocate for health at various sizes. I believe that being fat and fit can coexist. However, I also acknowledge the data and am well aware of the health risks associated with obesity: hypertension, hyperlipidemia, metabolic-associated liver disease, orthopedic issues, diabetes, cardiovascular risks, and mental health disorders. I want none of these for my beloved child, nor do I want her to perceive her body as “wrong.” When the FDA sanctioned GLP-1s for children as young as 12, I actually expressed my disapproval out loud at the time, convinced that Big Pharma had ulterior motives. It is ironic that now I feel driven to share our story.

There I stood, balancing medical facts in one hand and my child’s dignity, independence, and emotional health in the other. If she is meant to live in a larger body, I want her to feel proud of it, at ease within it, and healthy. But it has never been straightforward.

As a parent, these seemingly conflicting forces left us paralyzed in inaction. We felt powerless, confused, and torn, especially since, as a pediatrician with a focus on nutrition and coaching, I should have known what to do. We went on endless waiting lists to see healthy lifestyle clinics, to no avail. Limiting her food access felt wrong. Pressuring her to exercise did not help our relationship or the messages she received about movement and bodies. So, for quite a while, we just watched, anxious and stuck.

Then one day, seemingly out of nowhere, it struck me that my child had a medical diagnosis: a metabolic condition that has a behavioral aspect. When my mind processed those words in that sequence, I experienced a deep sense of relief and clarity. It was not a shortcoming on anyone’s part. I have not failed as a parent. She has not failed either. It is not merely about willpower or the correct way to eat. The child requires medical intervention. I once heard Dr. Fatima Cody-Stanford describe obesity as a relapsing, remitting, neurobehavioral metabolic disease, and I think that description is spot-on.

This realization came at the perfect moment. At nearly twelve, we were able to consult a board-certified obesity specialist, undergo evaluation, and ultimately begin a GLP-1 treatment. She is not fond of injections, but she was genuinely ready (even desperate) to obtain effective assistance for her metabolic condition. She increasingly felt a lack of control over her body and eating habits, and we now understand that obesity is a multifactorial, multisystem chronic condition that can improve with treatment. We know that the many comorbidities can improve with appropriate treatment, and we now have effective strategies to employ alongside the valuable guidance of lifestyle medicine specialists and dietitians.

Our journey is still ongoing. She is losing weight, and her urge for food has diminished to a more typical level. She feels proud of her achievements and is interested in healthy options from a standpoint of curiosity and dignity, rather than compliance and restriction. She is actively participating in a structured exercise program that she enjoys and takes pride in the muscles she is developing. I can see her self-image improving with each week that passes. She even granted me permission to share her story in hopes that