The American Academy of Pediatrics (AAP) has released new guidelines on childhood obesity. This set of recommendations is meant to move away from “watchful waiting” and refocus on treatment for obese kids. It is a significant step forward for children’s health and the obesity community.
According to the AAP, obesity is a chronic disease with complex causes. Weight loss drugs are an option for older children, as are lifestyle changes. Surgery is also recommended for teens with severe obesity. There is limited data on the use of these interventions in younger children. However, behavioral interventions such as coaching and physical activity are effective.
Currently, there are two FDA-approved medications for pediatric obesity: semaglutide and phentermine. These medicines are used to help people feel full and reduce their appetite. But there are other weight loss drugs that are currently being studied in the pediatric population.
Using these medications is important for those who are not able to make dietary and behavioral changes. Also, pharmacotherapy has been shown to reduce the risk of complications associated with obesity. Other treatments include bariatric surgery, which is the most effective weight loss method. However, the AAP does not specifically recommend this surgery. Instead, it urges doctors to consider a combination of medication and lifestyle changes.
Although obesity is a chronic condition, the AAP suggests that children and teenagers be treated at an early age. Those with severe obesity should be considered for bariatric surgery. They will need to undergo at least two years of follow-up to determine whether the procedure is successful. In addition to that, patients will need to meet with a team of specialists before undergoing the procedure.
Children and adolescents are at higher risk for many conditions, including type 2 diabetes, sleep apnea, heart disease, and bone and joint problems. These factors can be dangerous and lead to long-term medical conditions. So, a pediatrician should evaluate the risks and benefits before offering a surgical procedure to an obese child.
Obesity is a biological problem, and genetics can play a role. Therefore, it is critical to recognize the biological and psychosocial causes of obesity and treat them accordingly. Medications targeting gut hormones and insulin stabilization may offer some support for this approach.
However, the AAP does not recommend using drugs alone to treat childhood obesity. Rather, they recommend using these treatments in conjunction with health behavior therapy. Both pharmacotherapy and lifestyle changes have modest benefits for treating obesity.
In addition to medication, the AAP is calling for a “whole-child” approach that emphasizes non-stigmatizing communication and a focus on lifestyle modification. Parents should discuss their concerns with their children’s doctors and take advantage of every opportunity to teach their kids about fitness.
While some studies have found weak evidence that lifestyle changes can improve BMI in younger children, there is no evidence that these interventions are more effective than other treatments in the pediatric population. Intensive therapy is also difficult to deliver, and it is not universally available.