Updated childhood obesity treatment guidelines include medications, surgery for some young people

Updated childhood obesity treatment guidelines include medications, surgery for some young people


The American Academy of Pediatrics’ updated obesity treatment guidelines call for the immediate use of behavioral therapy and lifestyle changes, and say that surgery and medications should be used for some youngsters.

The guidelines, published Monday in the journal Pediatrics, are the first comprehensive update of the academy’s obesity treatment guidelines in 15 years. They provide treatment guidelines for children ages 2 and up through adolescence.

The guidelines recognize that obesity is complex and related to access to nutritious foods and health care, among other factors.

Treatment for younger children should focus on behavioral and lifestyle treatment for the whole family, including nutrition support and increased physical activity. For children 12 years and older, the use of weight-loss medications is appropriate in addition to health behavior therapy and lifestyle treatment, the AAP says. Adolescents 13 years of age and older with severe obesity should be evaluated for surgery, according to the guidelines.

“There is no evidence that ‘watchful waiting’ or delayed treatment is appropriate for children with obesity,” said Dr. Sandra Hassink, an author of the guideline and vice chair of the AAP Clinical Practice Guideline Subcommittee on Obesity. “The goal is to help patients make lifestyle, behavioral or environmental changes in a way that is sustainable and involves families in decision-making every step of the way.”

Myles Faith, a psychologist at the State University of New York at Buffalo who studies childhood eating behaviors and obesity, praised the new report as acknowledging that the causes of childhood obesity are complex and that its treatments must be a team effort.

“It’s not a cause for all kids,” he says. “There has not been such a report to say that there are more options and that we should not automatically reduce the possibility of medication, that we should not reduce the role of surgery. For some families, it might be something to consider,” said Faith, who was not involved in creating the guidelines.

The AAP says more than 14.4 million children and adolescents live with obesity. Children who are overweight or obese are at higher risk for asthma, sleep apnea, bone and joint problems, type 2 diabetes and heart disease, according to the US Centers for Disease Control and Prevention. For children and adolescents, overweight is defined as a body mass index at or above the 85th percentile and below the 95th percentile; obesity is defined as a BMI at or above the 95th percentile.

The new guidelines do not discuss obesity prevention; will be addressed in another AAP policy statement to come, he says.

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