New guidelines for treating childhood obesity include medications and surgery for first time


obesityobesityFor the first time in 15 years. The American Academy of Pediatrics on Monday released. New guidelines for the treatment of childhood obesity. Emphasizing the need for early and intensive treatment.

The guidance comes as childhood obesity rates. Have risen steadily over the past decade and a half.Rising from 17% to 20%, according to data from the Centers for Disease Control and Prevention. Since the 1980s, obesity rates have tripled among children and quadrupled among teenagers.

The epidemic has made matters worse. Said Dr. Joan Hahn, professor.And chief of pediatric endocrinology and diabetes. At Mount Sinai Kravis Children’s Hospital. Who was not involved in the new report. A CDC report found that weight gain rates nearly doubled in 2020 compared to pre-pandemic years.


Obesity affects about 15 million children and adolescents in the United States, CDC data show. Being overweight not only has physical health consequences. Including type 2 diabetes and
high blood pressure, but also affects mental health.

The new guidelines emphasize that obesity is a complex and chronic condition without an easy solution. Intensive behavioral and lifestyle changes should be the first-line approach. But the AAP also includes recommendations for anti-obesity medications and first-time surgery. These novel recommendations are in response to a flurry of research and drug approvals over the past few years.

“We now have evidence that obesity therapy is effective. There are treatments. And it’s time to recognize that obesity is a chronic disease. And should be recognized as we address other chronic diseases,” said Dr. Sandra Hassink. Of the AAP Institute for Healthy Childhood Weights. Medical Director and co-author. New guidelines.

Part of that involves intervening sooner rather than later. There is no evidence. According to the guidelines. That waiting for a so-called visit or delaying appropriate treatment is beneficial.

For children age 6 and older with obesity — and in some cases ages 2 to 5 — the first approach should be to work. With pediatricians and other health care providers on behavior. And lifestyle changes. The new guidelines say. It’s most effective when it includes at least 26 hours of face-to-face counseling over about a year. Something that experts admit can be a challenge for families.

New treatments

For children age 12 and older A major shift in recommendations is to include weight-loss surgery. In addition to anti-obesity medications and lifestyle changes.

In recent years Research has increasingly shown that a person’s weight is determined solely by diet. And physical activity levels; Genetics and hormones can also play a role in. How a person’s body uses and stores energy. This new understanding has been the basis for the development of new drugs.

“The progress that has happened in the last few years is that people are starting to understand. That there are hormones made in the gut that play multiple roles in relation to obesity. By targeting these, drugs can help people feel full faster and stabilize insulin levels,” Han said.

The guidelines state that pediatricians should prescribe weight-loss medications to children. With obesity ages 12 and older.

Four drugs are now approved to treat adolescent obesity starting at age 12 — Orlistat, Saxenda, Qsymia and Wegovy — and one. Phentermine. For teens 16 and older. Another drug, cetmelanotide (brand name Imciviri). Is approved for children age 6 and older who have Barde-Biedel syndrome, a genetic disease that causes obesity.

Wegovi — which gained popularity last year as a weight-loss drug for adults — was approvedAnd Drug Administration in late December for people 12 and older. Clinical trial results published in the New England Journal of Medicine showed that a weekly injection of the drug, along with. Healthy exercise and eating habits, could help children age 12 and older reduce their body mass index by about 16%, up from 0.5%. For a group that took a placebo.

However, new drugs are not available to everyone.

“The problem with these drugs is that they’re very expensive and insurance often doesn’t cover them,” Hahn said. Adding that a month’s supply of Wegovi can cost as much as $1,500, which is unaffordable for most families.

The guidelines also recommend that adolescents age 13 and older. With severe obesity consider discussing weight-loss surgery. Which evidence suggests may be a safe and effective treatment with long-lasting results.

“For many things the sooner the better,” Hahn said. “There is research showing that early bariatric surgery can reverse. Health problems such as type 2 diabetes and high blood pressure, which is why surgery should be considered for pediatric patients.”

A holistic approach
AAP’s Hassink emphasizes that drugs and surgery are not first-line treatments.

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