Is More Agressive Treatment Needed For Childhood Obesity?

A leading pediatricians’ group has issued new guidelines on treating obesity in children and teens that, for the first time, call for early, aggressive intervention that can include weight-loss drugs and surgery.

“There is no evidence that ‘watchful waiting’ or delayed treatment is appropriate for children with obesity,” Dr. Sandra Hassink, an author of the new American Academy of Pediatrics (AAP) guidelines and vice chair of the Clinical Practice Guideline Subcommittee on Obesity, said in a statement.

About 20% of U.S. children now live with obesity, about 15 million children altogether, according to the U.S. Centers for Disease Control and Prevention.

New guideline recommendations

The new guidelines recommend against watching and waiting, instead suggesting families of children aged 6 and up should work with their pediatricians on behavior and lifestyle changes. In some cases, families of children aged 2 to 5 should, too, the guidelines recommend. This should include at least 26 hours of counseling over about a year.

The new guidelines also suggest that pediatricians should offer obese children aged 12 and up new weight-loss drugs that include Orlistat, Saxenda, Qsymia and Wegovy. Phentermine is approved for kids over 16 years of age, the guidelines said.

“The breakthrough that happened in the last few years was people started realizing that there are hormones made in the gut that have multiple roles related to obesity. By targeting these, medications can help people feel full faster and help stabilize insulin levels,” Dr. Joan Han, chief of the division of pediatric endocrinology and diabetes at Mount Sinai Kravis Children’s Hospital in New York City, told NBC News.

The new AAP guidelines also recommend discussing weight-loss (or “bariatric”) surgery with teens aged 13 and up who have severe obesity.

“The sooner, the better for many things,” Han said. “There is research that shows that getting bariatric surgery sooner can reverse health issues like type 2 diabetes and high blood pressure, which is why surgery should be considered for pediatric patients.”