Obese boys and girls should be evaluated and treated early and aggressively, including medication for boys as young as 12 and surgery for minors as young as 13, in the United States published recommend new guidelines.
According to the authors, the long-standing practice of “waiting and watching” — delaying treatment to see if children and adolescents lose obesity on their own or if it subsides over the years — only worsens a problem affecting millions of children. of new guidelines.
If left untreated, obesity can lead to lifelong health problems including high blood pressure, diabetes and depression.
“Waiting doesn’t work,” said Ihuoma Anelli, co-author of the first childhood obesity guidelines in 15 years from the American Academy of Pediatrics.
“What we see is a continuation of weight gain and the likelihood that they will be obese in later life.”
For the first time, the guidelines establish the ages at which children and adolescents should be offered medical treatments such as drugs and surgery, in addition to intensive diet, exercise and other lifestyle interventions, said the director of the Center for Healthy Weight and Nutrition. at Nationwide Children’s Hospital.
“The guidelines seek to redirect a misguided view of obesity as a personal problem, perhaps a failure of an individual’s persistence,” said Sandra Hassink, MD, medical director of the AAP Institute for Healthy Childhood Weight and co-author of the guidelines.
“It’s no different than having asthma, and now we have an inhaler for you,” Hasink said.
Youth with a body mass index (BMI) greater than or equal to the 95th percentile of children of the same age and gender are considered obese.
Children who reach or exceed the 120th percentile are considered severely obese. BMI is a measure of body size based on a calculation of height and weight.
Aaron Kelly, MD, co-director of the Minnesota Center for Pediatric Obesity Medicine, said the group’s guidelines take into account that obesity is a biological problem and that the condition is a complex chronic disease.
“Obesity is not a lifestyle problem. It emerges primarily from biological factors,” he said.
The guidelines come as new drug treatments for obesity in children, including the approval late last month of Vegovy, a weekly injection for children 12 years and older, appear.
Experts have their reservations
An expert in pediatric obesity cautioned that while obese children should receive early and intensive treatment, he worries that some doctors resort to drugs or surgery too quickly.
“It’s not that I’m against drugs,” said Robert Lustig, MD, a pediatric endocrinologist at the University of California, San Francisco. “I am against indiscriminate use of these drugs without addressing the cause of the problem.”
Lustig said children need to be assessed on an individual basis to understand all the factors that contribute to obesity.
Youth with a body mass index (BMI) greater than or equal to the 95th percentile for children of the same age and gender are considered obese.