Children with obesity should be evaluated and treated early and aggressively, including medications Surgery for children up to 12 years and children up to 13 years, Under the new guidelines issued on Monday.
The longstanding practice of “watchful waiting” or delaying treatment to see if children and teens grow out of obesity on their own makes the problem worse. affects more than 14.4 million youth in the US, If left untreated, obesity can lead to lifelong health problems. , including high blood pressure, diabetes and depression.
“wait doesn’t work”, Co-author of the first childhood obesity guideline in 15 years from the American Academy of Pediatrics, Dr. Ihuoma Eneli said. “What we see is a continuation of weight gain and the likelihood that they will have[obesity]in adulthood.”
For the first time, the group’s guidance sets out the ages at which medical treatments such as medicine and surgery should be offered to children and adolescents.In addition to intensive diet, exercise, and other behavioral interventions and lifestyle, said Anneli, director of the Center for Healthy Weights. and nutrition at the National Children’s Hospital.
In general, physicians should provide obese adolescents 12 years of age and older with access to appropriate medications and refer severely obese adolescents to weight loss surgery, although circumstances may vary.
Guidelines aim to rehabilitate wrong view of obesity “a personal problem, perhaps a failure of the individual’s diligence”, Medical director of the AAP Institute for Healthy Childhood Weight and co-author of the guidelines, Dr. Sandra Hassink said. ,
“It’s no different than having asthma, and now we have an inhaler for you,” Hasink said.
young people who have a body mass index that reaches or exceeds the 95th percentile for children of the same age and sex is 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.
According to the Centers for Disease Control and Prevention, obesity affects about 20% of children and adolescents and about 42% of adults in the US.
Aaron Kelly, MD, co-director of the Center for Pediatric Obesity Medicine at the University of Minnesota, said the group’s guidance takes into account that obesity is a biological problem and that the condition is a complex chronic disease.
“Obesity is not a lifestyle problem. It is not a lifestyle disease.” Told. “It emerges primarily from biological factors.”
The guidelines come as new drug treatments emerge for obesity in children, including the approval late last month of Vegovy, a weekly injection, for use in children 12 years and older. Different dosages of the drug, called semaglutide, are used under different names to treat diabetes. A recent study published in the New England Journal of Medicine found that Vegovy, made by Novo Nordisk, helped teenagers reduce their BMI by an average of 16%, which is better than adults.
Within days of the December 23 authorization, pediatrician Dr. Claudia Fox prescribed the drug to one of her patients, a 12-year-old girl.
“It offers patients the possibility of having a near-normal body mass index,” said Fox, a weight-management expert at the University of Minnesota. “It’s like a whole other level of growth.”
Obesity researcher Dr. Justin Ryder at Chicago’s Lurie Children’s Hospital said the drug affects the way energy is regulated between the brain and the gut.
“It works with how your brain and gut communicate with each other. And it helps you feel fuller than you would otherwise,” he said.
Still, specific doses of semaglutide and other anti-obesity drugs have been hard to come by due to manufacturing issues and recent shortages due to high demand, claims of weight loss by celebrities on TikTok and other social media platforms Is.
Plus, many insurers won’t pay for the drug, which costs about $1,300 a month. Fox said, “I submitted the prescription yesterday. I’m not holding my breath because insurance will cover it.”
An expert on pediatric obesity has warned 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,” says Dr. Robert Lustig said. “I am against the voluntary 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. Excessive sugar has long been blamed for the rise in obesity. He urges paying close attention to diet, especially ultra-processed foods that are high in sugar and low in fiber.
Dr. Stephanie Byrne, a pediatrician at Cedars Sinai Medical Center in Los Angeles, said she would like more research into the drug’s effectiveness in a more diverse group of children and potential long-term effects before prescribing it routinely.
“I would like to see it used a little more consistently,” he said. “And you have to come in often to keep an eye on that patient.”
Also, they welcomed the group’s new emphasis on rapid and intensive treatment of obesity in children.
“I definitely think it’s a realization that diet and exercise are not working for many teens who are struggling with this, probably the majority,” she said.