Experts recommend orlistat or metformin to treat disease affecting more than 14 million children
The American Academy of Pediatrics (AAP) on Monday recommended the use of weight-loss drugs in children ages 12 and older to treat obesity, which affects an estimated 14.4 million children and adolescents in the United States and Can cause serious health complications. ,
The new guidelines, the first in more than a decade, focus on obesity treatment rather than prevention. “I think they’re important because there are actually many misunderstandings about the causes of obesity and some unwanted prejudice, including about childhood obesity, by medical providers,” said Dr. . Mark Michalski said. Author of the guidelines.
The expert group said that treatments such as weight loss pills
OrlistatNovo Nordisk’s semaglutide, an injectable diabetes treatment repurposed for weight loss under the brand
Wegsand the oldest generic drug for diabetes,
metformincan be given in addition to lifestyle and health behavior changes.
metformin It has been used off-label to reduce weight in children. Of 27 randomized trials of metformin for weight loss in children that were reviewed by the guideline panel, 74% showed some positive effect of the drug. “In particular, children with more immediate and life-threatening co-morbidities, those who are older, and those with more severe obesity may require additional therapeutic options,” the group said.
The threshold for pediatric obesity is a body mass index (BMI), which is a ratio of weight and height above the 95th percentile for children of the same age and sex. Severe obesity is defined as a BMI greater than 20% above the 95th percentile cutoff point.
Orlistat GlaxoSmithKline is approved by the US Food and Drug Administration for the long-term treatment of obesity in children 12 years of age and older. The appetite suppressant phentermine is approved for ages 16 and older.
Last month, Wegovy received US approval for chronic weight management in children 12 years of age and older. The FDA has also approved Novo Nordisk’s diabetes drug Saxenda (liraglutide) for the treatment of obesity in adolescents 12 years and older.
Metabolic and bariatric surgery for some teenagers
The FDA has also approved an add-on indication for Vivas Qsymia (phentermine and topiramate extended-release capsules) for chronic weight management in obese patients 12 years of age and older.
The guideline panel noted that many of the trials it reviewed excluded children with mental health problems, limitations in physical activity or use of certain medications. “In clinical practice, these children are often in greatest need of assistance in overcoming obesity,” said the authors. For children ages 2 to 12, the AAP states that there is currently not enough evidence to recommend the use of these drugs.
They also include recommendations for annual diagnosis of obesity in children age 6 and older through exercises such as BMI control and motivational interviewing.
The group also recommends metabolic and bariatric surgery for the treatment of severely obese adolescents.
Intensive counseling of children and parents on health behaviors and lifestyle over a period of three to 12 months is an effective treatment for childhood obesity, but is “difficult to administer and not universally available,” the AAP said.