Childhood obesity should be treated early with aggressive treatments, including anti-obesity drugs and weight-loss surgery, according to new guidelines released Monday.
The American Academy of Pediatrics’ guideline — the first in 15 years — suggested that children struggling with obesity should be evaluated and offered intensive treatment options earlier, such as medications for children as young as 12 and surgery for those as young as 13. According to the group, delaying treatment or practicing “watchful waiting” will only exacerbate the disease.
“There is no evidence that ‘watchful waiting’ or delayed treatment is appropriate for children with obesity,” said Dr. Sandra Hassink, co-author of the guideline and medical director for the AAP Institute for Healthy Childhood Weight, in a statement.
More than 14.4 million children and teens in the United States are affected by obesity, according to the AAP. When left untreated, obesity can cause serious short and long-term health problems, including cardiovascular diseases, diabetes, and depression.
The group’s guidance “highlights more evidence than ever that obesity treatment is safe and effective,” according to an AAP news release.
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The guideline sets ages for when children and teens can be offered medical treatments such as medication and surgery — in addition to exercise, dieting, and other behavioral or lifestyle interventions, said Dr. Ihuoma Eneli, co-author of the guideline and director of the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital in Columbus, Ohio.
According to the group, the guideline intends to change the stigma around obesity and highlights the disease as a complex, biological issue.
“Weight is a sensitive topic for most of us, and children and teens are especially aware of the harsh and unfair stigma that comes with being affected by it,” said Dr. Sarah Hampl, a lead author of the guideline.
The AAP recommends that doctors should offer adolescents 12 and older with obesity access to appropriate pharmacotherapy and teens 13 and older with severe obesity should be evaluated for weight-loss surgery. But situations may vary and the group urged for a comprehensive review of each individual’s medical history and other related factors.
According to the AAP, young people with a body mass index that reaches or exceeds the 95th percentile for children of the same age and gender are considered obese. Those who reach or exceed that by 120% are considered to have severe obesity.
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The guideline follows the emergence of new drug treatments for childhood obesity, such as the approval of Wegovy in December. Wegovy is a weekly injection used for children ages 12 and older.
The drug is also used in different doses under different names to treat diabetes.
A recent study published in the New England Journal of Medicine found that Wegovy helped teens reduce their BMI by about 16% on average, better than the results in adults.
But anti-obesity medications have been inaccessible due to recent shortages caused by manufacturing problems and high demand.
Doctors have also cautioned about the immediate use of medication and surgery, emphasizing the need for individual evaluation.
“It’s not that I’m against the medications,” Dr. Robert Lustig, a longtime specialist in pediatric endocrinology at the University of California, San Francisco, told The Associated Press. “I’m against the willy-nilly use of those medications without addressing the cause of the problem.”
Contributing: The Associated Press