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The latest guidelines from the American Academy of Pediatrics on the treatment of obesity urge the immediate use of behavioral therapy and lifestyle changes, and say surgery and medication should be used for some young people.
The guidelines, published Monday in the journal Pediatrics, are the first comprehensive update of the Academy’s obesity treatment guidelines in 15 years. They provide guidance on treating children from age 2 through her teenage years.
The guidelines acknowledge that obesity is complex and linked to factors such as access to nutritious foods and health care.
Treatment for younger children should focus on behavioral and lifestyle treatments for all family members, including nutritional support and increased physical activity. According to the AAP, the use of weight-loss medications, in addition to health-behavioral and lifestyle treatments, is appropriate for children over the age of 12. According to the guidelines, severely obese teens over the age of 13 should be , should be evaluated for surgery.
Dr. Sandra Hasink, author of the guidelines and Vice Chair of the AAP’s Clinical Practice Guidelines Subcommittee on Obesity, said: statement“The goal is to help patients make lifestyle, behavioral, or environmental changes in a sustainable way and involve their families in decision-making at every step.”
For children and adolescents, overweight is defined as a body mass index above the 85th percentile and below the 95th percentile. Obesity is defined as a BMI above the 95th percentile.
Miles Faith, a psychologist at the State University of New York at Buffalo who studies childhood eating behavior and obesity, said the causes of childhood obesity are complex and that treatment must be a team effort. I commended this new report, which acknowledged that
“It’s not one cause for all kids,” he says. “There are no reports of this kind saying that there are more options and that the possibility of medication should not be automatically downplayed and the role of surgery should not be downplayed. For some families, it should be considered. It could be that,” said Faith, who was not involved in creating the guidelines.
The new guidelines do not address obesity prevention. This will be addressed in another of his AAP policy statements going forward, the company said.
Rebecca Carter, Ph.D., pediatrician at the University of Maryland Children’s Hospital and assistant professor at the University of Maryland School of Medicine, said: email on Monday.
“New to these recommendations are several new medication management strategies that have proven highly successful in treating obesity as a chronic disease in adults and are currently being used in children and adolescents. “It’s recommended for use in people,” Carter said. “This is a big step toward seeing overweight and obesity as a chronic disease.”
She also added that the recommendations are “a big step forward” in helping both parents and medical teams “take responsibility” for the long-term health risks in children associated with overweight and obesity. .
“They have ways to treat these conditions, there are subtle causes for these conditions that go beyond simple solutions, and there are things that certainly take our focus away from outdated or unhealthy diet strategies. We provide a variety of tools to help families empower themselves with this,” Carter said.
While the new guidelines are designed for health care providers, Carter said parents should talk to their child’s doctor if they have concerns about weight and discuss strategies for optimizing health and monitoring changes. said.
“Also, it is appropriate to do this in a child-focused manner, being careful not to stigmatize children or make them feel bad about their bodies, but also to teach children to be themselves. It empowers you to feel that you have the tools your body needs to stay healthy.”
The new guidelines are “a much-needed advance” to bring holistic care in line with current science, says Jennifer Wu, assistant professor of pediatrics at Columbia University in New York City and director of the Childhood Obesity Initiative. Dr. Bidal said in a separate email on Monday. .
“The adoption of new guidelines can reverse the childhood obesity epidemic,” she said. , will be needed to moderate policies and practices that widen socioeconomic disparities. While the guidelines support the advocacy efforts of pediatricians, we, as a society, are committed to promoting healthy living for our nation’s children. We need to demonstrate our support for a safer environment.”
According to the AAP, more than 14.4 million children and teens are living with obesity. Overweight or obese children are at increased risk of asthma, sleep apnea, bone and joint problems, type 2 diabetes, and heart disease, according to the U.S. Centers for Disease Control and Prevention.
Another study published last month in the journal of the American Diabetes Association diabetes caresuggests that if current trends continue, the number of people under the age of 20 with type 2 diabetes in the United States could increase by nearly 675% by 2060.
Last month, the CDC announced updated growth chart This can be used to track severely obese children and teenagers.
A growth chart is a standardized tool used by health care providers to track growth from infancy through adolescence. But as obesity and severe obesity have become more prevalent over the past 40 years, more than 4.5 million children and their teens suffered from severe obesity in 2017-2018, the agency said. increase.
Growth charts used since 2000 are based on data from 1963 to 1980 and never exceeded the 97th percentile. New expanded percentiles incorporate more recent data and provide a way to monitor and visualize very high body mass index values.
According to the CDC, existing growth charts for nonobese children and adolescents won’t change, but the expanded growth chart will help health care providers treating patients with severe childhood obesity.
“Prior to today’s release, growth charts have not grown enough to plot the BMI of increasing severely obese children. help optimize the care of said in a statement“Providers can work with families on comprehensive care plans to address childhood obesity.
