Additional information: Use medicines and surgery early for childhood obesity.

By Justin Jones On Jan 10, 2023

Additional information: Use medicines and surgery early for childhood obesity. According to new guidelines announced on Monday, children who are battling with obesity should be examined and treated early and aggressively, including with drugs for children as young as 12 and surgery for children as young as 13.

More than 14.4 million children and adolescents in the United States are overweight or obese. Yet, this problem only worsens due to the common practice of “watchful waiting,” or delaying treatment in the hopes that the child or adolescent would outgrow their condition. Obesity is associated with severe health issues, including hypertension, diabetes, and depression, if left untreated.

Waiting around isn’t an option, according to Dr. Ihuoma Eneli, a co-author of the first American Academy of Pediatrics recommendations on childhood obesity in 15 years. This leads us to conclude that their weight gain will continue throughout adulthood, increasing the risk that they will be obese.

According to Eneli, director of the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital in Columbus, Ohio, the group’s guidance establishes for the first time ages at which children and adolescents should be offered medical treatments like drugs and surgery in addition to intensive diet, exercise, and other behavior and lifestyle interventions.

Adolescents over the age of 12 who are overweight should be offered appropriate medication, and those over the age of 13 who are severely overweight should be referred for surgical intervention. However, individual circumstances may call for different approaches.

Aiming to correct the misconception that obesity is “a personal problem, maybe a failing of the person’s diligence,” Dr. Sandra Hassink, medical director of the AAP Institute for Healthy Childhood Weight and a guideline co-author, explained the rationale behind the recommendations.

Hassink compared the situation to someone with asthma being given an inhaler.

Obese children and teens have a body mass index at or above the 95th percentile for their age and gender. Any child who reaches or exceeds such weight by more than 120 percent is regarded as severely obese. Height and weight data determine a person’s Body Mass Index (BMI).

The Centers for Disease Control and Prevention report that roughly 20% of American children and adolescents and about 42% of adults are obese.

According to Aaron Kelly, co-director of the Center for Pediatric Obesity Medicine at the University of Minnesota, the group’s recommendations consider that obesity is a biological problem and that the illness is a complicated, chronic disease.

The epidemic of obesity is not the result of poor choices in diet and exercise. He emphasized that poor lifestyle choices did not cause this illness. “Biological causes are mostly responsible for its emergence.”

Wegovy, a once-weekly injectable for treating obesity in children aged 12 and older, was approved at the end of last month, coinciding with the publication of these guidelines. Different brands of semaglutide, a medication used to treat diabetes, are available under several brand names. Novo Nordisk’s Wegovy was found to be more effective in helping adolescents reduce their body mass index (BMI) by roughly 16 percent compared to the findings seen in adults, according to a study published in the New England Journal of Medicine.

Dr. Claudia Fox, a pediatrician, prescribed the medication to a 12-year-old girl just days after it was approved on December 23.

Fox, an expert in weight management at the University of Minnesota, stated, “What it provides patients is the possibility of even having an almost normal body mass index.” We’re talking about a quantum leap, someone said.

Dr. Justin Ryder, an obesity researcher at Chicago’s Lurie Children’s Hospital, explained that the medicine alters how the brain and the gut communicate to control energy levels.

“It helps you feel more full than you would otherwise by altering the signals between your brain and stomach,” he explained.

However, semaglutide and other anti-obesity medications have recently been hard to procure due to shortages caused by manufacturing problems and strong demand, which has been stoked in part by celebrities on TikTok and other social media platforms bragging about accelerated weight reduction.

Not only is the monthly cost of the prescription, around $1,300, prohibitive, but many insurance companies also refuse to cover it. The drug was sent out yesterday,” Fox stated. I wouldn’t put any money on insurance to pay for it.

Although children with obesity require prompt and comprehensive treatment, one expert in the field expressed concern that some physicians might be too fast to resort to medicines or surgery.

Dr. Robert Lustig, a pediatric endocrinologist at UCSF for many years, has said, “It’s not that I’m against the drugs.” I’m afraid I must disagree with prescribing these drugs indiscriminately without first investigating the issue’s root.

According to Lustig, it’s essential to do in-depth assessments of each child to identify the causes of their obesity. As far back as he can remember, he has linked increased obesity rates to an increase in sugar consumption. The ultraprocessed, high-sugar, low-fiber foods are the ones he says people should pay the most attention to cutting out of their diets.

Dr. Stephanie Byrne, a pediatrician at Cedars-Sinai Medical Center in Los Angeles, said she wants to see additional studies on the drug’s long-term effects and effectiveness in a more diverse group of children before she prescribes it routinely.

She expressed her desire for “a bit more consistent use” of the term. Moreover, I’d need to see that patient often for follow-up checks.

She also applauded the group’s renewed commitment to providing intensive care for children with obesity as soon as possible.

“I think this is an awareness that diet and exercise are not going to solve it for a percentage of teenagers battling with this,” she added.