New Guidelines: Childhood Obesity Requires Early, Aggressive Treatment

Children with obesity should be offered more intensive treatment options earlier, including therapy and medication, says the leading U.S. pediatricians group.

The American Academy of Pediatrics updated its treatment recommendations on childhood obesity for the first time in 15 years. The new guidance moves away from “watchful waiting,” or delaying treatment to see if children outgrow obesity.

For years, the AAP has recommended that doctors take the ‘wait and see’ approach to treating a child’s weight. Now, the organization says delaying treatment could lead to lifelong health problems like heart disease and diabetes. 

The group is now advising pediatricians to offer treatment options early and at the highest available intensity for one of the most common chronic diseases among children. 

Children with obesity have a body mass index (BMI) at or above the 95th percentile, according to the Centers for Disease Control. Untreated, obesity is associated with a range of long-term health problems including heart disease and diabetes.

The guidelines acknowledge that obesity is complex and tied to access to nutritious foods and health care, among other factors.

Treatment for younger children should focus on behavior and lifestyle treatment for the entire family, including nutrition support and increased physical activity. 

For children 12 and older, the use of weight loss medications is appropriate, in addition to health behavior therapy and lifestyle treatment, the academy says. Teens 13 and older with severe obesity should be evaluated for surgery, according to the guidelines.

The new guidelines are designed for health care providers, but experts are advising that parents should talk with their children’s doctor if there are concerns about weight, and discuss strategies to optimize health and monitor changes.

The new guidelines do not discuss obesity prevention; it will be addressed in another policy statement to come, the American Academy of Pediatrics says.

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