Children struggling with obesity should be evaluated and treated early and aggressively, including with medications for kids as young as 12 and surgery for those as young as 13, according to new guidelines released Monday. The longstanding practice of “watchful waiting," or delaying treatment to see whether children and teens outgrow or overcome obesity on their own only worsens the problem that affects more than 14.4 million young people in the US, according to the guidance. Left untreated, obesity can lead to lifelong health problems, including high blood pressure, diabetes, and depression, per the AP.
"Waiting doesn’t work,” said Dr. Ihuoma Eneli, co-author of the first guidance on childhood obesity in 15 years from the American Academy of Pediatrics. “What we see is a continuation of weight gain and the likelihood that they’ll have (obesity) in adulthood.” For the first time, the group's guidance sets ages at which kids and teens should be offered medical treatments such as drugs and surgery—in addition to intensive diet, exercise, and other behavior and lifestyle interventions. In general, doctors should offer adolescents 12 and older with obesity access to appropriate drugs, while teens 13 and older with severe obesity should get referrals for weight-loss surgery, though situations may vary.
One expert in pediatric obesity cautioned that while kids with obesity must be treated early and intensively, he worries that some doctors may turn too quickly to drugs or surgery. “It’s not that I’m against the medications,” said Dr. Robert Lustig, a longtime specialist in pediatric endocrinology at the University of California, San Francisco. “I’m against the willy-nilly use of those medications without addressing the cause of the problem.”
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The guidelines aim to reset the inaccurate view of obesity as “a personal problem, maybe a failure of the person’s diligence,” said Dr. Sandra Hassink, medical director for the AAP Institute for Healthy Childhood Weight, and a co-author of the guidelines. “This is not different than you have asthma and now we have an inhaler for you,” Hassink said. Young people who have a body mass index that meets or exceeds the 95th percentile for kids of the same age and gender are considered obese. Kids who reach or exceed the 120th percentile are considered to have severe obesity. BMI is a measure of body size based on a calculation of height and weight
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