Medical professionals want to mitigate the stigma of childhood obesity by encouraging proactive treatment.
The American Academy of Pediatrics on Monday issued its first comprehensive guidelines for treating children and adolescents with obesity.
"Watchful waiting is no longer recommended," said Dr. Matthew Haemer, director of Clinical Obesity and Nutrition Fellowship for Physicians at Children's Hospital Colorado.
According to the Centers for Disease Control, approximately 20% of children and teens live with obesity, which can lead to long-term health problems when left untreated.
Haemer, who is a member and incoming chair of the AAP's executive committee of the section on obesity, said the new guidelines focus on behavioral treatment, medications and potentially surgery.
Behavioral health treatments should be centered around the family unit, dietitians and providers trained in treating obesity, Haemer said.
"The most effective treatments include 26 or more hours of face-to-face, family-based, multicomponent treatment over a 3- to 12-month period," the AAP says.
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Updated growth charts by the CDC now extend to a body mass index of 60 — up from previous charts that stopped at a BMI of 37.
The guidelines say providers should also consider medication to treat obesity in adolescents 12 years and older.
Haemer said the combination of phentermine and topiramate has been shown to be effective — with a degree of weight loss between 20 to 30 pounds. He added that a classification of drugs known as GLP-1 agonists has also been proven to help with weight loss, in excess of 30 pounds.
Haemer, who also serves as an associate professor in the Department of Pediatrics/Section of Nutrition at the University of Colorado Anschutz Medical Campus, noted that price can be a barrier. The generic version of phentermine and topiramate can cost around $30 a month and GLP-1 agonists are upwards of $1,500 per month, he said. However, he noted that drug companies offer programs that will provide the medications at a discounted rate.
In severe cases, teens with a BMI greater than 120% of the 95 percentile for their age and gender, surgery should be considered, according to the new guidelines.
"This is a complex issue, but there are multiple ways we can take steps to intervene now and help children and teens build the foundation for a long, healthy life," said Dr. Sarah Hampl, a lead author of the guidelines.
Haemer said one of the biggest takeaways from these guidelines is that childhood obesity is not just the result of a personal choice. He notes that there are various contributors, including genetics, socioeconomics, the environment and policies.
"It is a chronic disease that deserves medical follow-up," he said.
