Pediatricians say obese children in the US should be given weight-loss drugs in a controversial new ruling

The American Academy of Pediatrics (AAP) has released new guidelines for the treatment of childhood obesity for the first time in 15 years, including drugs and surgery as options for the first time.

The group noted that early and aggressive treatment is necessary because childhood obesity rates have risen over the past 15 years — from 17 percent to 20 percent, according to Centers for Disease Control and Prevention (CDC) figures.

The number of overweight children has tripled since the 1980s and quadrupled among young people.

The head of the division of pediatric endocrinology and diabetes at Mount Sinai Kravis Children’s Hospital, Dr Joan Han, said the pandemic made the problem worse, according to NBC News.

A report from the CDC revealed that the rate of weight gain nearly doubled in 2020 compared to the years before the pandemic.

Nearly 15 million children and teenagers in the United States are affected by obesity, according to CDC figures. Extra weight leads to physical health problems, such as type 2 diabetes and increased blood pressure, but also affects mental health.

The new guidelines note that obesity is a complicated and chronic condition with no simple solution.

The first approach should be to make lifestyle and behavioral changes, the AAP says, adding that the new recommendations also recommend for the first time that anti-obesity drugs and surgery be used.

The new approach comes after new research and approvals of new drugs.

The medical director of the AAP Institute for Healthy Childhood Weight, Dr Sandra Hassink, a co-author of the new guidelines, told NBC News that “we now have evidence that obesity therapy is effective. There is treatment, and now is the time to recognize that obesity is a chronic disease and should be addressed as we address other chronic diseases”.

The new guidelines encourage doctors to go in earlier rather than later, noting that there is no evidence that a wait-and-see approach works.

The guidelines state that among children aged six and over, and sometimes among those between two and five years of age, the first measure should be lifestyle and behaviour.

For those aged 12 and over, the new recommendations call for medicines and surgery to be used in addition to lifestyle changes.

Research has found that a person’s weight is affected by diet and exercise, but also by genetics and hormones, which has led to the development of new medicines.

“The breakthrough that happened in the last few years was that people started to realize that there are hormones made in the gut that have multiple roles related to obesity. By targeting these, drugs can help people feel full faster and help stabilize insulin levels, Dr Han told NBC News.

“The problem with these drugs is that they are very expensive and insurance often doesn’t cover them,” Dr Han added, noting that one of the drugs used, Wegovy, can cost $1,500 a month.

In addition to medication, the guidelines state that teenagers suffering from severe obesity should have the option of undergoing weight loss surgery.

“The sooner the better for many things,” Dr Han told NBC. “There is research showing that getting bariatric surgery earlier can reverse health problems like type 2 diabetes and high blood pressure, which is why surgery should be considered for pediatric patients.”

Dr. Hassink noted that surgery and drugs are not initial treatment options and should only be used in specific scenarios when lifestyle changes do not produce the necessary results.

She added that the lifestyle changes needed can be very difficult for many families to follow.

“It’s work in progress, but we can safely say that all of us in this country live in an environment that tends to promote obesity across the board,” Dr Hassink told NBC.

“There are a large number of drivers of obesity that come from the environment itself. The more unfavorable the environment around you, the more difficult it is to live a healthy lifestyle,” she added.

A pediatric endocrinologist at Cleveland Clinic Children’s, Dr Roy Kim, told the outlet that “we can recommend more servings of vegetables and more enjoyable physical activity. But if a person’s neighborhood doesn’t have any grocery stores to shop at or sidewalks or parks to walk in, these the recommendations not realistic”.

“We have to make hiking places safe, easy and comfortable. We need to find ways to take advantage of existing opportunities for people to exercise and access healthy food that is cheap and convenient,” Dr Han said.

“The best, most effective, safest and most economical approach will always be prevention,” Dr Kim added.

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