New guidelines recommend medication and surgery for some obese children in the US

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New guidelines in the US recommend early intervention, including medication and surgery, for some obese children. The American Academy of Pediatrics (AAP) released new guidance on child obesity for the first time in 15 years on Monday 9th January. One of the key points was to recommend treatment early rather than delaying therapies or interventions, which could increase risks. Statistics show that almost 15 million young people in the US are classed as obese.

The first step to reduce rates of obesity among children and young people should be changes in lifestyle and behaviour patterns, according to the AAP. These include adopting healthy eating plans, monitoring eating habits and increasing activity levels. Obesity is known to increase the risk of type 2 diabetes and elevated blood pressure. 

The new guidelines promote lifestyle changes and new behaviours as the first line of defence but they also warn against delaying intervention in cases where there is a high risk that children won’t be able to lose weight by adjusting their lifestyle. The revised guidance encourages health professionals to view obesity as a “biological disease” rather than thinking of it solely as a lifestyle problem. 

Dr Ihuoma Eneli, co-author of the guidelines, explained that it’s often beneficial to act early, stating that, “Waiting doesn’t work.” For the first time, the academy recommends treatments, including medication for children as young as 12 years old and surgery for children as young as 13. In most cases, these options would be offered when individuals cannot or have not lost weight through lifestyle adjustments. 

There are currently multiple weight loss medications on offer in the US, including an injection known as Wegovy. This weekly injection was approved by the US FDA recently and is suitable for adults and children over the age of 12. Trials indicate that it contributes to average weight loss of 16% in teenagers. 
Rates of childhood obesity have increased year by year in the US. In the last 15 years, the proportion of children who are obese has risen from 17% to 20%, according to CDC (Centers for Disease Control and Prevention) figures. The increased prevalence of obesity has contributed to a surge in the demand for weight loss therapies, surgery and medication. Some doctors have expressed concerns over the availability of medications, as well as the cost. 
Statistics show that the US has a higher rate of childhood obesity than Canada and European countries. Trends are ticking up across the world. Data from Obesity Evidence Hub suggests that rates are highest in the Pacific Islands. More than 30% of children are obese in Nauru, Palau and the Cook Islands. Globally, the number of obese children is set to reach 254 million by 2030. In 1975, 11 million children were obese. 

The aim of revising childhood obesity guidelines is to prevent children who are already obese from gaining more weight. By intervening early, experts believe that they can increase the chances of helping obese young people to lose weight and lower the risk of more complex health complications. 
There are several factors that can increase the risk of obesity among children. Obesity is often thought of as a lifestyle issue, but often, there is a genetic link. In some cases, underlying health issues and a child’s family life and environment can also cause them to gain weight. 

Obesity in children is usually diagnosed using BMI (body mass index). BMI is calculated using an individual’s height and weight. BMI calculators provide a figure based on the child’s height and weight. This figure will fit into a bracket, providing an insight into whether they are underweight, a normal weight, overweight or very overweight/obese. For children, the result is given as a percentile. A healthy weight falls between the 5th and 85th percentile in the US. In the UK, the NHS classes a healthy weight as a result between the 3rd and 91st centile.