New national guidelines for treatment of childhood obesity include options for medications, surgery

Published: Jan. 31, 2023 at 4:26 PM CST
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ST. LOUIS, Mo. (KMOV) - The American Academy of Pediatrics is releasing new guidelines for the treatment of childhood obesity, expanding options to include weight loss medication and surgery.

The guidelines, the first from the academy to address childhood obesity, come as nearly one in five children under the age of 18 is diagnosed with obesity.

“We encounter more and more kids who have very high weights and have comorbidities or complications from their high weights like diabetes, high blood pressure or sleep apnea,” said Dr. Jennifer Sprague, a Washington University Pediatric Endocrinologist at St. Louis Children’s Hospital. “In those kids, lifestyle alone is maybe not adequate to treat them so giving us these other tools like medication or thinking about surgery are a good addition to our treatment planning.”

Sprauge said while diet and exercise will remain a primary component of treatment plans, more drastic options need to be considered in some cases.

“It’s still important but we know even those interventions have a fairly small impact on people’s weights and it’s common to have regain after you complete an intervention like that,” she said. “So if I’m encountering a kid whose BMI is already 40 and they’ve developed Type 2 Diabetes that alone is probably not enough.”

The new guidance includes treatment plans that may include medication and in some cases, weight loss surgery. The guidelines recommend the option for gastric sleeves or gastric bypass surgery for children 13 years old and older, but Sprauge said St. Louis Children’s Hospital has performed weight loss surgery on children only as young as 15.

“It’s not a quick you come in to clinic, say you want weight loss surgery and you get it scheduled one week later,” she said. “It’s at least six months working with us on behavioral modification and a really extensive workup working with a lot of people before you get approval.”

The causes of obesity are complex, she says, and doctors are beginning to shy away from the thought process that many children will outgrow obesity and instead, intervene earlier.

“We know most children who have obesity will grow up to be adults with obesity,” she said.