Children and adolescents should be proactively assessed and treated for obesityaccording to the new American Academy of Pediatrics guidelines for childhood obesity.
The guidelines note that treatments, including medications and bariatric surgery, can be effective and can help reduce the risk of developing other health problems.
The AAP also said childhood obesity is a disease with genetic, social and environmental factors — not something caused by individual choices — and should not be stigmatized by health care providers.
“Weight is a sensitive subject for most of us, and children and adolescents are particularly aware of the harsh and unfair stigma that comes with it,” said Dr Sarah Hampl, lead author of the guidelines and pediatrician and specialist. of weight management. at Children’s Mercy of Kansas City, said in a statement. “Our children need the medical support, understanding and resources that we can provide as part of a treatment plan that involves the whole family.”
One in five American children and adolescents lives with obesity, according to centers for disease control and prevention. Obesity is a serious disease which, if left untreated, can lead to long-term health problems.
Overweight and obesity are diagnosed after a doctor uses height and weight to calculate body mass index, or BMI. The tool compares a child’s weight and height to those of other children of the same age and gender. Being overweight means having a BMI that is 85% higher than other people their age and sex, while obese children have a BMI of 95% or more. BMI is an imperfect tool, but can still help doctors identify patient concerns, experts said.
Obese children are at higher risk for diseases such as type 2 diabetes, heart disease, obstructive sleep apnea and depression.
Pediatricians should screen obese children for these and other conditions during routine exams, the AAP said in the new guidelines.
According to the AAP, reducing BMI with treatment can help prevent these other health problems.
Previous AAP guidelines, published in 2007, recommended a “watchful waiting” approach to childhood obesity. But evidence gathered over the past decade has shown that there is no benefit to delaying and that weight loss treatments are effective for children and adolescents. The new guidelines recommend using them for all overweight and obese children over 2 years old.
Children 6 and older can receive monthly behavioral therapy to help them make lasting health changes, according to the new guidelines. Teenagers may be eligible for weight-loss medication, as well as continued diet and exercise. And for teenagers with severe obesity, bariatric surgery is a safe and effective option.
The AAP recommends treating overweight and obesity as a chronic disease. For effective treatment, parents and children may need to see their doctor regularly.
All services for children and adolescents must also be delivered in a way that takes into account the culture and language preference of patients, the guidelines say. By working with families to identify personal beliefs, risk factors, and challenges, pediatricians can provide a personalized treatment plan.
Parents should speak to their child’s pediatrician about making additional health and lifestyle changes, but can model and encourage healthy eating and physical activity for their children, the AAP said.
Cooking with kids can get them excited about healthy eating. Preparing meals with vegetables, fruits and grains can provide a balanced diet. Children should be encouraged to stay active daily or play sports.
Although childhood obesity is common, the AAP said many children, teens and parents face weight-related stigma – even though many contributing factors to obesity, such as genetics and structural racism, are beyond individual control. The new AAP guidelines call on pediatricians and other healthcare providers to avoid stigmatizing language when discussing weight with patients.
The organization is also calling for policy changes that could help reduce racial disparities in childhood obesity, including improving access to healthy foods and treatment for groups most at risk.
Karra Maniér, MD is a member of the ABC News Medical Unit and Resident Physician at Los Angeles County + University of Southern California Medical Center.
Nicole McLean MD, MPH, is a member of the ABC News Medical Unit and a pediatric resident physician at Columbia University/New York-Presbyterian.