New Obesity Guidelines for Children and Adolescents
Jan 30, 2023
For the first time in fifteen years, the American Academy of Pediatrics (AAP) released new treatment guidelines for children and adolescents with obesity. The Guidelines recognize that this chronic disease is complex, and that in addition to our environment and lifestyle behaviors, our genes and biology play a large role in why children and adults have obesity. Obesity treatment is effective and should begin early in the course of the illness—watchful waiting usually doesn’t work.
More than 14.4 million U.S. children and teens are overweight or have obesity. To evaluate and treat obesity successfully, primary care physicians must first consider different factors that can affect a patient and their family; these factors include things like genetics or family history, social or environmental impacts, and biological risks. Due to inequities that promote obesity in childhood—like economic and social conditions—every patient needs care that is unique to them; there is no “one-size-fits-all” approach.
In addition to identifying factors that may influence a patient’s risk for obesity, the new guidelines recommend that clinicians use the following strategies to treat their patients:
Motivational interviewing or counseling
Intensive health behavior and lifestyle treatment
Medication and weight loss surgery (this can be considered at certain ages, depending on the severity of the obesity)
Primary care providers should guide their patient and family every step of the way, using shared decision making to navigate treatment options that improve their child’s physical and mental health. The foundation of treating obesity is helping the family change their lifestyle and build new habits like diet and exercise. When families can work as a team, there is more evidence that treatment plans will be successful.
The new recommendations take a comprehensive approach towards treating childhood obesity, and this requires ongoing evaluation and the usage of community resources. We know obesity cannot be treated only in the four walls of a clinic; we need policies, infrastructure and systems in our society that improve access to treatment for all children and make it easier to adopt and sustain healthy lifestyle behaviors. It takes a village to care for all children.
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Ihuoma Eneli, MD
Center for Healthy Weight and Nutrition
Ihuoma U. Eneli, MD, MS is medical director at the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital and an associate professor of Clinical Pediatrics at The Ohio State University College of Medicine.
Marc P. Michalsky, MD
Bariatric (Weight Loss) Surgery Program
Marc P. Michalsky, MD, FACS, is the director of the Center for Robotic Surgery and the surgical director for the Center for Healthy Weight and Nutrition at Nationwide Children's Hospital, a multidisciplinary center dedicated to the treatment of overweight and obese children and adolescents.
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