New Children's Obesity Treatment Guidelines: What Do They Mean for Your Child?

The American Academy of Pediatrics (AAP) recently released a report on evidence-based treatment recommendations for childhood obesity. The report grabbed headlines across the country, as it mentioned medication and surgery as two of the treatment options for children struggling with their weight. While the AAP did suggest medication or bariatric surgery for certain children as young as age 13, these recommendations represented a very small portion of the complete report.

“There is scientific evidence that obesity causes a myriad of adverse health outcomes,” says Amanda Jacobs, MD, Section Chief of Adolescent Medicine at WMCHealth’s Maria Fareri Children’s Hospital. “Historically, we’ve taken a ‘watch and wait’ approach to addressing childhood obesity. With these guidelines, the AAP makes it clear that this isn’t a successful approach — the sooner we address obesity, the more successful we are with treatment.” The AAP uses the full report to outline evidence-based recommendations for more proactive treatment methods.

Obesity affects more than 14.4 million children and adolescents across the United States, but its root causes vary greatly.

A Complex Condition

Obesity affects more than 14.4 million children and adolescents across the United States, but its root causes vary greatly. “This is a complex and chronic condition, and needs to be treated as such,” says Dr. Jacobs. “In their report, the AAP acknowledges that obesity isn’t just caused by individual or family history. A lot of factors contribute to obesity, such as structural racism, access to fresh foods, community safety and other social inequities.”

Structural and social inequities are often beyond people’s control, and they not only increase the risk of developing obesity but also impede access to effective treatment options. Some treatment recommendations involve programs that not everyone has access to, whether because of a lack of adequate insurance coverage, transportation or other factors.

“Obesity isn’t just a healthcare issue — it’s something that affects our society as a whole,” says Dr. Jacobs. “This report is mainly for providers, but it can also serve as inspiration for policymakers to address childhood obesity at a higher level.”

Communication Matters

The AAP’s guidelines go into detail about what pediatricians can do to address obesity and promote healthy lifestyle habits. “There’s no magic wand,” says Dr. Jacobs. “And obesity is a sensitive topic for everyone, which is why it’s important to use supportive, non-stigmatizing strategies when communicating with children about their weight.”

Within their recommendations, the AAP suggests that childhood obesity be diagnosed through a thorough medical assessment including conducting a physical exam, outlining medication and social history, screening for social determinants of health, assessing mental health, detecting disordered eating concerns and determining readiness for change.

The main evidence-based approach recommended by the AAP is an intensive health behavior and lifestyle treatment (IHBLT) program. This program involves support from pediatricians, registered dietitians, behavioral health and exercise professionals and more. “This type of program requires at least 26 hours of family-based, face-to-face treatment over three to 12 months,” says Dr. Jacobs. “Basically, this helps the family troubleshoot what they can do to shift into healthy lifestyle practices.”

While not everyone has access to such a comprehensive program, it’s imperative for pediatricians to talk to families about how they can make healthy lifestyle changes within the context of what they can afford, what’s feasible in their community and what their health insurance can cover. And obesity treatment requires the cooperation of the family to work — children cannot make these changes alone.

Addressing concerns about a growing weight stigma, Dr. Jacobs wants to assure parents that childhood obesity isn’t a judgment, but rather a chronic condition that puts people at risk for many health complications. “Weight bias does exist in this country,” she says. “This is why it’s important to talk about body mass index (BMI) as a tool, not a precise measure of health. And when talking about addressing obesity, especially with kids, we want to talk more about creating healthy lifestyle habits instead of numbers on a scale or going on a diet.”

If you’re concerned about your child’s weight or would like more information on preventing obesity, reach out to a pediatrician at Maria Fareri Children’s Hospital.