New Guideline Includes Family in the Treatment Approach for Childhood Obesity

Article

Intensive health behavior and lifestyle treatment is the most effective behavioral treatment for childhood obesity.

The American Academy of Pediatrics (AAP) published a guide, titled “Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity,” which provides evidence that obesity treatment requires addressing multiple factors for children aged 2 years and older. Evidence-based recommendations include motivational interviewing, intensive health behavior and lifestyle treatment, pharmacotherapy, metabolic surgery, and bariatric surgery.

“Weight is a sensitive topic for most of us, and children and teens are especially aware of the harsh and unfair stigma that comes with being affected by it,” said Sarah Hampl, MD, chair of the Clinical Practice Guideline Subcommittee on Obesity and a lead author on the guideline, in a press release.

Obesity is defined as a body mass index (BMI) above the 95th percentile in children and teens of the same age and sex. In the United States, more than 14.4 million children and teens live with obesity. Left untreated, the condition is associated with short- and long-term health concerns, such as diabetes and cardiovascular disease (CVD).

The guideline supports policy changes to improve childhood health and wellbeing. Policies should address structural racism—considered a key driver in childhood obesity and health disparities—increased risk among children with special health care needs, and inequities associated with socioeconomic status and food insecurity, according to the AAP.

Further, the AAP recommends comprehensive obesity treatment with nutritional, behavioral, and physical therapies; intensive health behavior and lifestyle treatment (IHBLT); evidence-based treatment delivered by a trained health care professional and parent or caregiver; adjunct pharmacotherapy for positive behavior and lifestyle changes in children aged 12 years and older; and metabolic or bariatric surgery for severely obese children aged 13 years and older.

The AAP recommendations and guideline emphasize family involvement during the healing process. By including family in the decision-making process, sustainable lifestyle, behavioral, and environmental changes can be made, explains Sandra Hassink, MD, guideline author and vice chair of the Clinical Practice Guideline Subcommittee on Obesity, in the press release.

“Research tells us that we need to take a close look at families—where they live, their access to nutritious food, health care and opportunities for physical activity—as well as other factors that are associated with health, quality-of- life outcomes and risks,” Hampl said in the press release.

The clinical practices guideline does not address preventative measures to combat obesity but will be addressed in a future statement.

“The medical costs of obesity on children, families and our society as a whole are well-documented and require urgent action,” Hampl said. “This is a complex issue, but there are multiple ways we can take steps to intervene now and help children and teens build the foundation for a long, healthy life.”

Reference

American Academy of Pediagrics. American Academy of Pediatrics Issues Its First Comprehensive Guideline on Evaluating, Treating Children and Adolescents With Obesity. News Release. January 9, 2023. Accessed on January 25, 2023. https://www.aap.org/en/news-room/news-releases/aap/2022/american-academy-of-pediatrics-issues-its-first-comprehensive-guideline-on-evaluating-treating-children-and-adolescents-with-obesity/

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