Children and adolescents should be proactively evaluated and treated for obesity, according to new American Academy of Pediatrics guidelines on childhood obesity.
The guidelines note that treatments, including drugs and weight-loss surgery, can be effective and can help reduce the risk of developing other health conditions.
The AAP also said that childhood obesity is a disease with genetic, social and environmental factors — not something caused by individual choice — and that it should not be stigmatized by health care providers.
“Weight is a sensitive topic for most of us, and children and teenagers are particularly aware of the harsh and unfair stigma that comes from being affected by it,” Dr Sarah Hample, lead author of the guidelines and a pediatrician and management specialist of weight at Children’s Mercy of Kansas City, it said in a statement. “Our children need the medical support, understanding and resources we can provide within a treatment plan that includes the whole family.”
One in 5 children and teens in the U.S. lives with obesity, according to the Centers for Disease Control and Prevention. Obesity is a serious condition that, if left untreated, can lead to long-term health problems.
Overweight and obesity are diagnosed after a doctor uses height and weight to calculate a body mass index, or BMI. The tool compares the child’s weight and height with other children of the same age and gender. Overweight means a BMI 85% higher than that of others their age and sex, while obese children are at or above 95%. BMI is an imperfect tool, but it can still help doctors identify patient concerns, experts said.
Obese children are at higher risk of diseases such as type 2 diabetes, heart disease, obstructive sleep apnea and depression.
Pediatricians should screen obese children for these and other conditions at routine checkups, the AAP said in the new guidelines.
Lowering your BMI with treatment can help prevent these other health problems, according to the AAP.
Previous AAP guidelines published in 2007 recommended a “watchful waiting” approach to childhood obesity. But evidence accumulated over the past decade shows that there is no benefit in delaying and that weight loss treatments are effective in children and adolescents. The new guidelines recommend that they be used for all children over the age of 2 who are overweight and obese.
Children 6 and older can receive monthly behavioral therapy to help them make lasting health changes, according to the new guidelines. Teens may be eligible for weight loss medications along with continued diet and exercise. And for severely obese teenagers, weight loss 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 teenagers must also be delivered in a way that takes into account the culture and language preferences 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 talk to their child’s pediatrician to make additional health and lifestyle changes, but they can model and encourage healthy eating and physical activity in their children, the AAP said.
Cooking with kids can get them excited about healthy eating. Preparing meals with vegetables, fruits and grains can ensure a balanced diet. Children should be encouraged to stay active every day or play sports.
While childhood obesity is common, the AAP said many children, teens and parents face weight-based stigma — even though many factors contributing to obesity, such as genetics and structural racism, are beyond individual control. New AAP guidelines urge pediatricians and other health care 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 treatments for the groups most at risk.
Cara Manier, MD, is a member of the ABC News Medical Unit and a resident physician at Los Angeles County + University of Southern California Medical Center.
Nicole McLean MD, MPH, is an ABC News medical staff member and a resident physician in pediatrics at Columbia University/NewYork-Presbyterian.
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