New guidelines for treating childhood obesity include medications and surgery

[ThatRobGuy]

A major medical group updated its guidance for treating childhood obesity. Here's what it says.

The American Academy of Pediatrics updated its recommendations on childhood obesity for the first time in 15 years.

www.nbcnews.com

For the first time in 15 years, the American Academy of Pediatrics on Monday released new guidelines for treating childhood obesity, emphasizing a need for early and intensive treatment.

The guidance comes as childhood obesity rates have continued to rise over the past decade and a half, increasing from 17% to 20%, according to data from the Centers for Disease Control and Prevention. Since the 1980s, obesity rates have tripled in children and quadrupled in adolescents.

The new guidelines emphasize that obesity is a complex and chronic condition without a simple fix. Intensive behavioral and lifestyle changes should be the first-line approach, but the AAP also includes recommendations for anti-obesity medications and surgery for the first time. These novel recommendations are in response to a windfall of research and drug approvals in the past few years.

For children ages 12 and up, one of the major changes in the recommendations is the inclusion of anti-obesity drugs and weight-loss surgery alongside lifestyle changes.



To me this feels a bit like jumping the gun. While there are things that are bad enough that they need pharmaceutical and surgical interventions to either treat the condition, or prevent imminent bad outcomes... Being overweight at age 12 or 13 doesn't feel like one of them.

I feel this way for a couple reasons:

1) a lot of bodily changes happen during puberty...especially in males, in the form of getting one of mother nature's best fat burners in the form of the 30-fold increase of testosterone they're about to get in the next 3 years (and that will last 5-10 years before tapering off)

2) chronic issues and serious outcomes related to weight are far from being "imminent" at that age... There's plenty of time to change eating and exercise behaviors at that age before it's done any real serious damage that can't be reversed. A 15 year old is statistically unlikely to be dealing with the same consequences of a 30+ BMI at that age compared to their 40 year old counterpart.

3) weight loss surgeries don't exactly have a stellar track record if the person isn't being supported in other ways. Per the NEJM "Many people do indeed find success with gastric bypass in the short term, but a majority of participants unfortunately regain much of the weight they lost. In fact, one study indicated that 59% of people regained 20% or more of the weight they originally lost after surgery." And my hunch would be, if a 13 year old has gotten to a 30+ BMI by that age, the proper encouragement and discipline isn't there to provide that support structure at home (where they'll be living for at least the subsequent 5 years)



Obesity rates climbing that high among youths is definitely a problem. But I think the solution is a little more of the public getting behind the Michelle Obama "get up and get moving" and the Jamie Oliver "let's find ways to make healthier food appealing to kids", and little less of the "let's give them diet pills and surgically re-route their digestive tract"

 

[comana]

Childhood obesity is a huge problem and the children usually don’t just “grow out of it”: Obese children often become obese adults. Focusing on the children, though, only addresses part of the problem when it is the child’s caregivers that are providing poor food choices and likely also obese.

 

[ThatRobGuy]

Childhood obesity is a huge problem and the children usually don’t just “grow out of it”: Obese children often become obese adults. Focusing on the children, though, only addresses part of the problem when it is the child’s caregivers that are providing poor food choices and likely also obese.

If the caregivers are providing poor food choices and not making them exercise and get a little more active, then gastric bypass surgery and prescription diet pills are unlikely to solve the problem...and, in fact, will likely introduce more problems.

Life After Bariatric Surgery

The success of weight loss surgery depends on how you care for yourself from recovery on. See the medications and support you may need, plus changes in diet, lifestyle and more.

www.ucsfhealth.org

Look at these guidelines...

For a person who has "the impulsiveness of youth", a lot of these (especially the nutritional guidelines) are going to be tough to follow. And some of the guidelines are going to be even tougher once they're in their 20's.

The dietary guidelines you have to follow (or are supposed to follow) after surgery are stricter than ones they should've been following before surgery, and while it may not mean much to a 14 year old, any adult who's ever had an eye strain headache or tension headache after a long stressful day at work, or has pulled a muscle or thrown out their back, knows the benefits of being able to take an NSAID to alleviate the pain...once you get weight loss surgery, that's no longer as safe of an option as it used to be since the risks of stomach bleeding and gastric ulcers increases a lot if you've had bariatric surgery.

There's a lot of big lifestyle adjustments that have to take place after bariatric surgery if you expect it to have the desired effect. It seems like a lofty expectation that a 14 year old (who can't even resist nuggets and fries) is going to be able to stick to it.

 

[comana]

If the caregivers are providing poor food choices and not making them exercise and get a little more active, then gastric bypass surgery and prescription diet pills are unlikely to solve the problem...and, in fact, will likely introduce more problems.

Life After Bariatric Surgery

The success of weight loss surgery depends on how you care for yourself from recovery on. See the medications and support you may need, plus changes in diet, lifestyle and more.

www.ucsfhealth.org

Look at these guidelines...

For a person who has "the impulsiveness of youth", a lot of these (especially the nutritional guidelines) are going to be tough to follow. And some of the guidelines are going to be even tougher once they're in their 20's.

The dietary guidelines you have to follow (or are supposed to follow) after surgery are stricter than ones they should've been following before surgery, and while it may not mean much to a 14 year old, any adult who's ever had an eye strain headache or tension headache after a long stressful day at work, or has pulled a muscle or thrown out their back, knows the benefits of being able to take an NSAID to alleviate the pain...once you get weight loss surgery, that's no longer as safe of an option as it used to be since the risks of stomach bleeding and gastric ulcers increases a lot if you've had bariatric surgery.

There's a lot of big lifestyle adjustments that have to take place after bariatric surgery if you expect it to have the desired effect. It seems like a lofty expectation that a 14 year old (who can't even resist nuggets and fries) is going to be able to stick to it.

I agree.

 

[markkeller]

A major medical group updated its guidance for treating childhood obesity. Here's what it says.

The American Academy of Pediatrics updated its recommendations on childhood obesity for the first time in 15 years.

www.nbcnews.com

For the first time in 15 years, the American Academy of Pediatrics on Monday released new guidelines for treating childhood obesity, emphasizing a need for early and intensive treatment.

The guidance comes as childhood obesity rates have continued to rise over the past decade and a half, increasing from 17% to 20%, according to data from the Centers for Disease Control and Prevention. Since the 1980s, obesity rates have tripled in children and quadrupled in adolescents.

The new guidelines emphasize that obesity is a complex and chronic condition without a simple fix. Intensive behavioral and lifestyle changes should be the first-line approach, but the AAP also includes recommendations for anti-obesity medications and surgery for the first time. These novel recommendations are in response to a windfall of research and drug approvals in the past few years.

For children ages 12 and up, one of the major changes in the recommendations is the inclusion of anti-obesity drugs and weight-loss surgery alongside lifestyle changes.



To me this feels a bit like jumping the gun. While there are things that are bad enough that they need pharmaceutical and surgical interventions to either treat the condition, or prevent imminent bad outcomes... Being overweight at age 12 or 13 doesn't feel like one of them.

I feel this way for a couple reasons:

1) a lot of bodily changes happen during puberty...especially in males, in the form of getting one of mother nature's best fat burners in the form of the 30-fold increase of testosterone they're about to get in the next 3 years (and that will last 5-10 years before tapering off)

2) chronic issues and serious outcomes related to weight are far from being "imminent" at that age... There's plenty of time to change eating and exercise behaviors at that age before it's done any real serious damage that can't be reversed. A 15 year old is statistically unlikely to be dealing with the same consequences of a 30+ BMI at that age compared to their 40 year old counterpart.

3) weight loss surgeries don't exactly have a stellar track record if the person isn't being supported in other ways. Per the NEJM "Many people do indeed find success with gastric bypass in the short term, but a majority of participants unfortunately regain much of the weight they lost. In fact, one study indicated that 59% of people regained 20% or more of the weight they originally lost after surgery." And my hunch would be, if a 13 year old has gotten to a 30+ BMI by that age, the proper encouragement and discipline isn't there to provide that support structure at home (where they'll be living for at least the subsequent 5 years)


Obesity rates climbing that high among youths is definitely a problem. But I think the solution is a little more of the public getting behind the Michelle Obama "get up and get moving" and the Jamie Oliver "let's find ways to make healthier food appealing to kids", and little less of the "let's give them diet pills and surgically re-route their digestive tract" Childhood obesity is a real problem nowadays, and it's a very dangerous one. Childhood is a period of development, and obesity causes different health problems, which may influence that development, and it may lead to different diseases in the teenage years and in life years later. I don't know a lot of detailed info on that issue, but I'm working on it because I need to write my paper on childhood obesity. I've already found this guideline, and much other info, such as statistics and so on. And also, my friend, who is also my groupmate, recommended I visit this source https://papersowl.com/examples/childhood-obesity/ where I read different helpful and informative childhood obesity essay samples, which helped me to "see" the issues from different perspectives. And I can say that it's something parents shouldn't ignore, and have to take action. And also, our health care system should take action to make the treatment effective, safe, and up-to-date.

It's amazing that such a guideline was released because it's a real problem that may cause different serious consequences. And yes, obesity rates are becoming higher and higher. And I also think that there should be something done when it comes to parents, because some of them don't realize, or don't want to realize that the kid is obese, and do nothing.
I saw such an example in my life, but after all social worker managed to influence the mother, and she started doing something to save the kid

 

[FireDragon76]

The problem is the food Americans eat now days. There's too much processed food.

As a kid I was eating carrot sticks for snacks. Now people are eating things like potato chips and soft drinks. Of course you'll get fat eating that stuff, it's not rocket science.

 

[ThatRobGuy]

The problem is the food Americans eat now days. There's too much processed food.

As a kid I was eating carrot sticks for snacks. Now people are eating things like potato chips and soft drinks. Of course you'll get fat eating that stuff, it's not rocket science.

You're right about the calorie dense food aspect, that's the biggest contributor.

However, even with limiting the processed food aspect, there still needs to be some self control at the dinner table.

I've known more than one person fell into the trap of thinking that because they were cutting out processed food, or avoiding certain substances in foods, that they would somehow magically get healthier. (Think: people on the 'paleo diet' or people who think they're making any real change by buying the organic/non-GMO versions of the junk food they were eating)