Updated Childhood Obesity Guidelines. Surgery is not the solution

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DUBAI, United Arab Emirates (CNN) – The American Academy of Pediatrics, in its updated guidelines for the treatment of obesity, urged the immediate use of behavioral therapy and lifestyle changes, stressing that the use of surgery and drugs concerns only certain young cases.

The guidelines, published in the journal Pediatrics Monday, are the first comprehensive update of the academy’s obesity treatment guidelines in 15 years. Treatment guidelines were given to children from two years old through adolescence.

The guidelines recognize that obesity has multiple causes and is linked to the intake of nutritious foods and health care, among other factors.

She noted that treatment for young children should focus on behavioral and lifestyle therapy that includes the whole family, including nutritional support and increased physical activity. The academy said it is appropriate for children 12 and older to use weight-loss medication, in addition to health behavior therapy and lifestyle therapy. As for adolescents 13 and older who are obese, they should be evaluated for surgery, according to the guidelines.

“There is no evidence that ‘watchful waiting’ or delayed treatment is appropriate for obese children,” said Dr. Sandra Hasink, author of the guide and vice chair of the clinical practice subcommittee of the group obesity. in a sustainable way, with families involved in decision-making at all stages.

Children and adolescents are obese when their BMI is at or above the 85th percentile and below the 95th percentile, and severely obese when their BMI is at or above the 95th percentile.

Miles Faith, a psychologist at the State University of New York at Buffalo who studies eating behaviors and obesity in children, applauded the new report, which recognizes that the causes of childhood obesity are complex and that the treatment should be a team effort.

“It is not the result of a single cause that affects all children,” he said, adding that “there has not been this kind of report to say that there are d ‘other options should not automatically be ruled out the possibility of treatment, and the role of surgery should not be ruled out.’

“For some families, there may be something to consider,” added Faith, who was not involved in developing the guidelines.

The new guidelines do not address obesity prevention. The American Academy of Pediatrics said it will be addressed later in a separate statement.

“These are the most comprehensive, patient-centered guidelines that address childhood overweight and obesity,” Dr. Rebecca Carter, MD, a pediatrician at the University of Maryland Children’s Hospital and assistant professor at the University of Maryland College of Medicine. .

Carter pointed out that “what is new in these recommendations is the development of several novel drug delivery strategies that have been shown to be highly effective in the treatment of obesity as a chronic disease in adults, and which is now recommended for use in children and adolescents”.

“It’s a major step that allows overweight and obesity to be considered chronic diseases, because they are,” she added.

And she added that these recommendations are a “significant step forward” that will help parents and medical teams “take responsibility” for the long-term health risks to which children are exposed, linked to overweight and obesity.

Carter noted that with this update to the guidelines, “they offer a variety of tools to help families feel empowered in having ways to deal with these medical conditions, and that there are subtle causes for these conditions that go beyond the easy fixes, and certainly take us away from focusing on adopting old or unhealthy eating strategies.

The new guidelines are designed for health care providers, but Carter says parents should speak with their child’s doctor if they have concerns about weight, discuss strategies to improve health and monitor changes.

“It is also appropriate to do this in a child-centred way, being careful not to stigmatize them or make them feel bad about their own body, while allowing the child to feel that he has the tools to keep his body healthy over time,” she added.

Dr. Jennifer Wu Pedal, assistant professor of pediatrics, director of the Pediatric Obesity Initiative at Columbia Vagelos College of Physicians and Surgeons and pediatrician at NewYork-Presbyterian, told CNN on Monday that the new guidelines are “much needed progress.” to align comprehensive care with modern science.

“Implementing the new guidelines will help reverse the epidemic of childhood obesity,” she noted. She added: “More policy work will be needed to mitigate policies and practices that permeate racial, ethnic, social and economic disparities in obesity from the earliest years of life. Although the guidelines support advocacy efforts pediatricians, we, as a society, must Expressing our support for healthy environments for children nationwide.”

Obesity issues

The American Academy of Pediatrics reports that more than 14.4 million children and adolescents are obese. The US Centers for Disease Control and Control (CDC) reports that overweight or obese children are more likely to develop asthma, sleep apnea, bone and joint problems, type 2 diabetes and heart disease.

Separate research, published last month in the American Diabetes Association Journal Diabetes Care, suggests that the number of young adults under 20 with type 2 diabetes in the United States could increase by nearly 675% by 2060, if it continues. is as it is now.

Last month, the US Centers for Disease Control and Control (CDC) released updated growth charts that can be used to track obese children and adolescents.

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