Should medications or surgery be used to help obese children lose weight?

(WXYZ) – Childhood obesity rates have been increasing at an alarming rate. According to a 2021 CDC report, nearly 20% of children ages 2-19 are obese, and nearly 6% are obese.

In response, the American Academy of Pediatrics is releasing updated guidelines on treating childhood obesity.

It’s a broad update, but one aspect is controversial — permanent weight-loss medications and surgery for middle school-aged children.

A native of Oakland County, Maeve Everett’s weight loss journey made her a TikTok star.

“I posted one video on Tik Tok less than a year ago today, and it kind of exploded overnight,” Everett said.
It got 25 million likes.

“What did you start on this journey?” I asked.

“I think the motivation is just to be healthy and feel better about myself,” she said.

Maeve says weight has been a struggle for as long as she can remember. During the COVID-19 lockdown, I focused on eating better and moving more.

“The main thing for your health is what you put in your body is food. As much as you exercise, you can’t overdo it with a bad diet,” she said.

According to the Centers for Disease Control and Prevention, nearly 15 million American children are obese. In response, the American Academy of Pediatrics created new guidelines for the first time in more than a decade.

Dr. Zeina Al-Rifai, MD, is a pediatrician at Shelby Pediatrics and an expert in bariatric medicine. She says the guidelines focus mostly on lifestyle management but when that fails, he suggests the use of pediatric medicine and weight-loss surgery for middle-school-aged children.

She said that they usually have type 2 diabetes, high blood pressure or cardiovascular disease.

“We want to put more effort into working with families early on and trying to prevent these things from happening,” Al-Rifai said.

But the use of permanent medications or surgery in children provokes severe reactions. Some say guidelines are “the bark of the wrong tree.” Others say, “These recommendations set me on fire… I’m afraid the new focus will lead to eating disorders.”

Dr. Jaime Taylor is the Director of Adolescent Medicine at Beaumont Children’s. She says she has seen unhealthy “ideal weight” patients and healthy patients with larger bodies. She worries about making permanent changes for children who are still developing.

“Particularly those 12-13 year olds, many of whom have not completed the process of puberty,” Taylor said.

She says that weight-loss surgery can change how children get the nutrients they need to grow, and using medications to lose weight is a long-term commitment. There are sticky ethical issues that need to be sorted out by the patient, provider, and guardian, according to clinical ethicist Abraham Bromet.

“Ultimately, parents will have the legal authority to, you know, give permission for these types of invasive procedures,” Bromet said.

All of the healthcare experts in this story say that the use of medication or surgery for weight loss is only to offset the negative long-term complications of obesity.

They say lifestyle choices like the one Maeve made are always the first step to weight management.