Practice guidelines from the American Academy of Pediatrics regarding children with obesity

Clinical Question

How should we manage excess weight in children?

Bottom line

Following the lead of other organizations, the American Academy of Pediatrics has issued guidelines for treating excessive body weight in children and adolescents using a chronic disease model. They stress the need for early identification of comorbidities and interventions aimed at changing eating and activity habits through intensive behavior and lifestyle modification. They suggest considering medication or bariatric surgery in adolescents. They offer ways of talking about weight that will not stigmatize the children, though I'm skeptical that the focus on weight instead of health will prevent shaming. The focus on individual behavior instead of structural solutions may set up patients, parents, and clinicians for failure. 5

Study design: Practice guideline

Funding: Self-funded or unfunded

Setting: Various (guideline)

Reviewer

Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA


Discuss this POEM


Comments

Nell Thomas

Terribly miss guided guidelines for pediatric obesity.

They favor surgery to benefit whom!?!?! The suggestion of surgery for anybody who is obese is criminal. 100% of patients post bariatric surgery become overweight, or obese again. And are now obese with malabsorption and chronic malnutrition. This is a crime to suggest surgical interventions, rather than choosing and teaching nutrition and fitness and wellness. Governments and health policies and public health must ban packaged processed foods for so many reasons. And public health has terribly dropped the ball on exercise, fitness, and nutrition for public consumption in the first world.

ARUP KUMAR DHARA

Impact assessment

Very good

Anonymous

Children with obesity

A behavioural disorder mistakenly promoted as a medical disease - and an approach that will have little, if any, beneficial effect.

Anonymous

Wow...

" They offer ways of talking about weight that will not stigmatize the children, though I'm skeptical that the focus on weight instead of health will prevent shaming. The focus on individual behavior instead of structural solutions may set up patients, parents, and clinicians for failure. "

This sums it up rather nicely.

Anonymous

Obesité

Des programmes pour aider les familles de ces jeunes requière une approche pluridisciplinaire et on a peu accès à ces services. Pour l’approche pharmaceutique, l’option est bonne mais on risque d’avoir des jeunes sur des médicaments sur le long terme!