番茄社区

A new (CPS) from the Obesity Medicine Association serves as a handy guide to evaluate children (ages 2-12) living with obesity, defined as a body mass index (BMI) > 95th percentile for age and sex.

The statement highlights the complexity of the factors contributing to childhood obesity ranging from societal to genetic factors. It outlines the impact of obesity on our children, highlighting the multiple health complications that arise with untreated progressive weight gain.

One of the factors noted was the association between increased body weight at prepubertal age (i.e., before age 8 in girls and 9 in boys) with early onset of puberty. This premature onset impacts emotional and social development later on.

Treatment of the child with obesity should result in slowing the increase in BMI percentile. Lifestyle intervention is the recognized cornerstone of treatment, however, as many studies show.

Intensive health behavior and lifestyle treatment or IHBLT -- services with limited funding -- achieves only a small weight change of 1-3%. Early identification of the child with obesity not responding to IHBLT is critical. Prompt referral is encouraged.

The CPS outlines pharmacotherapy for obesity treatment. For children under age 12, the statement lists (1) the anti-obesity medication FDA approved for the indication of obesity; and (2) the medications affecting weight that are FDA approved for other indications. The statement summarizes the research and outcomes regarding weight change, along with safety considerations for treatment of children younger than age 12.

Clinicians are encouraged to utilize shared decision-making and discuss the risk-benefit ratio in assessing the impact of delayed care based on age versus providing treatment based on disease burden. This is especially the case when we recognize that the more we leave obesity untreated, the more difficult it is to treat later on.

The CPS sheds light on a special population of children who have obesity and special healthcare needs and children with hypothalamic dysregulation. These groups tend to have more challenges and typically require a multidisciplinary team trained in obesity medicine, including a physician or nurse practitioner, psychologist, and dietitian, as well as a speech or occupational therapist.

To summarize, obesity in children younger than 12 years of age is becoming more prevalent. There are many barriers including societal norms discouraging the treatment of obesity in children.

We currently have some tools and will have more on the horizon. It is important to recognize that intensive treatment now to prevent the progression of obesity will provide the most benefit to their health now and in the future.

, is the Physician Founder of , a Direct Care Wellness practice in central Pennsylvania, focusing on Weight Wellness and Midlife Empowerment. As a quadruple board-certified physician, she offers a holistic, individualized approach to sustainable weight loss using the 4M Pillar Foundation Plan, integrating nutrition, physical activity, mindset, and FDA-approved medications for weight. She can also be reached on and .

Read the Clinical Practice Statement here and an interview about it here.