NPR: Lifesaving or stigmatizing? Parents wrestle with obesity treatment options for kids
By Yuki Noguchi
Two mothers — Jen McLellan in Albuquerque, N.M., and Grace, of Bethesda, Md. — haven't met, but they share a common childhood trauma: Both came of age in the 1980s and '90s feeling burdened by shame and stigma over their body size. Both tried every known diet plan and pill available at the time, only to have doctor after doctor admonish them to restrict calories and exercise still more.
Since then, scientific understanding of obesity has transformed; doctors now consider it a disease driven by genetics, the brain and other organs, as well as by environmental or psychosocial factors. Studies have also confirmed what both women suspected all along: Diets usually do not result in long-term weight loss because food and exercise account for only some part of the puzzle.
Today, there are treatments for kids with severe obesity that weren't available to Grace and McLellan growing up. New drugs like semaglutide — approved for weight loss under the brand Wegovy — tamp down hunger and boost metabolism; adolescent bariatric surgery achieves similar results.
Both treatments were added early this year to the American Academy of Pediatrics' recommended treatment guidelines for children as young as 12 or 13 — acknowledging the increasing threat of the disease in children. Those guidelines help direct pediatricians in their treatment recommendations, which can, in turn, affect the likelihood that a patient might get diagnosed, get treated or get their care paid for by insurance.
The new AAP guidelines — as well as the rising awareness of the new class of effective weight-loss drugs — have touched off controversy among many parents who are now debating whether, when and how to treat a child's obesity.
"Some of these kids are having very serious complications that are life-limiting, that are happening to them right now," says Sarah Hampl, a pediatrician with Children's Mercy in Kansas City, Mo., who co-authored this year's new AAP guidelines. The document runs more than 70 pages and strongly emphasizes the importance of family lifestyle changes to ensure nutrition, exercise, sleep and stress management, Hampl says, but it also recognizes today's realities: "We need to take more urgent action."
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Children's Mercy Weight Management Program
Promoting Health in Teens and Kids (PHIT Kids) Clinic