Offer obese children weight-loss drugs and surgery, say US medics

‘These are Band-aids in a society that can’t figure out what to really do to protect the interests of its kids’

CHILDREN as young as 13 should be given weight-loss drugs and offered surgery to combat obesity, according to US medical guidance that has been criticised for overlooking healthy lifestyles.

The American Academy of Pediatrics (AAP) suggests doctors offer interventions sooner, including intensive therapy for children as young as six and weight-loss drugs and surgery for those in their early teens.

Obesity rates among school-age children in the US have nearly quadrupled since the 1960s and estimates suggest more than 14 million are overweight.

The AAP, made up of thousands of doctors who inform US government healthcare policy, stresses in its report that obesity is not only a result of poor eating habits and a lack of exercise, but also often of a genetic predisposition.

They point to studies suggesting that lifestyle changes are often not enough to prevent an obese adolescent becoming an overweight adult, when conditions such as Type 2 diabetes and high blood pressure can take hold. In a significant departure from past advice, the academy recommends that children aged 12 and older with obesity should be offered treatment with drugs such as Wegovy that suppress appetite.

Those 13 and older with severe obesity should be offered bariatric surgery, which reshapes the stomach and rearranges the digestive system’s anatomy, the academy says.

“Medical treatment and prevention need to go hand in hand,” writes Dr Nazrat Mirza, one of the authors of the guidelines. “Just like asthma, just like hypertension,” she said. “In hypertension you would tell somebody to cut salt, but then the blood pressure is still high, so you’re still going to give them medication.” Questions have been raised, however, about whether the recommendations come at the expense of a healthy and active lifestyle.

“Turning to surgery and pills is quintessentially American,” said Arthur Caplan, a bioethicist at the NYU Grossman School of Medicine.

Dr Caplan called obesity “one of the biggest moral challenges” US society faces but described medication and surgery as “Band-aids in a society that can’t figure out what to really do to protect the interests of its kids”.

Conservative commentators have suggested that the guidelines offer an easy way out for poor lifestyle choices. Dr Katy Miller, who works with teenagers struggling with eating disorders at Children’s Minnesota, said she fears that these guidelines might be “setting kids up for a challenging relationship with their bodies”.

“We are proposing treatment strategies that are expensive and even in the best circumstances are often unsuccessful,” she told the BBC.

Dr Miller believes the focus should be more on the societal factors that affect childhood obesity.