According to one influential advisory panel, school-aged children should be screened for obesity and be sent to intensive behavioral programs if they need to lose weight.
The potential plan could transform how doctors deal with overweight kids.
The panel of doctors issued possible new guidelines on Monday stating that treating obese children can help them lose weight. The treatment would only be effective if it involved rigorous diet, activity and behavioral counseling.
The U.S. Preventive Services Task Force, which makes medical-care recommendations based on research, concluded that after reviewing more than a dozen studies, obese children who participated in moderate to high-intensity weight-management programs for 25 or more hours over a six-moth period often had accountable weight loss.
Currently there are not enough programs for parents to get their children involved in, and those that are available are not covered under most health insurance plans. However, under this new recommendation, there is evidence that these programs would be effective and things may change, said Ned Calonge, chairman of task force and chief medical officer of the Colorado Department of Public Health and Environment.
Nearly 32% of children and teens are obese or overweight, according to the latest statistics. Almost 20% of kids between ages 6 and 11 are obese. 18% of those ages 12 to 19 are obese. Obesity puts children at a much higher risk for health problems such as high cholesterol, blood pressure and diabetes.
Kids are considered overweight if they fall within the 85th and 94th percentile on the body-mass index growth charts, which are adjusted for combined weight and height. Those with a 95th percentile or higher are considered obese.
Although studies conclude that children would benefit highly from weight-management programs more so than the same studies implemented five years ago, pediatricians are not equipped to offer that kind of treatment, and those that do, are hard to find and may be very expensive, according to Calonge.
The recommendations merely highlight evidence showing what types of treatments work, rather than “whether or not those services are currently available,” he added.
The advice from the U.S. Preventive Services Task Force coincides with that of the American Academy of Pediatrics. Many pediatricians have the tools to measure body-mass index and usually perform yearly checkups on its patients already. But more advanced treatments are currently not available in most communities.
After studying more than 20 cases since 2005, the task force has made many recommendations on how to treat obesity. Those not considered by the panel, include the use of two diet drugs, Xenical and Meridia, that have been recently approved for use in older children, due to potential side effects including elevated heart rate and that there is no evidence that the use of the drugs result in long-term weight loss. Another treatment option, obesity surgery, has been recommended in only severe cases.
The most effective treatment usually involves counseling parents and their kids, group therapies, and other programs that are not covered by some insurance companies. Most of these treatments can be too costly for parents, one of the main reasons the programs are so scarce. Not only does cost play into it, many parents and their children aren’t willing to make the necessary lifestyle changes needed for the treatment to be effective.
Keith Ayoob, associate professor of pediatrics at the Albert Einstein College of Medicine in New York, says parents have to be involved with their children in any weight-management program. “Part of the problem is that where there are obese children, there are often obese parents.” To make lasting changes for the benefit of their children, “parents often have to take a hard look at their own eating styles and how they may have morphed into less-than-healthy role models.”
The recommendations made by the U.S. Preventive Services Task Force are geared for children ages 6 to 18 years of age. Evidence lacks on the effectiveness of treatments and programs for children under the age of 6., according to Calonge.
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