Pediatricians Recommend Weight-Loss Drugs for Obese Children
By Sarah Toy, Jan. 9, 2023, WSJ
The American Academy of Pediatrics for the first time recommended physicians offer weight-loss drugs for children with obesity, aiming to take early action against an increasingly common condition linked to a host of health problems.

Children 12 or older who are obese should be offered meds for weight loss alongside lifestyle and behavioral counseling, according to guidelines published on Monday by the largest professional association of pediatricians in the U.S. The association also
recommended that doctors offer to refer severely obese children 13 or older to surgeons to assess whether they would be good candidates for bariatric surgery. It said pediatricians should screen obese kids for high cholesterol, diabetes and hypertension.

The guidance is more aggressive than previous recommendations the AAP published in 2007. It focuses on intensively treating obesity immediately rather than in stages, said Sarah Hampl, a lead author of the guidelines and a pediatrician at Children’s
Mercy Kansas City in Missouri.

“What we now know is that obesity is a chronic disease in kids and adolescents,” she said. “Treatment should be started early and at the highest available intensity.”

Obesity is on the rise in the U.S. About 1/5 of kids in the U.S. are considered obese, according to the most recent data from the CDC.

The rate of increase in BMI, a screening tool doctors use to detect excess body fat, more than doubled among young children and adolescents during the pandemic.

Public-health experts cited school closures, disrupted routines and increased stress as possible reasons for the surge. Rates of other health problems including stress, heart attack and stroke also increased during the pandemic.

The AAP mentioned some drugs that could be prescribed for such treatment, including orlistat, which blocks fat absorption; semaglutide, which decreases hunger; and metformin, a diabetes drug.

Orlistat and semaglutide are approved by the FDA for treatment of obesity in children 12 years and older. Metformin hasn’t been approved as a weight-loss drug, though it has been used off-label for that purpose in kids. Studies of its effect on weight
loss have shown mixed results, the AAP said. Pediatricians can consider prescribing it to kids with obesity under specific conditions, the AAP said: alongside intensive health behavior and lifestyle counseling and when there is another medical reason to
do so, such as Type 2 diabetes.

People who are overweight or obese are more likely to develop Type 2 diabetes, heart disease, stroke, arthritis and breathing problems. By the time children who are obese reach adulthood, they may already have some of those health problems, said Stanley
Spinner, a pediatrician and CMO of Texas Children’s Pediatrics.

“We have to prevent this and catch it early,” Dr. Spinner said. But he said he wouldn’t be comfortable prescribing weight-loss drugs to kids until long-term side effects are better understood.

Research has shown some benefit in prescribing certain drugs for weight loss and the AAP will continue to evaluate benefits and risks, Dr. Hampl said.

Sustained weight loss is difficult to achieve because so many factors affect it. Genetics, limited access to healthy food in some places and the promotion of unhealthy foods are among factors that can contribute to obesity, Dr. Hampl said.

Some people don’t have access to doctors who specialize in treating obesity, she added, so it is helpful for pediatricians to understand available options such as prescription medications.

“We have more tools in our toolbox now than ever before,” Dr. Hampl said.

https://www.wsj.com/articles/pediatricians-recommend-weight-loss-drugs-for-obese-children-11673213563

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On Monday, January 16, 2023 at 2:04:22 PM UTC+8, David P. wrote:

Pediatricians Recommend Weight-Loss Drugs for Obese Children
By Sarah Toy, Jan. 9, 2023, WSJ
The American Academy of Pediatrics for the first time recommended physicians offer weight-loss drugs for children with obesity, aiming to take early action against an increasingly common condition linked to a host of health problems.

Children 12 or older who are obese should be offered meds for weight loss alongside lifestyle and behavioral counseling, according to guidelines published on Monday by the largest professional association of pediatricians in the U.S. The association

also recommended that doctors offer to refer severely obese children 13 or older to surgeons to assess whether they would be good candidates for bariatric surgery. It said pediatricians should screen obese kids for high cholesterol, diabetes and
hypertension.

The guidance is more aggressive than previous recommendations the AAP published in 2007. It focuses on intensively treating obesity immediately rather than in stages, said Sarah Hampl, a lead author of the guidelines and a pediatrician at Children’s

Mercy Kansas City in Missouri.

“What we now know is that obesity is a chronic disease in kids and adolescents,” she said. “Treatment should be started early and at the highest available intensity.”

Obesity is on the rise in the U.S. About 1/5 of kids in the U.S. are considered obese, according to the most recent data from the CDC.

The rate of increase in BMI, a screening tool doctors use to detect excess body fat, more than doubled among young children and adolescents during the pandemic.

Public-health experts cited school closures, disrupted routines and increased stress as possible reasons for the surge. Rates of other health problems including stress, heart attack and stroke also increased during the pandemic.

The AAP mentioned some drugs that could be prescribed for such treatment, including orlistat, which blocks fat absorption; semaglutide, which decreases hunger; and metformin, a diabetes drug.

Orlistat and semaglutide are approved by the FDA for treatment of obesity in children 12 years and older. Metformin hasn’t been approved as a weight-loss drug, though it has been used off-label for that purpose in kids. Studies of its effect on

weight loss have shown mixed results, the AAP said. Pediatricians can consider prescribing it to kids with obesity under specific conditions, the AAP said: alongside intensive health behavior and lifestyle counseling and when there is another medical
reason to do so, such as Type 2 diabetes.

People who are overweight or obese are more likely to develop Type 2 diabetes, heart disease, stroke, arthritis and breathing problems. By the time children who are obese reach adulthood, they may already have some of those health problems, said

Stanley Spinner, a pediatrician and CMO of Texas Children’s Pediatrics.

“We have to prevent this and catch it early,” Dr. Spinner said. But he said he wouldn’t be comfortable prescribing weight-loss drugs to kids until long-term side effects are better understood.

Research has shown some benefit in prescribing certain drugs for weight loss and the AAP will continue to evaluate benefits and risks, Dr. Hampl said.

Sustained weight loss is difficult to achieve because so many factors affect it. Genetics, limited access to healthy food in some places and the promotion of unhealthy foods are among factors that can contribute to obesity, Dr. Hampl said.

Some people don’t have access to doctors who specialize in treating obesity, she added, so it is helpful for pediatricians to understand available options such as prescription medications.

“We have more tools in our toolbox now than ever before,” Dr. Hampl said.

https://www.wsj.com/articles/pediatricians-recommend-weight-loss-drugs-for-obese-children-11673213563

They are not good for children. Obesity drug has side-effects. Obesity comes back up again if stops. Bariatric surgery has side-effects too. Stomach is tied up and shortened. It is not reversible.

The feeling of bloating and fullness can be felt from shortened stomach. It can feel stretched when eating big meal. Friends will shame child for not able to eat like them. Child cannot accept why he cannot eat more like them. Child will have self-
concerns and self-consciousness and depression too.

The best option for children is not on diet control but to fast. Diet control is not sustainable method. Children can be taught, trained, educated, and monitored on how to fast. They can use 16/8 or 20/4 fasting methods.

16/8 is 16 hours fasting and 8 hour when food intake moderation is allowed. 20/4 is 20 fasting hours and 4 hours for food intake moderation is allowed.

Fasting is much easier to achieve if time for eating and fasting is managed well. One has to keep away from friends in binge eating.

If and when child gets used to one of the fasting methods, he will be able to manage his weight with food intake time and fasting time.

They can learn from Paul Kimelman. A native of the Bronx, NY, Paul moved to Pittsburgh, Pennsylvania with his mother, Olga Kimelman, in the early 1960s.

As a 19-year-old, Paul reached his peak weight; more than 520 pounds (235 kg).

Starting in 1967, as a New Year's resolution, he decided to start fasting to lose weight because he was tired of being ridiculed.[2]

In an interview posted in the Boca Raton News on March 22, 1981, Paul made this statement on the resolution, "I quit eating right there.

I fasted for as long as I could, then after that it was just clear soups, grapefruit juice, skim milk, and salads." Paul shed a little over 355 pounds (161 kg) in 7 months, dropping from 487 to 130 pounds (221 to 59 kg).

His achievement was recognized by The Guinness Book of World Records. Not only did he hold the Record for more than 12 years, he was also on the cover of the book in 1982.[3]They can emulate his motivation:

https://en.wikipedia.org/wiki/Paul_Kimelman#:~:text=I%20fasted%20for%20as%20long,Guinness%20Book%20of%20World%20Records.

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