Three publications recently discussed the challenges of pediatric obesity treatment and agreed that biological and environmental factors play a big role. Behavioral interventions, while certainly helpful when used a standalone, aren’t as effective as when also involving GLP-1 medications in weight management of children and teens. Let’s take a quick look.
In an interview with Morgan Ebert, Managing Editor at Contemporary Pediatrics, Kay Rhee, M.D., medical director of the Medical Behavioral Unit and research director in the Division of Pediatric Hospital Medicine at the University of California San Diego School of Medicine, highlighted the biological and environmental factors that make fighting childhood obesity management difficult. These include genetic predisposition, food cravings, and limited access to healthy resources in some communities.
Dr. Rhee emphasizes the role of behavioral interventions in helping children and teens adopt healthy eating and activity habits, often involving the whole family. Combining these interventions with medications like GLP-1 agonists can enhance weight loss by reducing appetite and cravings, making it easier for children to learn and stick to healthier behaviors.
She said:
Behavioral weight programs can really help teens/children learn to develop new healthy eating and activity habits. These programs usually involve the parent or caregivers too, so they help the whole family develop new routines and patterns with the hope that these behaviors become second nature to them.
Learning these new skills alongside the use of medications like GLP-1 agonists can be helpful because the medicines can decrease the cravings or decrease appetite to the point where children and youth can focus on learning the new behaviors. Then if they start to be successful in their weight loss efforts, they feel proud and energized because they have successfully learned a new skill that can be linked to these positive outcomes. This sense of pride and accomplishment can really reinforce the new behaviors, and it becomes a great positive feedback loop.
Dr. Rhee suggested practical strategies like removing unhealthy foods from the home to promote better choices. When addressing weight with patients, Dr. Rhee advises providers to focus on the link between obesity and metabolic risks rather than cosmetic concerns, and consider family history to guide conversations about potential health risks.
At the 2024 American Academy of Pediatrics (AAP) National Conference & Exhibition, Tanya Altmann, M.D., a UCLA-trained pediatrician and AAP spokesperson, discussed the growing problem of pediatric obesity in the United States. Her opinions were also published in Contemporary Pediatrics. According to Dr. Altmann, the availability of weight management medications, such as semaglutide, has provided a critical new tool for fighting childhood obesity.
She said:
It really helps those kids no longer be completely focused on what their next meal and snack is, and they’re not constantly hungry… They are able to focus more on eating a balanced meal with the rest of the family, exercising, they’re more self-confident, they can focus more in school and do better.
The article also emphasized that, according to a research letter published in JAMA in May of 2024, “the amount of adolescents and young adults receiving GLP-1 receptor agonists including semaglutide (Ozempic) and tirzepatide increased approximately 6-fold from 2020 to 2023.” Pretty impressive, isn’t it?
Finally, Caissa Troutman M.D., DABOM, CCMS, the Physician Founder of WEIGHT reMDy, a Direct Care Wellness practice in Pennsylvania, discussed the guidelines for evaluating and treating children aged 2-12 with obesity, provided by the Obesity Medicine Association in a new Clinical Practice Statement. She addressed the complex factors behind childhood obesity, including societal and genetic influences, with lifestyle interventions being the cornerstone of weight management.
At the same time, Dr. Troutman noted that intensive health behavior and lifestyle treatment often results in only modest weight changes (1-3%), making early identification of non-responders crucial for timely referrals.
According to Dr. Troutman, the Clinical Practice Statement outlines pharmacotherapy options, including FDA-approved anti-obesity medications and those approved for other uses that affect weight. In other words, multidisciplinary care may be required in “early, intensive treatment to prevent the progression of obesity and improve long-term health outcomes.”
Your responses and feedback are welcome!
Source: “Overcoming pediatric obesity: Behavioral strategies and GLP-1 support,” Contemporary Pediatrics, 10/4/24
“Special considerations for the child with obesity: An Obesity Medicine Association (OMA) clinical practice statement (CPS) 2024,” ScienceDirect, September 2024
“Highlights of OMA’s Clinical Practice Statement on Obesity in Children,” MedPageToday.com, 10/1/24
“Tanya Altmann, MD, discusses childhood obesity, lifestyle changes, and medications,” Contemporary Pediatrics, 10/2/24
Image by Kelly Sikkema on Unsplash
