Treating obesity in children and adolescents differs from treatment in adults. Involving the family in a child’s weight management program is a key element of treatment. As a support system, family is integral in meeting weight management goals.
It is important to talk with your physician about options for treating childhood obesity. According to the American Academy of Pediatrics, 2023 Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity:
Comprehensive obesity treatment may include nutrition support, physical activity treatment, behavioral therapy, pharmacotherapy, and metabolic and bariatric surgery.
- Nutrition support
- Physical activity
- Behavior modification
- Metabolic and Bariatric Surgery
Nutrition Support: When treating a child or adolescent affected by obesity, it is often recommended that they consult a dietitian specializing in children’s needs. Dietitians can best help children and their families understand healthy eating habits and how to implement them in their long-term diet.
Physical Activity: Another form of obesity treatment in children is to increase physical activity, which is crucial for long-term health. Studies have linked childhood inactivity to a sedentary adult lifestyle. The U.S. Surgeon General recommends that children engage in at least 60 minutes of daily physical activity.
Behavior Modification: Behavioral treatment includes a focus on nutrition, physical activity and behavioral change support. The intervention helps families turn newly-learned healthy behaviors into habits. Programs that engage the whole family can help support healthier weight and improve the health and well-being of children and adolescents who have obesity. Some behavior changes include:
- Changing eating habits
- Increasing physical activity
- Becoming educated about the body and how to nourish it appropriately
- Engaging in a support group or extracurricular activity
- Setting realistic weight management goals
Pharmacotherapy: Four anti-obesity medications are now approved for treating adolescents starting at age 12: Xenical®/Alli® (Orlistat), liraglutide (Saxenda®), phentermine/topiramate ER (Qsymia®), and semaglutide (Wegovy®). Additionally, Phentermine is approved for adolescents older than age 16. IMCIVREE® (Setmelanotide) is another medication that has been approved for children age 6 and older who have Bardet-Biedl syndrome, a genetic disease that causes obesity.
Metabolic and Bariatric Surgery: Both laparoscopic Roux-en-Y Gastric Bypass (RYGB) and vertical sleeve gastrectomy (VSG) are effective weight loss procedures in children, leading to sustained weight loss and resolving many obesity-related conditions. A referral to a comprehensive metabolic and bariatric surgery center with experience and expertise in the treatment of patients younger than 18 years does not necessarily mean the child or adolescent will ultimately have surgery. This referral provides the family with important information and additional evaluation of risks and benefits for use in making an informed decision.
Finding the right treatment for your child should be a family approach. As with adults, there is no one-size-fits-all treatment for childhood obesity. It is important for your child to be a part of the decision-making plan and feel comfortable throughout the process.