Docs Push Back on New Guidelines for Obese Kids

A panel of US health experts is urging more aggressive moves to fight childhood obesity, including a recommendation for intensive counseling. On Tuesday, the US Preventive Services Task Force released guidelines in JAMA that suggest "comprehensive, intensive behavioral interventions" for children and teens 6 years of age and older who have a BMI that's in the 95th percentile or higher.

• Obesity in America: According to the CDC, nearly 15 million children and adolescents in the US between the ages of 2 and 19 are categorized as obese, leading to more than $1 billion in health care spending annually, per the Washington Post.

• Guidelines: The panel recommends that kids in this demographic cut back on electronic devices; set health and fitness goals; get instruction on healthy eating; take part in supervised physical activity; and undergo at least 26 hours of intensive counseling per year. The USPSTF's research shows that kids who received such interventions "experienced small weight loss and reductions in BMI after six months to a year," per CNN.
• Why the concern: CNN notes that children with a high BMI can develop serious and even life-threatening conditions, including diabetes, trouble breathing, joint problems, hypertension, and high cholesterol, which can lead to heart problems. That doesn't include the social impact of bullying.
• Criticism: Some doctors aren't impressed with the new guidelines, noting that a) they're not substantially different from recommendations released in 2010 and 2017; b) appropriate programs can be inaccessible; and c) 26 hours of counseling per year may be prohibitive. That latter benchmark would be "extraordinarily difficult" to achieve in a clinical setting, and "almost impossible" in a primary care setting, says a pediatric obesity researcher with Ann & Robert H. Lurie Children's Hospital of Chicago.
• No surgery, no meds: Critics are also disappointed that neither bariatric surgery nor weight-loss meds such as semaglutide (sold under brand names like Wegovy and Ozempic) were included in the panel's recommendations. The USPSTF found "the totality of the evidence was found to be inadequate" on such drugs for weight loss in kids.
• Reaction: Some doctors and parents, however, say both options should be available. "Having the option of medication in the appropriate clinical scenario is very important," Susma Vaidya of Children's National Hospital in DC, tells the Post. "I am a big believer in medication, and I think that we have been advocating for lifestyle change for a long time and haven't made a whole lot of progress."

(More BMI stories.)