Health authorities repeatedly talk about obesity in children is a serious problem in the United States. Dr. Christopher F. Bolling, a retired pediatrician and honorary professor of pediatrics at the University of Cincinnati College of Medicine, told Salon that he personally witnessed childhood obesity increasing in the United States when he opened his own practice in the late 1980s.

“I saw the obesity epidemic from the beginning,” Bolling said. He stated that despite its limitations as a measure of individuals, body mass index (BMI) can provide insight into population patterns. “The percentile that has really exploded is several times higher than the 99th percentile of children with severe obesity,” he said. “And we’re seeing diseases that I never saw in children when I trained in the ’80s, like type 2 diabetes, a weight-related variant of diabetes.”

Bolling is part of a task force with the American Academy of Pediatrics which recently updated its own guidelines for preventing childhood obesity, or what the authors call “promoting healthy lifestyles.” In the report, Bolling and his colleagues focus on a variety of behavioral interventions for each stage of childhood, including focusing on good sleep and limiting screen time, all of which can enable a more sedentary lifestyle that can become problematic later in childhood.

“Not only are we trying to prevent obesity, but we’re trying to prevent all the things that come with it.”

Bolling also acknowledged that there are systemic problems when it comes to childhood obesity – such as school districts reducing or eliminating obesity Physical education programs. Still, it is a concern for many pediatricians and he believes the pediatrician can play a role in promoting preventive measures in childhood.

“We’re concerned about obesity as a disease and as a chronic disease,” Bolling said. “We are trying to put a stop to this chronic disease. So not only are we trying to prevent obesity, but we’re trying to prevent all the things that come with it.”

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The report comes out almost a year after the much criticized one Guidelines for treating childhood obesity were published in 2023 and included a mix of recommendations ranging from behavioral and lifestyle treatments to obesity medications and bariatric surgery. Specifically, AAP said doctors should offer weight-loss medications to teens diagnosed with obesity at age 12 or older. Severe obesity is defined as a BMI of 120% of the 95th percentileor approximately the 99th percentile for age and gender.

Judging by headlines at the time, these suggestions alarmed eating disorder specialists. But more than a year later, anecdotal data shows those guidelines are likely being followed, as more reports emerge of teens and teens being prescribed anti-obesity drugs like Ozempic and Wegovy, which has the generic name semaglutide.

Research has shown that medications like semaglutide can be effective in treating it Obesity in adolescents and adolescents. For example, a study of 12- to 18-year-olds found that those with severe obesity had greater reductions in BMI than lifestyle interventions alone, while lifestyle interventions did coupled with a once-weekly dose of 2.4 milligrams subcutaneous semaglutide.

Although the AAP prevention guidelines do not mention anti-obesity medications, they do reignite the debate about adolescent and adolescent use of semaglutide. Bolling said he considers them an option that pediatric patients should be aware of when faced with severe obesity, emphasizing that the guidelines that were rejected were based on physicians’ review of thousands of data articles.

“We were all very impressed with how the data showed medication for children with comorbidities such as hypertension, diabetes or sleep apnea, and the effect the medication had in managing weight,” he said. “The data told us: This works, and if you ever have something that works, you can’t suppress the data on it – it’s something patients should know about.”

He stressed that it is not intended to be used on adolescents and adolescents in “isolation” or for “cosmetic reasons.”

“This option is for people with severe obesity,” he said. “Who have physiological changes that cause them to develop life-limiting diseases.”

Society “treats obesity” without considering what drives it in America.

Kimberly Vered Shashoua, a therapist who works with young adults with eating disorders, told Salon that despite some anecdotal evidence, she is concerned about adolescents and teens being prescribed obesity medications from a mental health perspective Stories about how the drug improves young people’s mental health.

“I think it’s really helpful to think about what makes people fat,” Shashoua said. “There are a lot of longitudinal studies, there are a lot of animal studies stress and above all, experience traumawill increase fat accumulation.”

Shashoua said society “treats obesity” without considering what drives it in America.

“Is this because you’re seeing the improvements in mental health? [with youth on anti-obesity drugs] “Because society just despises fat people so much?” asked Shashoua. “It’s much harder to bring about social change.”

Shashoua said treating obesity with anti-obesity drugs is a reflection of America’s “bootstrapped, cultural, individual, ritual solution,” adding that dieting is a risk factor for developing eating disorders and higher if you have a lot of weight “If you lose weight, you are likely to end up with a heavier weight than when you started, and there are many negative health effects that come from weight cycling.”

In January, a report emerged that one in 10 teenagers worldwide have used so-called “cheap Ozempic” laxatives and other risky weight-loss products to lose weight. Because the drugs are not intended to treat obesity in teenagers, the study says The authors expressed concerns that this trend could pose immediate and longer-term health risks.

“These results were surprising,” said Dr. Natasha Hall, a co-author of the study, told Salon. “While the percentage may seem low to some, it actually affects a large number of American children.”

If people are looking for solutions, Shashoua said, “We need to look at the research that controls anti-fat bias.”

When asked about fat bias, Bolling said he agreed that there is too much weight stigma bias in the United States.

“People who are overweight are not their fault,” Bolling said. “You don’t blame people who have asthma for having asthma. We need to stop blaming people for their obesity, and we need to stop blaming people for something that is a combination of all sorts of things – genetics, environment, mental health issues.”

At the same time, Bolling said, severe obesity can lead to various comorbidities if ignored, and that is a cause for concern for pediatricians. The goal for pediatricians, he added, touching on prevention guidelines, is for patients to be “the happiest, healthiest patients you can be.”

“And that varies for different people,” Bolling said.

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