New guidelines for US pediatricians to treat childhood obesity have sparked controversy.
The American Academy of Pediatrics recommends in its new guidelines that overweight children undergo intensive therapy that includes weight-loss drugs from the age of 6, while for adolescents it suggests surgery.
However, some fear that this approach will come at the expense of a healthy and active lifestyle.
One in five children in the United States is obese.
Doctors argue that early treatment is needed to prevent lifelong diseases, such as diabetes.
parents speak
We speak with Tracy Sherman and her 14-year-old daughter, Jaelynn Pérez, who live in a Washington suburb. It is a residential complex surrounded by roads and some patches of green grass.
Sherman is upset. The reason? She just got the news that Jaelynn’s school is closing the PE class and replacing it with a classroom-based health course.
The woman is concerned that her daughter no longer has many opportunities to exercise and socialize with her classmates. Likewise, she fears that the new class will make the latter even more difficult.
Pérez, for his part, said that last year he enrolled in a summer camp organized by the YMCA. He went hiking during the day and spent a lot of time outdoors.
“It was a lot of fun,” the teen said. “I felt better, I felt healthier, and I loved making friends.”
Pérez has suffered from kidney disease since she was a child and her overweight negatively affects her condition. But her mother said that in the summer things began to improve.
“He lost almost six kilos in three months,” Sherman recounted.
“Her nephrologist was really impressed that she was able to lose so much weight so quickly. His health improved and so did his confidence,” she added.
This change, the mother explained, showed her how important it was for her daughter to be active outdoors.
one step further
For years, doctors have promoted a healthy lifestyle as the best way to combat childhood obesity.
However, in recent weeks, the debate on this issue has reignited, as the American Academy of Pediatrics issued, for the first time in 15 years, new guidelines to address the issue.
From the association they affirmed that eating well and exercising is not always enough.
“Medical treatment and prevention must go hand in hand,” said Dr. Nazrat Mirza, one of the guidelines’ authors.
“Obesity is a chronic medical condition, and in addition to healthy lifestyle changes, we’ve found that medications and surgery work, too,” she added.
Mirza said the guidelines want to end the double standards faced by people with obesity and make it easier for them to access available medical treatments, just like with any other condition.
“Just like asthma, just like hypertension. In case of hypertension, you would tell someone to reduce salt, but if the blood pressure is still high, you will give them medicine, ”he illustrated.
Other proposals
But some doctors are concerned by the emphasis on intensive early intervention.
Dr. Katy Miller, who works with teens battling eating disorders at Children’s Hospital of Minnesota, admitted she fears these guidelines could “set kids up for a challenging relationship with their bodies.”
“We are proposing treatments that are expensive and even in the best of circumstances are often unsuccessful,” he added.
The expert proposed that the approach focus more on the social factors that affect childhood obesity.
“How can we ask someone to diet when we’re not addressing things like poverty, food shortages and unstable housing access?” he said.
“I had a 15-year-old patient who had been told by doctors to lose weight,” he added, “and his family has been living in extreme poverty. They had a change in his financial circumstances and he said to me, ‘You know the best part about having money? You can buy fruit that doesn’t have mold on it.’”
We also spoke with Julia Guevara, a mother of three who just finished a year-long support group on healthy cooking hosted by the YMCA.
“I am the one who cooks at home. So if I cook healthy food my family stays healthy,” she said proudly.
The woman was referred to the program because she had been diagnosed with high cholesterol and prediabetes during her pregnancy. Her teenage son, she commented, was also beginning to have health problems and that motivated her to make a change in her life.
As she slices some fruit for her toddler, we asked her what she thinks of the new guidelines and she shook her head no.
“As a mother, I would first try to change the food we eat and make my children play sports,” Guevara said.
“In our country, children do not have many opportunities to exercise, schools do not have enough sports programs. Only if I had tried everything then I might consider it,” she added.
On the opposite side of town, Sherman agrees. “Surgery and medication should be the last resort,” he said.
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