The rising number of children carrying excess weight is a growing concern, as it poses significant risks to their current and long-term health. Fortunately, various effective treatments are available to address overweight and obesity in children and teens. This article provides families with essential information to navigate childhood weight loss programs and make informed decisions.
Understanding Childhood Obesity
Childhood obesity is a chronic disease, much like asthma or diabetes, and requires a comprehensive and sustained approach. It's crucial to understand that there is no quick "fix" or "cure." Treatments, such as lifestyle programs and medications, are effective while implemented, but weight regain is common upon cessation.
No One-Size-Fits-All Solution
After decades of research, healthcare professionals now have several options to help children and teens with obesity. The most suitable option is determined by various factors, including family values and health goals, the child's age and health status, and the severity of the obesity.
Deciding on the right treatment should involve a collaborative discussion between the child, family, the primary healthcare provider, and, in some cases, a child obesity specialist.
The Myth of "Growing Out Of It"
Medical studies have clearly demonstrated that there is no real benefit to "watching and waiting" to see if children will outgrow obesity. This approach can lead to the progression of health issues like high blood pressure and high cholesterol.
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Treatment Options
A range of treatment options are available, and the best approach often involves a combination of strategies tailored to the individual child's needs.
Behavioral and Lifestyle Treatment
Your doctor will discuss behavioral treatment options that support healthy habits. These options may involve healthcare specialists, community programs, or frequent visits with your doctor.
Weight-Loss Medication & Surgery
Weight-loss medications prescribed under the supervision of a qualified professional are a powerful tool in helping to treat obesity. In some cases, weight loss surgery is a safe and effective option. It is important to seek out comprehensive treatment programs with experience prescribing medications and performing weight loss surgery procedures in children and teens.
Medication or surgery does not replace high quality behavior and lifestyle treatment. You, your child and your child's doctor will together make the most informed decision regarding the best treatment plan for your family.
What to Expect When Starting Obesity Treatment
When starting obesity treatment, families can expect a supportive and respectful environment from healthcare providers and staff. It's important to remember that overweight and obesity, along with related health conditions, are complex issues influenced by various factors, including genetics, biology, environment, governmental policies, and stress.
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Treatment will take time and will consist of multiple visits with healthcare providers and others.
Goals of Obesity Treatment
The primary goal of obesity treatment is to improve health, which can manifest differently for each individual.
- Better physical health: This may include lower blood pressure, improved cholesterol levels, or increased endurance during physical activity.
- Improved weight: This could mean weight loss, weight maintenance, or slower weight gain. Doctors typically monitor body mass index (BMI) for children and adolescents, but interpretation is individualized.
- Improved quality of life: This encompasses good self-esteem, the ability to be physically active, attend school, and interact with family and friends.
Addressing Concerns About Harmful Effects
High-quality obesity treatment is safe. Children and adolescents who receive obesity treatment in a supervised and structured program show less disordered eating than those who do not get treatment. Obesity treatment and eating disorder treatment both emphasize balanced, nutritious eating and a healthy relationship with food.
Intensive Health Behavior and Lifestyle Treatment (IHBLT)
The American Academy of Pediatrics (AAP) recommends family healthy weight programs (FHWPs) as multi-component behavioral interventions to help treat childhood obesity. FHWPs are comprehensive, family-based lifestyle change programs. The U.S. Preventive Services Task Force (USPSTF) and the American Psychological Association also recommend FHWPs to help treat childhood obesity. CDC-recognized family healthy weight programs meet AAP's recommendation for dose and intensity to provide 26 or more contact hours over 3 to 12 months.
These programs help children with overweight or obesity make progress toward a healthier weight through positive behavior changes and lead to Improved parental stress, self-efficacy, and quality of life.
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Examples of CDC-Recognized Family Healthy Weight Programs
Several CDC-recognized FHWPs are available, each with a unique approach to addressing childhood obesity:
- Mind, Exercise, Nutrition…Do It! (MEND): For families with children aged 2 to 13 years who have overweight or obesity. MEND combines physical activity, healthy eating, and behavior change to encourage safe, effective weight management and lasting lifestyle changes.
- Healthy Weight and Your Child: For families with children aged 7 to 13 years who have obesity. The curriculum for Healthy Weight and Your Child is adapted from MEND and implemented at participating YMCA locations. The program engages children and adults in nutrition education and physical activity to elicit positive change and to help families learn skills for healthier lifestyles.
- Smart Moves: For families with children aged 7 to 18 years who have overweight or obesity. Smart Moves combines nutrition education, behavior modification, physical activity, and parental/caregiver support. The goals are to nurture children's self-esteem and healthful behaviors while improving body mass index, body composition, and insulin resistance. The 12-week program includes two 45-minute exercise sessions and one 40-minute nutrition or behavior modification session weekly.
- Healthy Weight Clinic: For families with children and young adults aged 2 to 20 years who have overweight or obesity. Healthy Weight Clinic is conducted in the primary care setting. It focuses on achieving positive behavior change, setting goals, managing obesity-related conditions, and linking families to community resources.
- Family-Based Treatment (FBT): For families with children and young adults aged 2 to 20 years who have overweight or obesity. FBT emphasizes healthy eating, physical activity, and positive parenting. The goal is to empower families to practice new behaviors in a variety of settings to sustain healthy changes. FBT can occur in person or virtually, in a group setting, and through individual sessions with the child and parent or caregiver.
- Building Healthy Families: For families with children aged 6 to 12 years who have obesity. Building Healthy Families is tailored for people living in areas with less than 50,000 residents. Building Healthy Families works with families, especially children, to identify healthier food choices, modify unhealthy behaviors, and increase physical activity.
Is Weight-Loss Surgery Right for My Child?
Some children with obesity cannot achieve a healthy weight through home-based lifestyle changes alone. To meet their needs, some hospitals offer medically-supervised weight management programs. These programs focuses on medically managing the child’s obesity and any associated conditions, such as lipid abnormalities or diabetes. The team - which consists of a physician, nurse practitioner, registered dietitian and a social worker - meets with patients on a monthly basis to track their progress and make adjustments to their treatment plan.
Resources and Support
The American Academy of Pediatrics (AAP) provides numerous resources and support for families and healthcare professionals addressing childhood obesity. The Section on Obesity (SOOb) is the AAP professional home for members and healthcare professionals interested in pediatric obesity prevention, assessment, management, and treatment. In 2023, the AAP has published new clinical practice guidelines on the evaluation and treatment of children and adolescents with overweight and obesity.
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