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American Academy of Pediatric Pushes Medication, Surgery to Treat Obese Kids

American Academy of Pediatric Pushes Medication, Surgery to Treat Obese Kids

Yes, the guidelines include structural racism.

The American Academy of Pediatrics (AAP) finally released guidelines to tackle obesity in children instead of continuing its “watchful waiting” policy.

This is not the first time AAP vocalized its support for weight loss surgery on children. It’s just the first time the group put it in guidelines. AAP adapted its policy statement in 2019 to these guidelines.

The guidelines include common sense approaches but also push parents and doctors not to wait regarding medicine and surgery:

“Weight is a sensitive topic for most of us, and children and teens are especially aware of the harsh and unfair stigma that comes with being affected by it,” said Sarah Hampl, MD, a lead author of the guideline, created by a multidisciplinary group of experts in various fields, along with primary care providers and a family representative.

“Research tells us that we need to take a close look at families — where they live, their access to nutritious food, health care and opportunities for physical activity–as well as other factors that are associated with health, quality-of- life outcomes and risks. Our kids need the medical support, understanding and resources we can provide within a treatment plan that involves the whole family,” said Dr. Hampl, chair of the Clinical Practice Guideline Subcommittee on Obesity.

The guidelines have a discussion on “structural racism” because, of course, it does. This information is important because it comes into play when talking about the surgery:

Racism as an SDoH [social determinants of health] has been defined as a “system of structuring opportunity and assigning value based on the social interpretation of how one looks (race) that unfairly disadvantages some individuals and communities (and) unfairly advantages other individuals and communities…” that “impacts the health status of children, adolescents, emerging adults and their families.”

Inequalities in poverty, unemployment, and homeownership attributable to structural racism have been linked to increased obesity rates. Racism experienced in everyday life has also been associated with increased obesity prevalence. Youth with overweight and obesity have been found to be at increased risk not only for weight-based harassment but also for sexual harassment and harassment based on race and ethnicity, socioeconomic status (SES), and gender. In adults, studies have found positive associations between self-reported discrimination and waist circumference, visceral adiposity, and BMI in both non-Latino and Latino populations.

I’m glad that, overall, AAP emphasizes intensive health behavior and lifestyle treatment (IHBLT). But it also encourages using the medicine for kids between 8 and 11, ages before puberty and full development. How many kids have shed that “baby fat” people talk about by age 8? When you hit puberty, you grow, and the weight usually evens out.

AAP lists eight medications.

Metformin is for patients 10 and older. AAP mentions it is not a weight loss drug, and the FDA hasn’t approved it for “prediabetes, PCOS, and prevention of weight gain when used with atypical antipsychotic medications.”

AAP also lists Phentermine and topiramate, taken as a combination medication, but is only approved for adults trying to lose weight.

Then there’s the push for surgery for those with “severe forms of pediatric obesity (ie, ≥class 2 obesity; BMI ≥ 35 kg/m2, or 120% of the 95th percentile for age and sex, whichever is lower).” I do not see a minimum age requirement in this section except that the FDA approved laparoscopic surgery for people 18 and older. And yet (emphasis mine):

These studies suggest that weight loss surgery is safe and effective for pediatric patients in comprehensive metabolic and bariatric surgery settings that have experience working with youth and their families. Laparoscopic Roux-en-Y gastric bypass and vertical sleeve gastrectomy are both commonly performed in the pediatric age group and result in significant and sustained weight loss, accompanied by improvements and/or resolution of numerous related comorbid conditions.Laparoscopic adjustable gastric band procedures, approved by the FDA only for patients 18 years and older, have declined in use in both adults and youth because of worse long-term effects as well as higher-than-expected complication rates.

Similar to the adult experience, an expanding body of data shows that pediatric bariatric patients also experience durable reduction in BMI, as well as significant improvement and/or complete amelioration of several obesity-related comorbid conditions. These include HTN, T2DM, dyslipidemia, cardiovascular disease risk factors, and weight-related quality of life.

But age is not the only requirement. The AAP recommends that doctors look at the child’s surroundings:

Age is not the sole determinant of eligibility for metabolic and bariatric surgery. The pediatrician or other PHCP should take into account the patient’s physical and psychosocial needs. Evaluation for metabolic and bariatric surgery should include a holistic view of the patient and family, including individual and social risk factors. Families should be fully informed of the benefits and risks of metabolic and bariatric surgery, and their preferences are paramount. As highlighted in a recent AAP policy statement, the decision to continue care with a pediatrician or pediatric medical or surgical subspecialist should be made solely by the patient (and the family, as appropriate).

So instead of working it out with eating less and moving more, the kid should immediately have surgery?

we’re not the only ones who have reservations about the jump to use medicine and surgery on our children. The Associated Press spoke to a few doctors:

“It’s not that I’m against the medications,” said Dr. Robert Lustig, a longtime specialist in pediatric endocrinology at the University of California, San Francisco. “I’m against the willy-nilly use of those medications without addressing the cause of the problem.”

Lustig said children must be evaluated individually to understand all of the factors that contribute to obesity. He has long blamed too much sugar for the rise in obesity. He urges a sharp focus on diet, particularly ultraprocessed foods that are high in sugar and low in fiber.

Dr. Stephanie Byrne, a pediatrician at Cedars Sinai Medical Center in Los Angeles, said she’d like more research about the drug’s efficacy in a more diverse group of children and about potential long-term effects before she begins prescribing it regularly.

“I would want to see it be used on a little more consistent basis,” she said. “And I would have to have that patient come in pretty frequently to be monitored.”

At the same time, she welcomed the group’s new emphasis on prompt, intensive treatment for obesity in kids.

“I definitely think this is a realization that diet and exercise is not going to do it for a number of teens who are struggling with this – maybe the majority,” she said.

Here is a report in 2019 about the policy statement:

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Comments

The Gentle Grizzly | January 9, 2023 at 5:13 pm

I know a good treatment for obese kids. Playing outdoors, and “let’s go ride our bikes!” No video games.

    henrybowman in reply to The Gentle Grizzly. | January 10, 2023 at 2:04 pm

    That works in the country. In the cities and suburbs, government weenies call CPS on you if you let your kids walk across the street alone to play in the park, because they might encounter thugs and molesters that those same government weenies are too incompetent to flush out of the park, and that’s all your fault.

“Racism experienced in everyday life has also been associated with increased obesity prevalence.”

“Experts.”

I notice a lot of fat kids have recently taken up a version of exercise that involves jumping up on fast food counters and assaulting the employees, or engaging in weight training by lifting and carrying as much merchandise as possible from department stores.

They are going to kill the kid’s one way or another
Vaccinations, medications and surgery

My daughter found a holistic OD by her.

Can’t trust her pediatrician she’s very woke

The cure for obese kids is military training with a controlled diet. They go to camp and don’t get to leave until they are a normal weight.

    txvet2 in reply to The_Mew_Cat. | January 9, 2023 at 6:30 pm

    Didn’t work for me. I gained 20 pounds.

    Tv show called the Biggest Surgical Loser with 4 episodes:

    1. Pre-surgery (sumptous eating while discussing weight issues)
    2. Surgery (surgeon demonstrating the procedure)
    3. Weigh in (awards to celebrate biggest loser)
    4. Six month follow up (showing nothing changed)

I knew “kids” in their 20s who still hadn’t lost their “baby fat.”
Amazing what less than a month in the Armed Forces did for their waistline, beer and all.

    diver64 in reply to paracelsus. | January 10, 2023 at 4:23 am

    Been there, done that. Went in overweight but not obese, came out having just run the All American Marathon at Ft. Bragg. Funny what diet and exercise will do for you

Stop drinking soda and get off the couch. That would be the cure for most obese kids.

    CommoChief in reply to Eddie Baby. | January 9, 2023 at 6:46 pm

    No sugary drinks is a start. Eliminate processed foods is another. Substitute water and home cooked meals. Parents have to do a better job on what’s in the pantry and fridge. Then they must get their child off the couch and into some sort of physically challenging activity.

    It sucks being a fat kid. I was one until puberty despite eating healthy and being active; PE program at school, Boy Scouts (a timed hike 5+ miles each month to qualify for the longer 25 mile hike annually), running around playing in the woods after school. Still ‘husky’ until I suddenly grew five inches from Feb to August when I turned 12. Then another four inches the next year and three the year after that. Suddenly I was 5’10’ 170 lbs in 8th grade. Grew a few more inches in HS and the weight room added muscle mass.

    Some b

nordic prince | January 9, 2023 at 7:01 pm

Dr. Lustig is right. Dump the processed food and especially the sugar, and the vast majority of these kids will shed the weight naturally.

Tighten up what foods can be purchased with EBT and I do believe we would see lower obesity rates among those who rely on SNAP. Changing the nutritional guidelines for school lunch programs sure wouldn’t hurt. Letting schools develop their own meal plans with fresh foods instead of mass produced “Sysco” style commodities should be an option.

They sure are bound and determined to cut kids open every chance they get, for whatever excuse they can dream up.

Transgirth Conversion Therapy

Transgastrointestinal Correctional Therapy

They did it with ADD, why not obesity? Turn those children into little medical gold mines for unethical doctors!

Control, Leftists are always about control. Drug them early and often, ADHD, obesity, soon other forms of compliance. They know how to live your and your kids lives better than you. Better living through chemistry. Next, education camps, ’cause public schools just aren’t enough.

Stop feeding them garbage. Reform snap so that refined carbs are not included. No garbage food with added sugar.

    diver64 in reply to Sanddog. | January 10, 2023 at 4:26 am

    Personally, I’m all for government grocery stores where they are the only place SNAP cards work. Nothing unhealthy in the stores. Potato’s, rice, milk etc. Want government money then you can use it where we say you can.

Introduce animal protein into their diets. A lot of it.

Agree with Sanddog. Reform Snap so none of the benefit can be used on junk, only on basic healthy food. No idea the times I’ve watched my tax money be spent on chips, ice cream, soda and frozen french fries.

The food industry—-all of them from fast food to cereal to bread—— have scientist employed whose sole purpose is to create foods that trigger the reward centers in the brain to get you to eat more.

The government has people employed that give us guidelines like the food pyramid, which is a guideline to become obese. They push ”low fat” and have no concern at all that low fat products have to be supercharged with sugar to make them edible and get the person addicted.

The drug companies dream is to get a baby hooked on some type of drug or multiple drugs, and have that person on the drug for life….hopefully 60-70 years of profitability.

Med schools teach very little about nutrition and the body’s own power to heal itself.

Doctors are in bed with drug reps, getting a kickback every time they prescribe a drug, incentivizing more drugs instead of healthy lifestyles.

Advertisers showcase obese models, and don’t you dare say that being obese is unhealthy.

In light of this, It’s actually amazing that 100% of all of us aren’t obese.