The American Society for Metabolic and Bariatric Surgery (ASMBS) fully supports the new “Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity” issued from the American Academy of Pediatrics (AAP) calling for earlier and more intensive treatment of obesity in children and teens. Published in the journal Pediatrics in February, this is the first comprehensive guideline on obesity in 15 years from the AAP, the largest professional association of pediatricians in the U.S.
According to AAP, more evidence exists than ever that obesity treatment is safe and effective while there is “no evidence to support either watchful waiting or unnecessary delay of appropriate treatment of children with obesity.” About 14.7 million children and teens or nearly 20% of the younger population in the United States have obesity, a number that rises dramatically in the adult population. The U.S. Centers for Disease Control and Prevention(CDC) reports 42.4% of American adults have obesity with 9.2% having severe obesity.
The AAP Guideline “recommends early evaluation and treatment at the highest intensity level that is appropriate and available.” Treatment options may include exercise, nutrition support, behavioral or lifestyle interventions, and pharmacotherapy as early as age 12. It also recommends that patients 13 years and older with severe obesity be referred to comprehensive and multidisciplinary centers that provide pediatric-focused metabolic and bariatric surgical care. This strong endorsement comes after the publication of Pediatric Metabolic and Bariatric Surgery, Evidence, Barriers, and Best Practices, a 2019 AAP policy statement that called for better access to bariatric surgery for teens with severe obesity .
“These are significant recommendations from the American Academy of Pediatrics that provide further recognition and understanding that diet and exercise alone are insufficient solutions for obesity,” said Teresa LaMasters, MD, President, ASMBS. “Younger patients need not get any sicker or gain more weight or wait until adulthood to access the most proven and effective treatments available. As with many serious diseases including obesity, early diagnosis and treatment leads to better outcomes.”
In its own pediatric guidelines issued in 2018, the ASMBS stated that “children who suffer from obesity are at a significant disadvantage if they are denied metabolic and bariatric surgery,” generally considered the most effective long-term treatment for severe obesity that has been shown to improve quality of life and longevity, as well as produce significant weight loss and prevent, improve or resolve related diseases including type 2 diabetes, high blood pressure, heart disease, stroke and certain cancers.
“It is our hope pediatricians, health systems, community partners, payers, and policy makers recognize the significance and urgency of treating obesity early in the disease process and advance its availability and accessibility to all children and adolescents who need it,” said Marc P. Michalsky, MD, MBA, FAAP, co-author the AAP Guideline and pediatric surgeon and surgical director at the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital in Ohio.
About Metabolic and Bariatric Surgery
Metabolic/bariatric or weight-loss surgery such as gastric bypass and sleeve gastrectomy have been shown to be the most effective and long-lasting treatment for severe obesity. The operations improve or resolve diseases including type 2 diabetes, heart disease and high blood pressure and leads to significant and durable weight loss. Its safety profile is comparable to some of the safest and most commonly performed surgeries in the U.S., including gallbladder surgery, appendectomy and knee replacement.
The ASMBS is the largest organization for bariatric surgeons in the nation. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of severe obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for patients with severe obesity. For more information, visit www.asmbs.org.
Subject of Research
Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity
Article Publication Date