Are weight loss pills and shots or bariatric surgery right for your teen? When the new pediatric guidelines came out this year, it was shocking to many. Given that it had been 15 years since an update, everyone knew a lot had changed. It wasn’t long before many pediatricians, dietitians, and child psychologists started speaking out. The trouble is that many don’t agree with the American Academy of Pediatric’s new guidelines. I’ll go over some of what is being said regarding childhood obesity and liver disease.
Historical Look at the Guidelines
First, its’s important to know that pediatricians go by a growth chart when looking at weight, height, and Body Mass Index or BMI. Many pediatricians watch their young patients trend throughout their lives. So if there is a patient aged 2-18 who generally falls in the 70th percentile in growth, it can be seen as healthy. That is especially true if there are no other health related concerns. We’re talking about a healthy kid with good blood pressure, no gut related problems, and is strong enough to have an active life.
If a child were overweight, parents and physician were to take a watch and wait approach. Most doctors would encourage diet changes and more physical activity.
2023 Updated Guidelines
Ages 2 and Up – First, the obesity guidelines call for 26 hours of classes. These educational modules would include treatment plans. In addition, the family would receive instruction on physical activity, nutrition, and overall behavioral and lifestyle changes. Moreover, a lot of it is geared toward providing good food in the home and being a role model for the child or children.
Age 12 and Up – The newer guidelines have gone WAAY out on a limb, even advising medication for weight loss. In fact, a drug that is given for diabetes was shown to cause weight loss. Wegovy and Ozempic are both injections that acts as an appetite suppressant. If an adolescent needs to lose weight, the family is advised to begin therapies that would include these weekly injections. Wegovy is proven to reduce BMI up to 16% (according to the New England Journal of Medicine) Pharmacy shortages seem to be the biggest problem.
Age 12 – Up are also being encouraged to have bariatric surgery, should the previous treatments not produce the desired results. This is a serious step and a far cry from the previous watch and wait tactic.
How Many Kids Will This Affect?
Close to 20%, or over 14 million kiddos are considered obese. I’m adding an image from the CDC looking at the chart that pediatricians follow for childhood obesity and liver disease.
The big picture is that modern families need helping learning to shop, cook, and eat at home. It’s something that is discussed in The Liver Loving Diet Book. We are already 2 generations away from the family table being a gathering place for most American’s. Fast food chains were virtually unheard of in my childhood, and now they seem to be a staple at every household meal time.
Childhood Obesity and Liver Disease
NASLD which was formerly NAFLD and young people caused the AASLD to call for screening for obesity for fatty liver. We all know that liver enzymes are not elevated early enough to show any inflammation. My liver enzymes were fine right up until my liver failed, however I presented with ascites and varices in the emergency room.
With the new nomenclature regarding fatty liver and increasing cases of adults having fat liver, I’m adding just a few of the studies that contributed to this blog. We’ve reacher the 42% mark of adults with obesity, and for many, that can create liver damage. While the AASLD has not come out with a statement, keep watching here. We can learn about childhood obesity and liver disease with this new pediatrics guideline. I am sure that guidelines regarding childhood obesity and liver disease.will be available soon on the AASLD website patient resources.
If you see something, or have an opinion of this piece, let me know. Furthermore, knowing what can happen may bring the change that is needed for our children. Xo Karen
Image from heart foundation
https://www.nejm.org/doi/full/10.1056/NEJMoa2208601
