According to a draft suggestion made on Wednesday by a group of US specialists, children with obesity should begin receiving intense counseling to develop healthy diet and exercise habits at the age of six.
In 2017, the government-backed U.S. Preventive Services Task Force (USPSTF) suggested that screening for obesity begin at the age of six.
Since then, research has proved the effectiveness of intensive behavioral interventions – defined as at least 26 hours of counseling with one or more health experts – in helping children and adolescents achieve a healthy weight and improve their quality of life, according to the panel. The recommendation did not include a timetable.
The new USPSTF guidance makes no mention of the use of drugs, such as Novo Nordisk’s (NOVOb.CO) Wegovy, which is licensed for children aged 12 and up, or surgery.
According to the Task Force, it assessed the evidence on weight reduction drugs but concluded that additional research is needed to properly understand the long-term health implications of medications.
According to task force member Dr. Katrina Donahue of the University of North Carolina School of Medicine, behavioral therapies would be “a package” that included physical activity, support for behavior modification, and information about healthy eating.
Because local resources varied, the interventions will “look different in different cities,” according to Donahue.
However, an assessment of data from 58 randomized controlled trials involving over 10,000 children by the panel indicated that these programs are effective “as long as the child receives a total of at least 26 hours of contact with professionals,” according to Donahue.
The evidence supporting intensive interventions received a “grade B” from the USPSTF, indicating that there is a high likelihood that the interventions would have at least a moderate benefit. The children in the studies shed an average of 4 to 6.5 pounds (2 to 3 kg), with the weight loss lasting at least a year.
Obesity in children and adolescents up to the age of 19 is defined as having a body mass index – a weight-to-height ratio – that is greater than 95% of children of the same age and gender.
According to the Centers for Disease Control and Prevention, nearly one in every five children and adolescents in the United States falls into this category.
According to AAP guidelines, lifestyle support should include 26 or more hours of “face-to-face, family-based, multicomponent treatment over a 3- to 12-month period.”
However, the AAP has urged pediatricians to give weight-loss medications to children aged 12 and over who are obese, as well as referral for evaluation for metabolic and bariatric surgery to adolescents aged 13 and older who are very obese.
AAP spokesperson Dr. Sarah Hampl of Children’s Mercy Kansas City and the University of Missouri-Kansas City School of Medicine, who was not involved in the USPSTF guideline, noted that many factors contribute to childhood obesity, including socioecological, environmental, and genetic influences, and that treatment should include identifying and addressing as many of these risk factors as possible.
“A minimum of 26 hours of intensive health behavior and lifestyle treatment has been shown to improve children’s weight-related and other health outcomes,” she went on to say.
“Each child who is obese should be evaluated and reevaluated over time.” Children with obesity have a disease continuum, with some requiring more advanced treatments in addition to intense health behavior and lifestyle care.”