COLUMBUS, Ohio (WCMH) — Children struggling with obesity should receive aggressive treatment earlier, including medications and surgery, according to new guidance from a leading U.S. pediatricians group. 

The American Academy of Pediatrics released new guidelines on Monday for children with obesity and shifted from previous guidance that delayed treatment to see if they outgrew obesity in their teenage years. Now, the group recommends “early treatment at the highest level of intensity” for the common pediatric chronic disease affecting more than 14 million children. 

“Obesity is a challenging disease, and it’s difficult sometimes to treat,” said Dr. Ilhuoma Eneli, director of the Center for Healthy Weight and Nutrition at Nationwide Children’s Hospital and co-author of the new guidance. “The earlier that you start treatment, the more likely you’re going to have better outcomes.” 

The guidelines outline a “comprehensive, intensive behavioral treatment” plan as 26 hours or more over three to 12 months of in-person behavior and lifestyle treatment, including coaching for changes in health behavior, nutrition and physical activity. The AAP recommends this approach for patients six and older. 

Following lifestyle treatment, the group recommends considering weight loss medications for patients beginning at age 12 and weight loss surgery for patients with severe obesity beginning at age 13. 

Treatment options can be implemented singularly or in combination to find a plan that works best for the patient’s family, factoring in the patient’s age, the severity of the obesity and the presence of comorbidities. Eneli said treatment success is no longer tied to a number, like weight or body mass index. 

“We now have an incredible amount of evidence and data that tells us that success is more about health; it’s about the whole child,” said Eneli. “It’s about making a child have a better quality of life, feel happier, be healthier, and, of course, that can come with weight loss.” 

AAP’s holistic approach aims to factor in complex causes for obesity, like inequalities in poverty, unemployment, homeownership attributable and structural racism. The guidelines said reframing the conversation combats stigma and weight-based harassment, which can contribute to binge eating and social isolation. 

Comprehensive treatment can also remedy other severe health conditions often associated with obesity, like type-two diabetes, hypertension, high cholesterol and sleep apnea, said Eneli. She stresses that pediatric healthcare providers are here to use evidence-based tools to create an integrated plan that addresses each patient’s concerns. 

“As a parent, what is most important is that you’re able to share and discuss with [pediatricians] what you feel is the priority for your child,” said Eneli. “You know your child best, and you’re the best advocate for your child.” 

View the American Academy of Pediatrics’ new guidelines on childhood obesity here.