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Between 2017 and 2020, the prevalence of pediatric obesity (defined as a body mass index [BMI] at or above the 95th percentile for sex and age) in the United States was 19.7%, with obesity and severe obesity rising significantly since 1999.1 This trend raises concerns as pediatric obesity is linked to long-term health issues like hypertension, asthma, and type 2 diabetes. Management strategies, as reviewed by Matson and Fenn,2 are multifactorial, encompassing nonpharmacological, pharmacological, and surgical interventions.

In February 2023, the American Academy of Pediatrics (AAP) released guidelines for the evaluation and treatment of children and adolescents with obesity, which consist of 14 key action statements addressing evaluation, assessment, comorbidity prevention, and treatment.3 Notably, pharmacologic therapy is recommended in patients 12 years of age or older and may be considered for those 8 years or older. Medications such as metformin, orlistat, phentermine/topiramate, and glucagon-like peptide 1 (GLP-1) agonists are included, though no drug is preferred over another. For patients at least 13 years of age with severe obesity, guidelines recommend referral for evaluation for metabolic and bariatric surgery.

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