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Writer's pictureAnoop Kumar, MD

Injections for Kids with Obesity?

Earlier this year, the American Academy of Pediatrics (AAP) recommended the use of drugs as part of the treatment for obesity in children.


Here is part of what they recommend:


"Physicians should offer adolescents ages 12 years and older with obesity weight loss pharmacotherapy, according to medication indications, risks, and benefits, as an adjunct to health behavior and lifestyle treatment."


The problem I have is that "as an adjunct" sounds good, but earlier in the same document, the AAP throws up it hands and declares that health behavior and lifestyle treatment are "challenging to deliver and not universally available."


No such qualification is seemingly necessary for weekly pediatric injections, which apparently should be interpreted as not challenging and universally available.


I've seen many posts about this on LinkedIn, often offering the perspective that many kids have no other options and nothing else is working. The fact that decreasing the body mass index can decrease the likelihood of other diseases is stressed. The fact that kids are teased because of obesity and that we should do something about it is stressed. I do understand that. My question is: What will we adults do differently about it other than prescribe drugs? Have we as adults and professionals truly reached the limits of our abilities in helping our children and the children of our neighbors?


From a commercial perspective, you can bet that the interest in manufacturing these drugs is to ensure patients stay on them as long as possible. Everyone, including the AAP, knows this. This drug is not intended to be a bridge, just as drugs for hypertension, type 2 diabetes, depression, and more are not manufactured to be short-term bridges while people are supported in learning and changing behavior and becoming independent of medication.


So the question is, what is the American Academy of Pediatrics going to do differently to change the fact that health behavior and lifestyle treatment are challenging and not universally available? What are they going to do about the fact that their advice is not working, other than prescribe new drugs? What new training, new money, new standards, new accountability, and new resources are going to be dedicated to ensuring that health behavior and lifestyle treatment is going to become less challenging and more universally available?


If we truly place our kids first and want them to be healthy enough to be as independent from life-long medication as possible, we must look at ourselves and answer those questions first. If we do not hold ourselves responsible for choices that made health challenging and unavailable in our society, what can we teach our children?

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