New guidelines for managing obesity in children and adolescents

A new guideline to help healthcare providers manage obesity in children and adolescents takes a patient-centred approach, emphasising behavioural and psychological supports that focus on outcomes valued by patients and their families. The guidance was developed by Obesity Canada through an extensive, year-year-long collaboration involving adolescents and caregivers with lived obesity experience, methodologists, health care providers and more than 50 multidisciplinary experts.

“The guideline is designed to support shared and informed clinical decision-making rooted in systematic, interpretable summaries of scientific evidence,” said Dr Bradley Johnston, associate professor of nutrition and health research methods and co-chair of the guideline development committee. “To achieve that, we devised a transparent process to assess the totality of scientific evidence for relevant interventions to manage paediatric obesity, while prioritising outcomes that matter the most to children, adolescents, and their families.”

These outcomes include quality of life, mental health, related cardiovascular risk factors, avoiding harms, and more.

Paediatric obesity is a complex, chronic, progressive, and stigmatized condition that increases risk for more than 200 health conditions. In Canada, about one in four children aged 11 years or younger and one in three adolescents aged 12–17 years have an elevated body mass index, suggesting overweight or obesity. International data indicate that severe obesity appears to be on the rise globally.

“The health consequences and persistence of paediatric obesity into adulthood highlight the need for available, accessible, family-oriented interventions for effective obesity management,” said Dr Sanjeev Sockalingam, scientific director, Obesity Canada. “Success in managing paediatric obesity is most likely when children and their families can access support and practical strategies to make and sustain positive behavioural changes, complemented by pharmacologic and surgical interventions, if necessary and available.”

The guideline contains ten recommendations, including guidance on nutritional, physical activity, psychological, and technology interventions, and medications and surgical options, as well as nine good practice statements. The authors recommend combining at least 2 options to help manage obesity.

“We know the time to act on paediatric obesity is now. Waiting until children and adolescents become adults before providing meaningful, informed, evidence-based care and support only heightens the risk for developing complications and prolongs the experience of living with a stigmatised chronic disease, which can worsen further physical and mental health outcomes,” said Lisa Schaffer, executive director, Obesity Canada.

Obesity Canada has developed resources including infographics and videos to help health care providers and families determine the best path to take in managing childhood obesity.

The new guidelines were reported in the paper, ‘Managing obesity in children: a clinical practice guideline’, published in the Canadian Medical Association Journal. To access this paper, please click here