A welcome paradigm shift in the management of childhood obesity has landed. New Canadian guidelines endorse a multifaceted approach that aims to reduce stigma and harm while expanding treatment options. These best practices have not been updated since 2007. Third, they emphasize that health care providers should provide more intensive and effective interventions only when these specific conditions are present. They shed much-needed light on the perils of weight stigma, which harms children’s mental health and overall well-being.
Jennifer Yoon, a health news reporter at CBC News, explains this rapidly changing landscape in obesity treatment. The updated guidelines aim to help families navigate the challenges of childhood obesity with more comprehensive resources and a focus on individualized care.
Our young patient Brenndon Goodman, who had weight-loss surgery with us, shared his personal journey with obesity and its challenges to the audience. He was under tremendous pressure and emotional strain. Faced with the unforgiving truth of his weight, his pride and pain as a failure came tumbling out. His story is a great illustration of the strong relationship between physical health and mental health in kids who struggle with obesity.
Revised Guidelines for Treatment
The guidelines released today call for stronger actions to address the treatment of childhood obesity. Indeed, there are fondly referenced interventions such as GLP-1 medications and bariatric surgery, but again only in very limited circumstances. Healthcare providers should consider the unique context of each child before commencing these procedures.
Dr. Sanjeev Sockalingam is an associate professor in the psychiatry department at the University of Toronto. Yet he cautions against allowing these more extreme interventions to always become our first resort.
“We’ve had a long-standing history in obesity care and management, where people have attributed it as something to do with willpower.” – Dr. Sanjeev Sockalingam
He warned against the idea that these interventions are silver bullets. For children, scant evidence is all that’s left when it comes to the side effects of GLP-1 drugs. This underscores the crucial need for more research to understand the long-term effects of these powerful medications on our youngest patients.
Dr. Jill Hamilton, head of the endocrinology division at the Hospital for Sick Children, acknowledged that there have been big accomplishments in treating pediatric obesity.
“Currently it’s only recommended for ages 12 and up, and obviously further research is needed because these are relatively new medications.” – Dr. Jill Hamilton
This careful approach acknowledges that while medications like Wegovy, Ozempic, and Mounjaro have shown promise in treating obesity, their implementation requires thorough consideration and ongoing study.
The Importance of Addressing Stigma
Perhaps the most notable aspect of the new guidelines is their focus on addressing weight stigma. Dr. Sockalingam noted that societal attitudes towards obesity often lead to stigmatizing experiences for children and adolescents.
“All that stigma just perpetuates all the negative experiences, especially children and youth experience day to day.” – Dr. Sockalingam
Vincci Tsui, a registered dietitian based in Calgary, echoed this sentiment, arguing against treating higher body weight as an inherent disease.
“The problem is when you pathologize a body size, or pathologize this idea of ‘excess body fat,’ that in and of itself also increases stigma.” – Vincci Tsui
This understanding highlights the importance of being sensitive to the way healthcare professionals talk to kids about their weight. We want the best possible, most caring outcomes for our children. This method fosters their holistic wellbeing while avoiding instilling shame or feelings of inadequacy.
A Call for Comprehensive Solutions
The updated guidelines call for a holistic approach to childhood obesity management that goes beyond traditional methods like diet and exercise. Dr. Sockalingam emphasizes that if you just focus on behavior change, that’s failed to work long-term.
“In terms of, you know, the ‘eat less, move more’ movement, we know that alone, as a treatment for obesity, does not provide sustained success.” – Dr. Sanjeev Sockalingam
He is a passionate proponent for a broader set of tools to address this complex, chronic disease. He understands that fighting childhood obesity requires different approaches to address different needs.
Goodman’s experience illustrates the profound impact of obesity on children’s lives. Even with all of his ups and downs with food, he is optimistic about what’s to come.
“It’s a choice I would make again a hundred times,” – Brenndon Goodman
His statement further highlights the need for policy makers to consider surgical options when developing a comprehensive treatment plan whenever appropriate.
