The updated AmerAcadPeds guidance on using weight-loss drugs and bariatric surgery to treat more severe child obesity cases has attracted a lot of attention. SandyHassinkMD discussed what the guidelines she co-authored do and don’t say
in 15 years took an urgent tone. The kind of lifestyle changes the guidelines stress aren’t new, but the AAP’s updated guidance on using weight-loss drugs and bariatric surgery to treat more severe child obesity cases has attracted a lot of attention. For more perspective on the guidelines and the reaction they’ve prompted, I spoke with Sandra Hassink, one of the doctors who helped write them.
I think we have to realize that we now understand that obesity is a complex chronic disease. Obesity itself causes metabolic and inflammatory changes in the body that can result in what we call the comorbidities of obesity, which are the associated diseases of type 2 diabetes, liver disease, lipid problems, hypertension. But this disease, which affects 14 million children in the United States, lives within an environment of incredible weight stigma and bias.
The guidelines talk about an extensive physical laboratory evaluation, evaluation for eating disorders, evaluation for mental health problems. And based upon that evaluation, then we have an individualized treatment plan for that individual. So I think that it’s important to recognize that there’s a huge component of evaluation going on here, and we’re interacting with the family and parents and the kid and evaluating the whole situation to figure out how best to help the kid.
How do you think these guidelines will trickle down, not only to the medical Establishment but to people’s primary-care physicians and local doctors? Will this be like gospel to them or more like some friendly advice? Yeah. And we actually say in the guidelines that this implicit bias about obesity is in the medical profession and provide resources for doctors to assess their own implicit bias and be aware of it. So we know that that’s a problem. And the point of backing up the guidelines with a lot of education is to help doctors and move the needle on this.