For the first time in nearly 20 years, Canada has updated its national clinical guidelines for childhood and adolescent obesity. This time we will not focus on the number of sizes.
Instead, the new approach recommends focusing on quality of life and mental health, including medications such as GLP-1 for children, if necessary.
GLP-1 drugs such as Ozempic and Wegovy have been approved by the Health Canada as they have not successfully lost weight through diet and exercise alone in adolescents over 12 years of age and older with obesity. However, the drug is not approved for younger children.
The new guidelines, published Monday in the Journal of Canadian Medical Association of Canada, have been developed with the help of obesity Canada, and will create 10 recommendations and nine good practice statements for managing obesity in children.
“Our basic understanding of what this disease is fundamentally. It's actually more of a brain disease than anything else (changed). So, because of its true complexity, we need to recognize obesity and try to preempt it as its chronic disease and then preempt it.”
“And that's why we really wanted to update our clinical practice guidelines for childhood obesity.”
Obesity is a complex, chronic, progressive, highly condemned disease, which increases the risk of over 200 health conditions, says guidelines. Prices are rising.
In Canada, approximately 25% of children aged 4-11 and 33% of children aged 12-17 have a Body Mass Index (BMI), which can indicate that they are overweight or obese, the guidelines say.
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According to Schaffer, more than 50% of children aged 7 to 11 who live with obesity continue to do so throughout adolescence, with about 80% of teens aged 12 to 18 becoming adults.
Because obesity is so complex, the guidelines (first updated since 2007) focus on shared decision-making between obese children, their families and health care providers, highlighting evidence-based options for managing them.
Weight loss may be part of someone's journey, but it is no longer the only or major measure of success.
Instead, the authors recommend multicomponent interventions as the basis of care, including physical activity, nutrition and psychological support. Medications and surgery may also play a role if appropriate and accessible.
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This includes GLP-1 drugs.
The guidelines recommend GLP-1 medications to manage childhood obesity, but be careful. They acknowledge that although these drugs can help with weight loss and some health markers, evidence regarding long-term benefits and side effects is still unknown, and results may vary from person to person.
The guidelines also suggest that two types of weight loss surgeries in children over the age of 13 may be useful under some conditions.
This includes laparoscopic sleeve gastrectomy and gastric bypass. Both surgeries work by limiting the amount of food the stomach can hold, altering how food is digested, and when combined with behavioral and psychological support, leads to weight loss and improved health.
However, the authors point out that there are several risks, including mild side effects such as nausea and stomach pain, and rarely more severe complications.
“With only two surgical centres, a patchwork of interdisciplinary obesity management clinics, and widespread fair and affordable access to treatments in Canada, families know that there are few practical options right now.”
“The authors of the guidelines have advocated for establishing new standards of obesity care for children and adolescents and provided us with a solid, transparent, and interpretable foundation that allows us to begin to receive education.
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