Nov. 3, 2008 -- Drug therapy is increasingly being used to treat children and teens with obesity-related health problems, such as diabetes, hypertension, high cholesterol, and depression, a new study shows.
In addition, more children and teens between 5 and 19 are taking drugs for asthma and attention deficit hyperactivity disorder (ADHD), which aren't related to obesity, say scientists at St. Louis University in the November issue of the journal Pediatrics.
"The main message of our study is that we are using chronic medication a lot more than we used to," Donna Halloran, MD, a professor of pediatrics at St. Louis University, tells WebMD. "We know obesity causes other medical complications, like diabetes, high blood pressure, cholesterol problems, and depression."
Chronic Medications for Kids: The Upside
Though there is no known link between obesity and ADHD, pediatricians are increasingly choosing drug therapy for it, too, she says.
Robert Geller, MD, a professor of pediatrics at Emory University School of Medicine in Atlanta, tells WebMD it's likely more youngsters are taking drugs for ADHD because "there's been a reduction in the stigma" associated with those conditions.
"Now people are more willing to admit it and get appropriate help," he says.
The study doesn't answer whether asthma severity and incidence are related to increasing obesity among young people, he says, but the problems seem to have some overlap.
Halloran and colleagues studied prescription claims data for more than 3.5 million commercially insured youngsters between 5 and 19, covering the period 2002 to 2005.
During that period, the prevalence rate for diabetes medicines among those youngsters doubled, and asthma medication use jumped 46.5%, the study shows. Drug use to combat ADHD rose 40.4%, and 15% for medications to lower lipids and cholesterol.
"We are seeing more disease, better detection of disease, and more use of medication," she says. "We don't know the risks for long-term medication use, but better diagnosis is a good thing."
Scientists don't know if there's a link between obesity and ADHD or obesity and asthma, she says, and "we don't know whether obesity causes depression or vice versa. But a tie-in would make sense."
Lifestyle Changes Prescribed
Halloran recommends families eat more fresh fruit, stop eating salt-rich fast foods and drinking high-calorie sodas, and engage in more physical fitness activities. And parents, she adds, should talk more to teachers if they think their children have attention deficit or hyperactivity problems.
"We are seeing more high cholesterol in children, we think related to the obesity epidemic," she tells WebMD. "Good cholesterol, or HDL, is dramatically affected by exercise in a positive way. And LDL, the bad cholesterol, is dramatically affected by diet."
"Patients are receiving therapy for medical conditions that may previously have gone untreated, such as asthma and ADHD," Geller says. "It is good that they are being treated, [but] it is bad that they need the treatment. If we had better physical fitness and less obesity and better diets, many of these illnesses would not require treatment."
Young people "need to stay on the drugs as long as their conditions are problems," he says.
Chronic Medication Use in Children: The Study
The number of children taking drugs to treat chronic conditions increased across all treatment classes evaluated, Halloran and the other researchers write.
"Additional study is needed into the factors influencing these trends, including growth in chronic disease risk factors, greater awareness and screening, and greater affinity toward early use of drug therapy in children."
In use of blood pressure medications, lipid-lowering agents, diabetes drugs, and antidepressants, prevalence for youths 15-19 was at least two times greater than in 10- to 14-year-olds and three times greater than in youngsters 5 to 9, the study shows.
The study's findings:
- Overall, girls took more blood pressure medication, even though boys are more likely to have hypertension.
- Children more than doubled their use of type 2 diabetes medications between 2002 and 2005, with girls 10-14 showing a 166% increase.
- The largest increases in high blood pressure treatments were seen in teens 15 to 19, but the researchers say that may reflect increased obesity rates and better screening in that age group.
- The prevalence of diabetic prescription use among children more than doubled from 2002 to 2005, driven by a rise in use among girls, the study shows.
- Overweight and obese youngsters, the research shows, are about twice as likely as those of normal weight to develop diabetes.
- The number of males 15 to 19 using a blood pressure drug increased 15.4%. Among females in the same age group, use of blood pressure drugs declined 1.6%.
- Females 15-19 on antidepressants increased 6.8%, while medication use among males in that age range declined slightly.
The data used in the study consisted of pharmacy claims and eligibility information for youngsters enrolled with Express Scripts, which serves thousands of client groups, employers, and insurance carriers, among others.
The researchers say their findings "hold important implications for children's health and health care costs in the United States."