Expert Panel Urges Behavioral Coaching for Kids With High BMI

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June 19, 2024 – The U.S. Preventive Services Task Force recommends that children and adolescents with a high body mass index, or BMI, receive intensive counseling – but not weight reduction drugs – to achieve a healthy weight.

In a report issued Tuesday, the USPSTF said that children and adolescents over age 6 with a BMI in the 95th percentile should receive 26 or more hours of counseling a year. The counseling could include supervised physical activity sessions, information about healthy eating and reading food labels, diet and activity monitoring, and help with setting goals.

The USPSTF said it did not recommend weight loss drugs sold under brand names such as Wegovy or Lomaira because there had not been enough research into their effect on children, and they have been known to cause stomach upset. Also, limited evidence shows that people who do take the drugs have weight rebound when they stop taking them, the report said.

“Therefore, the USPSTF encourages clinicians to promote behavioral interventions as the primary effective intervention for weight loss in children and adolescents,” the report said.

The USPSTF is a volunteer panel of medical experts that “makes evidence-based recommendations about preventive services such as screenings, behavioral counseling, and preventive medications,” its website says.

Several experts in weight loss for children criticized the report for not backing the use of drugs to help obese children and teens lose weight.

“Having the option of medication in the appropriate clinical scenario is very important,” Susma Vaidya, MD, MPH, an associate medical director at the IDEAL Clinic, the weight loss program at Children’s National Hospital in Washington, DC, told The Washington Post. “I am a big believer in medication, and I think that we have been advocating for lifestyle change for a long time and haven’t made a whole lot of progress.”

“We don’t have long-term data on weight loss drugs, and I get that it is a concern, but we do have long-term data on the outcomes associated with obesity, and we know that individuals with obesity are at risk for certain comorbidities,” she said.

Obesity has been linked to a host of physical and emotional problems, including diabetes, heart trouble, and depression.

Experts also criticized the USPSTF’s recommendation as unrealistic, saying it would be very difficult to achieve 26 hours of counseling in a clinical setting and nearly impossible in a primary care setting.

BMI uses your height and weight measurements to estimate how much body fat you have. The USPSTF report said about 19.7% of children and adolescents ages 2 to 19 years in the U.S. have a BMI at or above the 95th percentile for age and sex. That means these children have BMIs higher than 95% of other children of the same age and gender, based on CDC growth charts from 2000.

The CDC has an online calculator to help parents or caregivers estimate their child’s BMI.