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'They'll grow out of it' is no longer an accepted response to childhood obesity

A smiling child, sitting on a granite kitchen counter top, feeds his mother while she prepares a salad
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This stock photo shows a mother and son preparing a salad. Doctors say proper nutrition is essential for childhood health.

For the first time in 15 years, the American Academy of Pediatrics has released new guidance for the evaluation and treatment of children who are overweight and obese.

The guidelines include early, aggressive and multi-pronged treatment plans and in more severe cases, medication and even bariatric surgery.

Obesity affects over 1.4 million U.S. children and teens and has long been stigmatized. The new AAP recommendationsreleased on Jan. 9 are based on the view that obesity is a complex disease with both short and long-term health implications, rather than a problem merely resulting from lifestyle choices.

The guidelines for treatment have an air of urgency. "We can't just tell parents, 'Oh, they'll grow out of this,' which, for a long time we felt was probably an okay thing to do," said Dr. Stephen Cook, a pediatrician at the University of Rochester Medical Center.

Cook said years of research-based evidence now points to proven strategies centered on intensive health behavior and lifestyle treatment programs involving nutritionists, exercise physiologists, and social workers.

It's important that this approach involves the whole family, Cook said, even if the goal for other family members isn't weight loss. "It's always better to be exercising more, to not going to food as a coping mechanism, to be aware of stressful events and how the body responds to them," he said.

Listen to Beth's full talk with Dr. Stephen Cook
Dr. Stephen Cook, a pediatrician with the University of Rochester Medical Center, discusses new childhood obesity treatment guidelines.

Overweight children have a body mass index at or above the 85th percentile for their age and sex. Obesity is classified as a BMI at or above the 95th percentile. When children are above the average target weight for their age but not obese, the goal is not necessarily weight loss, but the prevention of further weight gain.

"We have to work against certain marketing forces," Cook explained. "But there's also genetics and biology, that if we can improve a child's weight, get it more on track earlier, it will be less of an issue the older they are."

He said weight loss surgery, when done in an appropriate setting and with the proper support services, has proven effective for severely obese adolescents, who represent perhaps only 3% of school-aged children. But Cook stressed that surgery shouldn't even be considered unless the child also has other significant medical complications such as pre- type 2 diabetes, severe sleep apnea, or fatty liver disease.

Beth Adams joined WXXI as host of Morning Edition in 2012 after a more than two-decade radio career. She was the longtime host of the WHAM Morning News in Rochester. Her career also took her from radio stations in Elmira, New York, to Miami, Florida.