For the first time in 15 years, the American Academy of Pediatrics (AAP) updated its recommendations on childhood obesity, and new guidelines include treatment with medications and surgery.

As childhood obesity rates seem to skyrocket, for the first time in a decade and a half, the AAP is recommending new guidelines for treatment. Emphasizing both the need to have early intervention as well as intensive treatment, the organization suggests that the pandemic has made obesity issues in children even worse.

According to data from the Centers for Disease Control and Prevention (CDC), since the 1980s, obesity rates have tripled in children and quadrupled in adolescents. In the past 15 years, they've gone from 17% to 20%, with one CDC finding showing the rate of weight gain nearly doubled in 2020 as compared to prepandemic years.

According to the CDC, obesity affects almost 15 million children and adolescents in the United States. Consequences of childhood obesity include rises in Type 2 diabetes and high blood pressure, as well as mental health burdens.

The AAP now highlights that obesity is complex and chronic, and there's no simple fix. And while they recommend that intensive behavior and lifestyle changes should be the first avenue for treatment, clinicians should not rule out anti-obesity medications and even surgery for children. This is a first-of-its-kind recommendation for the organization.

Dr. Sandara Hassink is the medical director of the AAP Institute for Healthy Childhood Weight and co-author of the new guidelines. She says that there is evidence that obesity therapy is effective, as is treatment and the time to recognize obesity as a chronic condition should be addressed as we address other chronic conditions. That means, according to Dr. Hassink, that intervening sooner than later is key, as no evidence shows delaying treatment is beneficial. Obviously, they recommend working with pediatricians and other health care providers to implement healthy changes, but

For children who are 12 and older, a major recommendation change is the introduction of anti-obesity medicines and weight-loss surgery in addition to lifestyle changes.

There are four drugs that are approved for obesity in adolescents 12 and over--Orlistat, Qsymia, Sexenda and Wegovy. Phentermine is for teens 16 and older. The drug Imcivree (setmelanotide) has been approved for kids 6 or older who have Barde--Biedl syndrome, which is a genetic disease that causes obesity.

Wegovy is a popular weight-loss drug for adults and was just approved in December for kids 12 and up. That said, a one month supply can cost as much as $1,500.

For teens 13 and older who have severe obesity, the guidelines recommend talking about weight-loss surgery, and the sooner the better, as research suggests getting bariatric surgery sooner can possibly reverse high blood pressure and Type 2 diabetes.

Dr. Hassink emphasized that surgery and medicine should NOT be first-line treatments and only be considered in special situations where lifestyle changes are impossible or prove ineffective.

For many low-income and overworked families, telling them to eat more greens and get more exercise sounds easy but if you live in a neighborhood with few safe places to walk/exercise and or have restricted access to affordable healthy foods, it's not as easy as it sounds..

Future guidance will directly address obesity prevention, but the current guidance emphasizes the importance of public policy aimed at preventing obesity.

Additionally, having healthcare facilities that offer psychological and nutritional help with other specialties all in one place may make it easier for families to help their children.

And most important to remember, the best, cheapest and most effective way to treat obesity will be preventing it, so cultural focus across the country is key.