How to Decide About Treatment for Teens with Excess Weight?

Recent guidelines recommend novel medications to treat obesity in teens. Some doctors urge a more nuanced approach.

In January of this year, the American Academy of Pediatrics published recommendations stating that obese teens should be offered weight loss medication. The announcement was met with concern by many in the community. In an op-ed about the guidelines in Vogue, writer Emma Specter shared, “accepting my body in its current form is an ongoing struggle. What must it be like to be 10 or 11 or even 5 years old and to absorb the implicit message that your body is something to be fixed—by any means necessary?”

A number of pediatricians, including those who commented on the original published guidelines, agree that the guidelines seem more prescriptive than is useful. “I take the greatest issue with the wording in these guidelines,” says family medicine physician, Neil Skolnik, who published his opinion in JAMA Pediatrics. “The guidelines emphasize that we now have medicine approved for treating obesity in teens, and I agree that’s important and can be useful for many teenagers. But we need to be careful in our decisions when it comes to long-term prescription of medication as an approach to obesity and it shouldn’t be the first solution we turn to for young people.”

So how do families figure out the best path forward for their children? Dr. Skolnik discusses the guidelines and offers some strategies for families to consider.