For the first time in nearly 20 years, the Canadian Medical Association Journal (CMAJ) has released new guidelines on how to treat children and teenagers living with obesity. The new approach emphasizes early intervention, individual care and moving away from the historic “eat less, move more” approach.
“We know if it was that easy, many people would be doing it by now and we wouldn’t have the problem we face today,” said Dr. Sanjeev Sockalingam, scientific director of Obesity Canada and psychiatry professor at the University of Toronto. “So it really doesn’t do justice to obesity being a chronic disease that has complex causes and pathways.”
The 10 new recommendations, published Monday by the CMAJ, emphasize a focus on mental health and quality of life over the numbers on a scale.
“We now have a lot better understanding of obesity as a chronic disease and how it works,” said Ian Patton, director of advocacy and public engagement at Obesity Canada. “So the recommendations focus on early intervention and making sure timely care happens.”
The recommendations also urge a “family centric” approach to care, rather than simply treating the individual behaviours of a child. Surgery and glp-1 medication like Ozempic or Wegovy, are also recommended when appropriate.
“We are not suggesting that everyone living with obesity should be taking a medication or should be going for bariatric surgery especially in pediatric,” said Patton. “But they are evidence-based solutions that are available.”
According to Obesity Canada, roughly 80 per cent of teenagers living with obesity will carry the condition into their adult years, which can increase the risk of more than 200 different health conditions. Obesity also increases the risk of stigma, which can begin as early as elementary school.
“People were trained (to think) that this is a lifestyle disease, this is about will power, that people are failing,” Sockalingam said.
Obesity is a genetic condition, for which Sockalingham says there is “no silver bullet.”
“We also know there are brain circuitry that predisposes us.”
The study’s authors recommend personalized interventions that include physical activity, nutrition and psychological support.
“Children and adolescents living with obesity deserve comprehensive care,” Sockalingham said. “There are options that are available.”
