The new Canadian clinical guideline for childhood and adolescent obesity focuses on quality of life and mental health rather than solely on weight loss. The guidelines recommend the use of GLP-1 medications for adolescents aged 12 and up who have obesity and have not been successful with diet and exercise alone. These medications have been approved by Health Canada for this age group, but not for younger children. The guidelines include 10 recommendations and nine good practice statements for managing obesity in children, emphasizing the importance of evidence-based options for care.
Obesity is a complex, chronic, and highly stigmatized disease that puts individuals at risk for more than 200 health conditions. In Canada, around 25% of children aged four to 11 and 33% of those aged 12 to 17 may be classified as overweight or obese. The guidelines stress the importance of early intervention, as more than 50% of children with obesity will continue to have the condition into adolescence, and roughly 80% will carry it into adulthood. The updated guidelines encourage shared decision-making between children, their families, and healthcare providers when managing obesity, with a focus on a combination of physical activity, nutrition, and psychological support as key components of care.
While weight loss may be a part of the treatment plan, it is not the sole measure of success in managing obesity. The guidelines recommend multicomponent interventions that address the various factors contributing to obesity, with medications and surgery considered in some cases. GLP-1 medications are recommended for pediatric obesity, but with caution due to uncertainties about long-term benefits and side effects. Weight-loss surgeries, such as gastric bypass and laparoscopic sleeve gastrectomy, may also be helpful for adolescents aged 13 and over, although these procedures come with risks and require additional support to be effective.
Dr. Sanjeev Sockalingam, the scientific director of Obesity Canada, highlights the lack of equitable and affordable access to treatments for pediatric obesity in Canada. With only two surgical centers and limited multidisciplinary obesity management clinics, families have few practical options for care. The new guidelines aim to provide a transparent and interpretable foundation for advocating and educating towards establishing a new standard of care for children and adolescents with obesity, emphasizing the right to evidence-based care to improve health and well-being.
Overall, the focus of the updated Canadian clinical guidelines for childhood and adolescent obesity is on improving quality of life and mental health outcomes rather than solely on weight loss. The guidelines recommend a holistic approach to managing obesity that includes physical activity, nutrition, and psychological support, with medications and surgery considered in some cases. While GLP-1 medications and weight-loss surgeries may offer benefits in managing pediatric obesity, the guidelines stress the need for caution and additional support to ensure long-term success. The authors emphasize the importance of early intervention and shared decision-making in providing evidence-based care for children and adolescents living with obesity.
