“Why Experts Are Urging Swifter Treatment for Children With Obesity: Growing Research Has Shown That Intensive Interventions Are Needed, Scientists Say. Here Is Why Their Advice Is Changing”, Gina Kolata2023-01-27 (semaglutide)⁠:

…What do the guidelines say should be done now? It’s not that lifestyle interventions cannot work for some. The A.A.P. says that children and adolescents with overweight and obesity should be offered “intensive behavioral and lifestyle treatment”, which is the most effective intervention short of medications and surgery.

The most effective programs involve at least 26 hours of in-person treatment over 3–12 months and include the family. The treatment focuses on nutrition, physical activity and behavior change. The expected result? A decline of 1–3 points in B.M.I.

But intensive programs are not always available, and insurers often do not pay for them. The A.A.P. advises that doctors instead should “provide the most intensive program possible”, referring families to additional programs to help with food insecurity and to community recreation programs.

The underlying message is one of urgency. In a substantial departure from past advice, for example, the A.A.P. recommends that children 12 and older with obesity should be offered treatment with any of the few approved drugs, including newer ones like Wegovy (a brand name for semaglutide) that elicit substantial weight loss by suppressing the appetite.

Those 13 and older with severe obesity should be offered bariatric surgery, the academy says. These are drastic (and expensive) interventions for doctors and parents to contemplate, but the authors of the recommendations note that obesity rarely ends without a concerted effort.