Aaron S. Kelly, PhD, an author and expert from the University of Minnesota Medical School, joins to tackle the pressing issue of adolescent obesity, affecting around 20% of U.S. teens. He discusses the complex interplay of screen time, food insecurity, and genetics in driving obesity. Kelly emphasizes the importance of BMI screening and recent treatment innovations, including anti-obesity medications like GLP-1 receptor agonists. He advocates for a compassionate approach in healthcare to effectively manage health risks and improve long-term outcomes for affected adolescents.
Approximately 20% of U.S. adolescents face obesity, significantly increasing their risk for serious health issues like prediabetes and insulin resistance.
Effective treatments for adolescent obesity now include both newly approved anti-obesity medications and the importance of behavioral counseling alongside lifestyle modifications.
Deep dives
The Rising Rates of Adolescent Obesity
About 20% of adolescents in the United States between the ages of 12 and 18 live with obesity, a statistic that has been on the rise since the mid-1970s. Various complications associated with this condition include prediabetes, insulin resistance, and dyslipidemia, all of which can have serious long-term health impacts. These health issues often manifest as low HDL cholesterol levels, high triglycerides, liver disease, and musculoskeletal problems. The complex nature of obesity is influenced not only by lifestyle factors like screen time but also by biological predispositions and an environment that promotes obesity, highlighting the multifactorial causes behind this growing crisis.
Screening and Managing Adolescent Obesity
Screening for adolescent obesity should begin with the use of body mass index (BMI), as recommended by the American Academy of Pediatrics’ Clinical Practice Guidelines. Clinicians are encouraged to track BMI at least annually to monitor weight trajectories and to engage families in discussions about these trends. Rather than relying on a wait-and-see approach, which has proven ineffective, it is essential to recognize that obesity in adolescents often persists into adulthood, necessitating early intervention. This underscores the need for a multidisciplinary approach in the management of obesity, where all stakeholders understand that the burden does not fall solely on the individual.
New Treatment Options and Their Efficacy
Recent years have seen the introduction of effective anti-obesity medications approved for adolescents, including GLP-1 receptor agonists like liraglutide and semaglutide, which have demonstrated significant efficacy. Studies indicate that these medications can yield substantial BMI reductions and improvements in cardiometabolic risk factors, marking a shift in how obesity treatment is approached, moving away from traditional lifestyle-only methods. However, lifestyle modification remains crucial, as these medications alone should be accompanied by behavioral counseling to achieve the best outcomes. Surgical options such as bariatric surgery also offer effective long-term solutions, with significant BMI reductions seen among adolescents, yet there is still a need for more research on their long-term impacts and safety.
About 20% of adolescents in the US are living with obesity. Author Aaron S. Kelly, PhD, of the University of Minnesota Medical School joins JAMA Senior Editor Karen E. Lasser, MD, MPH, to discuss Obesity in Adolescents: A Review. Related Content: