Young Breton by the Sea

Medical Obesity Care Can Make Life Better for Teens

September is at our doorstep and it is National Childhood Obesity Month. In the course of this month, you will hear lots about healthy eating and active living. This has been the dominant theme since this observance began. The implicit message is to urge families and youth to heal themselves. Not a bad idea, but by itself, this strategy has done little to solve the problem. For young persons actually dealing with the medical problem of obesity, it turns out that actual medical care can help. In the journal Obesity, a new review tells us that medical obesity care for teens can actually make their lives better.

There’s a catch, though. These services are not widely available. So instead, most teens follow the DIY track. Mostly they pursue self-directed weight loss, which is largely ineffective.

The Focus on DIY Weight Loss

Hiba Jebeile, Michelle Cardel, Ted Kyle, and Ania Jastreboff focused on psychosocial health in their new review. They write that self-directed approaches to obesity almost always focus on weight loss:

“Among youth with obesity, 75% report attempting to lose weight in the previous 12 months. Methods for attempted weight loss were varied, with adolescents (84%) reporting exercise as the most common method, followed by drinking extra water (52%) and reducing dietary intake (49%). In assessing specific dieting behaviors used by adolescents, one study found 95.4% reported healthy weight control behaviors (e.g., increased physical activity and fruit and vegetable consumption and reduced fat), 76% reported unhealthy practices (fasting, skipping meals, smoking cigarettes to inhibit appetite), and 17.9% reported using extreme practices (taking diet pills, laxatives, or self-induced vomiting).”

These ineffective approaches do little to solve the problem. More often, they compound it. Moreover, they leave these young people vulnerable to a poor quality of life. Self-esteem, body image, and unhealthy eating behaviors are key factors.

Outcomes with Medical Obesity Care

Medical obesity care can include lifestyle programs, meds, and metabolic surgery. Lifestyle programs can help teens with a better quality of life. The review cites improvements in self-esteem, body image, depression, and eating disorders. The key is having skilled support. With support, teens can find strategies that actually work for them, ones that don’t add to the problem.

In drug therapy, the data on psychosocial outcomes is thin. Few drug makers have sought approval for anti-obesity meds in youth. For those that have done so, the focus was on weight-related outcomes and the complications of obesity. With metabolic surgery, there is a bit more data on psychosocial outcomes. Systematic reviews report improvements in quality of life and depression. And yet, the data remains thin.

The Need to Refocus

The bottom line here is pretty simple. The primary focus in obesity care has long been on weight loss. But softer outcomes for quality of life are just as important. In fact, one might argue they are more important. In the end, Jebeile et al point to the need for refocusing the priorities in obesity care and research. Psychosocial outcomes deserve more attention.

Teens do need better access to medical obesity care that can make their lives better. But just as important, providers and researchers need to focus more on psychosocial outcomes.

Click here for the new review and here for further perspective.

Young Breton by the Sea, painting by Paul Gauguin / WikiArt

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August 25, 2021