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Treatments and drugs

By Mayo Clinic staff

Treatment for childhood obesity is based on your child's age and if he or she has other medical conditions. Treatment usually includes changes in your child's diet and level of physical activity. In certain circumstances, treatment may include medications or weight-loss surgery.

Treatment for children under age 7
For children under age 7 who have no other health concerns, the goal of treatment may be weight maintenance rather than weight loss. This strategy allows the child to add inches in height but not pounds, causing BMI-for-age to drop over time into a healthier range. However, for an obese child, maintaining weight while waiting to grow taller may be as difficult as losing weight is for older people.

Treatment for children 7 years of age and older
Weight loss is typically recommended for children older than age 7 or for younger children who have related health concerns. Weight loss should be slow and steady — anywhere from 1 pound (about 0.5 kilograms) a week to 1 pound a month, depending on your child's condition.

The methods for maintaining your child's current weight or losing weight are the same: Your child needs to eat a healthy diet and increase his or her physical activity. Success depends largely on your commitment to helping your child make these changes. Think of eating habits and exercise habits as two sides of the same coin: When you consider one, you also need to consider the other.

Healthy eating
Parents are the ones who buy the food, cook the food and decide where the food is eaten. Even small changes can make a big difference in your child's health.

• When buying groceries, choose fruits and vegetables. Convenience foods, such as cookies, crackers and prepared meals, are often high in sugar and fat. Always have healthy snacks available. And never use food as a reward or punishment.
• Limit sweetened beverages, including those containing fruit juice. These drinks provide little nutritional value in exchange for their high calories. They also can make your child feel too full to eat healthier foods.
• Sit down together for family meals. Make it an event — a time to share news and tell stories. Discourage eating in front of a screen, such as a television, computer or video game. This leads to fast eating and lowered awareness of how much you're eating.
• Limit the number of times you eat out, especially at fast-food restaurants. Many of the menu options are high in fat and calories.

Physical activity
A critical part of weight loss, especially for children, is physical activity. It not only burns calories but also builds strong bones and muscles and helps children sleep well at night and stay alert during the day. Such habits established in childhood help adolescents maintain healthy weight despite the hormonal changes, rapid growth and social influences that often lead to overeating. And active children are more likely to become fit adults.

To increase your child's activity level:

• Limit recreational computer and TV time to no more than 2 hours a day. A surefire way to increase your child's activity levels is to limit the number of hours he or she is allowed to watch television each day. Other sedentary activities — playing video and computer games or talking on the phone — also should be limited. Don't let your child eat while viewing an electronic screen; it keeps your child from being aware of how much he or she is eating.
• Emphasize activity, not exercise. Your child's activity doesn't have to be a structured exercise program — the object is just to get him or her moving. Free-play activities, such as playing hide-and-seek, tag or jump-rope, can be great for burning calories and improving fitness.
• Find activities your child likes to do. For instance, if your child is artistically inclined, go on a nature hike to collect leaves and rocks that your child can use to make a collage. If your child likes to climb, head for the nearest neighborhood jungle gym or climbing wall. If your child likes to read, then walk or bike to the neighborhood library for a book.
• If you want an active child, be active yourself. Find fun activities that the whole family can do together. Never make exercise seem a punishment or a chore.
• Vary the activities. Let each child take a turn choosing the activity of the day or week. Batting practice, bowling and swimming all count. What matters is that you're doing something active.

Medications
One prescription weight-loss drug is available in the United States for adolescents: orlistat (Xenical). Orlistat, which is approved for adolescents older than 12, prevents the absorption of fat in the intestines.

The Food and Drug Administration has approved a reduced-strength over-the-counter (nonprescription) version of orlistat (Alli). Though readily available in pharmacies and drugstores, Alli is not approved for children or teenagers under age 18.

Prescription medication isn't often recommended for adolescents. The risks of taking a prescription medication long term is unknown, and the medication’s effect on weight loss and weight maintenance for adolescents is still questioned. And weight-loss drugs don't replace the need to adopt a healthy diet and exercise regimen.

If your child has high cholesterol, it's possible your doctor may recommend giving your child a statin medication. Statins help lower cholesterol, but their use in children remains controversial, since it's uncertain what long-term side effects they might have. Because of disagreement in the medical community about treating high cholesterol in children, talk to your child's doctor about what's best for your child.

Weight-loss surgery
Weight-loss surgery can be a safe and effective option for some severely obese adolescents who have been unable to lose weight using conventional weight-loss methods. However, as with any type of surgery, there are potential risks and long-term complications. Also, the long-term effects of weight-loss surgery on a child's future growth and development are largely unknown.

Weight-loss surgery in adolescents is uncommon. But your doctor may recommend this surgery if your child's weight poses a greater health threat than do the potential risks of surgery. It is important that a child being considered for weight-loss surgery meet with a team of pediatric specialists, including a pediatric endocrinologist.

Even so, surgery isn't the easy answer for weight loss. It doesn't guarantee that your child loses all of his or her excess weight or that your child keeps it off long term. It also doesn't replace the need for following a healthy diet and regular physical activity program.

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• See Also

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• Individualization key in weight loss program
• Children and TV: Limiting your child's screen time

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