After struggling with weight gain in her early teens, Alejandra Hernandez was 17 in March 2019 when she underwent a form of bariatric surgery known as gastric sleeve surgery.
“Ever since having the surgery, a lot of people asked me like, 'do you recommend it?' And I say 'I do, I do recommend it,'” Hernandez said.
Now 21 years old and in nursing school, Hernandez says she’s been off prediabetes medications since her surgery and hasn’t needed an inhaler for her asthma in years.
“To this day, I’m so grateful. I think about what my daily life looks like and how it would look life if I didn’t do it,” Hernandez said.
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New guidelines released this week from the American Academy of Pediatrics say teens age 13 and over with severe obesity should be evaluated for surgery.
The new guidelines also say weight loss medications are appropriate for children age 12 and older.
“We're not talking about serving up medications when you first walk in the door. We definitely do a lot of other things before we even start having those conversations,” said Dr. Jeremy Daigle, a pediatrician and director of the Healthy Active Living program at Advocate Children’s Hospital.
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Daigle said lifestyle changes always come first but the guidelines now mirror the latest research.
“There are definitely studies that show the importance and how these can help these kids long term,” he said.
Dr. Caren Mangarelli is an assistant professor of pediatrics at Northwestern University’s Feinberg School of Medicine. She said it’s possible children who start weight loss medications could need to take them for the rest of their life, but says that such a move would still be medically-prudent.
“You wouldn't question that if a kid developed, you know, high blood pressure, or if they had a seizure disorder,” she said. “I feel like the medical community as a whole is starting to recognize obesity as a chronic disease. Like any chronic disease, there are medications available, but there is a problem with access."
Mangarelli says that those limitations come through spotty insurance coverage of drugs and due to socioeconomic factors, and hopes that the new guidance will help spur changes.
“They're not covered by most insurance plans, even private insurance plans,” she said. “We know obesity disproportionately affects lower socioeconomic patients. They really need to be available to all patients."
