AAP urges continuing obesity management

The coronavirus disease 2019 (COVID-19) has led to many changes in a child’s life, including the possibility of less physical activity, greater access to food, an increased chance of turning to eating as a way of combating boredom. There’s also a chance that children may not be going to the pediatrician as often. To offer some tools to provide obesity management during the pandemic, the American Academy of Pediatrics has offered some guidance to bolster previous guidance for nutrition as well as guidance on why in-person education was so important.¹

The guidance first mentions that many families are currently having a difficult time providing a healthy lifestyle for children because of food insecurity, school closings that meant less physical activity because no gym classes or sports teams as well as no access to free or reduced fee breakfast or lunch, and the economic toll of shutdowns including furloughs, fewer hours, and lost jobs that could lead to more processed foods and fewer fruits, vegetables, and whole grains on a child’s plate. For children, a number of risk factors include disrupted routines, sleep dysregulation, and less access to school breakfast and lunch with properly portioned food. Many families have also turned to eating nonperishable processed foods as well as snack foods filled with calories for a variety of reasons, including low costs, ease of preparation, and mental health struggles.

As children with obesity are at increased risk for COVID-19 as well as having their obesity worsen during the pandemic, the guidance recommends that pediatricians continue to monitor and assess children for the onset of obesity. For children who require it, it also recommends maintaining obesity treatment. This should include performing routine follow-up care; addressing current barriers; diagnose and treat any comorbidity related to obesity; and don’t delay providing obesity treatment, even bariatric surgery because these treatments are not elective, but necessary care. When providing obesity treatment, providers should ensure that treatment addresses the realities of the current pandemic, including:

• Discuss the increased risk of COVID-19 and share the additional protections recommended by the Centers for Diseases Control and Prevention.
• Ask questions to discover any disordered eating that has developed
• Discuss the state of the family’s social determinants of health. Offer information to families about local, state, and federal programs that can provide resources to help with those determinants.
• Promote a healthy lifestyle. Continue to screen for smoking, substance use, and other mental health concerns.
• Ask questions about the family’s current stressors as well as the stressors that are unique to the child

Reference

1. American Academy of Pediatrics. Obesity management and treatment during COVID-19. Services.aap.org. Published December 9, 2020. Accessed January 25, 2021. https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/clinical-guidance/obesity-management-and-treatment-during-covid-19/.