DURHAM, N.C. (WTVD) -- For the first time since 2007, the American Academy of Pediatrics has released new guidelines regarding identifying and treating childhood obesity.
In a change from previous practices, which called for "watchful waiting," updated recommendations push early intervention to avoid future, long-term health issues.
"In the past, we may have provided some nutritional guidance, asked parents and children to look for options and follow up in a year. Now we know that that likely leads to a worsening of the obesity and the related health conditions, and really what we should be doing is addressing the whole child in the family context immediately with the best tools that we have available," said Dr. Sarah Armstrong, a Duke Professor of Pediatrics who serves as the Chair of the section of Obesity for the American Academy of Pediatrics.
Children and adolescents with obesity are at greater risk for health problems ranging from type 2 diabetes to hypertension to depression.
A 2021 report from the North Carolina Partnership for Children found statewide, nearly 30% of low-income children aged two to four years old are overweight or obese, with "children who are obese by age six or overweight by age 12 have great than 50% likelihood of becoming obese adults."
"We have seen disparities in access to effective treatment for obesity for years," said Armstrong.
Treatment options can vary, and including intense behavioral counseling to weight loss medication to bariatric surgery.
"Lifestyle alone is unlikely to have a child or an adult even with severe obesity become non-obese. It's hard, it requires a lot of work and a lot of intensive time, especially if you're swimming upstream against genetics, (it's) even harder. So the key message - lifestyle is for everybody. Children with obesity just need extra support around that and that holistic childcare," explained Armstrong.
The problem has been exacerbated by the regionalization of health care, access to medical personnel and health food options, and socioeconomic factors including insurance coverage.
"There is a strong recommendation that we now know what works, and we need to advocate with our leaders and policymakers to make sure that all children have equitable access to effective treatment," Armstrong said.
At the Poe Center in Raleigh, staff focus on preventative measures and implementing healthy lifestyle patterns, offering courses for children on nutrition, gardening, and cooking.
"We know that children that are able to get their hands on a skill, so hands-on cooking skills, are more likely to try the items that they're preparing themselves because they were actually involved in the process of making it. So that's one of the ways that we try and really foster that connection and those healthy fundamentals," said health educator Taylor Holste.
She runs a number of programs, including a joint venture with WakeMed, where they offer in-person and virtual lessons on cooking.
"All of our recipes that we use in our kitchen programming have a focus on produce and whole grains. We're really trying to give very balanced meal suggestions but also easy recipes," said Holste.
There's also a focus on the bottom line, with suggestions on how to reuse leftover ingredients, and ingredient swaps.
"The guidelines state that nutrition support is a key component of obesity treatment, and obviously access to healthy food is really critical. And we know unfortunately that North Carolina ranks really high in food insecurity," said Morgan Wittman Gramann, Executive Director for the North Carolina Alliance for Health.
A 2020 report from Feeding America that the food insecurity rate in the state was at 12%, which ranked it in the bottom ten nationally.
Gramann explained the organization is working with legislators during the upcoming session to push for more funding to provide meals in schools.
"There is one place where we know that kids have access to two nutritious meals a day, and that's in school. And studies show that school meals are the healthiest and sometimes the only meals that kids eat in a day," said Gramann.