Endocrine News Podcast · Endocrine Society

ENP97: Childhood Obesity Treatment

February 12, 2025·26 min

Aaron Lohr frames childhood obesity treatment as a question of fit, not just efficacy. What helps adults does not always carry over neatly to children or adolescents. He asks whether pharmacotherapy and surgery have a role in pediatric care, what other treatment options exist, and where current guidelines still leave room for judgment. He welcomes Dr. Susan Wolford of the University of Michigan and Dr. Sarah Geiger of Cincinnati Children's Hospital. The conversation reflects their participation in the Endocrine Society's recent Obesity Fellows Conference. The guests start with the main updates in pediatric obesity management and the questions clinicians still need to answer. They keep returning to the challenge of identifying which children may have monogenic obesity rather than more typical weight gain. Early onset obesity and hyperphagia are treated as important warning signs. The history may include insatiable hunger, strong food preoccupation, and distress when food is denied soon after a meal. When those features are present, genetic testing may be reasonable. The episode then moves to comorbidities seen in children with obesity. Prediabetes and type 2 diabetes come first because they are increasingly common in adolescence. The speakers describe the AAP recommendation to screen children with obesity at age 10, and to screen some children with overweight when risk factors are present. They list fasting glucose, glucose tolerance testing, and hemoglobin A1C as common screening approaches. Puberty is part of why the timing matters, because insulin sensitivity often falls as hormones change. The discussion also covers PCOS, hypertension, steatohepatitis, and sleep apnea. Blood pressure monitoring, fasting lipids, and ALT checks are described as routine parts of the workup for many children with overweight or obesity. The episode closes by returning to lifestyle treatment, social determinants of health, and the challenge of making interventions cost-effective and sustainable without losing efficacy. It ends on a practical note that favors careful screening, targeted testing, and realistic treatment planning.

As heard by us

A practical pediatric obesity overview that brings guidelines, genetics, and screening into one clinical discussion.

This episode treats pediatric obesity care as the gap between adult treatment progress and what children and adolescents actually need. It moves through medication, surgery, genetics, and the screening questions that matter in clinic, with the clearest stretch in the guideline…

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Why you'd press play

If you need the pediatric obesity map, not the adult one, start here.

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