The American Academy of Pediatrics no longer wants parents to “watch and wait” for childhood obesity, as it had advised for the last 15 years.

On Monday, the AAP published a study that broke with prior guidance, now recommending early monitoring and treatment of childhood obesity. For teens, recommended treatment for severe obesity could include weight loss medications and surgery.

Pediatricians and primary care providers now have more effective treatments than ever, treatments that provide lasting overall health benefits and that reduce risk of disordered eating, the study reads.

“In contrast to previous recommendations, these clinical guidelines highlight the urgency of providing immediate, intensive obesity treatment to each patient as soon as they receive the diagnosis of obesity,” the study reads.

The change in guidance has distinct implications for Butler County, which ranked among the 64 counties that saw an increase in obesity rates since 2012. Only three counties in Pennsylvania evaded such a rise, highlighting Butler's role in a national trend likely propelled by the COVID-19 pandemic.

“The COVID-19 pandemic has significantly affected the lives and routines of children and adolescents,” the study reads.

The pandemic period coincided with a doubling in body mass index rates when the AAP compared these rates with the pre-pandemic period, it added.

Pediatrician Brian Donnelly, who has a medical practice in Seven Fields and is a member of the Allegheny Health Network, said he also suspects COVID contributed greatly to this problem, with lockdowns disrupting active lifestyles that helped people stay in better shape. He also said a rise in the cost of good food, which has grown much more expensive than it used to be, also may have contributed.

“Ideally, you want to eat more healthy fruits and vegetables; cooking, preparing the food at home, is probably the biggest challenge,” he said. “And just from a practical perspective, that would be what parents can focus on. Prepared food may taste better, at least to the kids who are used to eating them, but in the long run, they’re not good for you.”

More advanced treatments such as medication or surgery expand on the same advantages of healthy lifestyle and diet changes, he said.

In one sense, it’s a little bit simple, in that energy intake and energy expenditure always play a key role, so diet and exercise remain priorities, he said. Treatments such as medication and surgery both aim to decrease appetite, and ideally extra exercise will build on those benefits, he said.

“Our bodies are designed ... that we do better when there’s not enough to eat, and if there’s too much to eat, then the body’s tendency is to unfortunately store the energy as extra fat,” he said.

The recent change in guidance marks a dramatic shift in confronting an issue that involves adults as well as children, he said.

“I think it just reflects urgency, a greater sense of urgency,” he said. “The ‘watch-and-wait’ approach didn’t work, I suppose. Public health problem No. 1 in the U.S., not just for kids, is overweight, and No. 2 is obesity. So those lead to other longstanding chronic problems, like diabetes and heart disease.”

Preventing problems such as these would call for doing something more than just monitoring one’s weight, he said.