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Balance Risk Of Childhood Obesity Medications

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National trends indicate an increase in 8- to 17-year-olds who are overweight or obese and suffering from hypertension.

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By MARY SHEDDEN | The Tampa Tribune

Published: November 12, 2008

Childhood obesity is talked about so much, I sometimes worry parents and other adults will stop taking it seriously.

Instead of action, I fear we'll come to accept the issue of overweight and obese children as something that just "is."

That's the underlying sense I got while reading some new research chronicling the increase in the number of children taking prescription medication to treat common weight-related diseases such as type 2 diabetes and hypertension.

Researchers from St. Louis University and the Kansas Health Institute used private health insurance records to track chronic medication use for more than 3 million children a year, from 2002 to 2005. They looked at drugs used to treat five chronic ailments: asthma, attention deficit disorder, depression, high cholesterol and type 2 diabetes.

Overweight and obese children are candidates for the latter two categories. The research, published this month in the journal Pediatrics, found prescription rate increases of 15 percent, 20 percent and even 103 percent for drugs designed to treat heart, cholesterol and diabetes-related problems.

Pre-teen and teenage girls saw the largest increases. Drugs used to treat type 2 diabetes jumped 166 percent for girls ages 10 to 14, and 135 percent for girls ages 15 to 19. And this bump is just within a three-year period.

The authors say the research is consistent with national trends showing an increase in 8- to 17-year-olds who are overweight or obese and suffering from hypertension. The National Center for Health Statistics estimates that today, 16.3 percent of children and adolescents (ages 2 to 19) were obese. An estimated 19 percent of children and 17 percent of adolescents were deemed overweight, national health surveys show.

When it comes to adults, and in particular the elderly, I expect them to need prescription medication to keep their high cholesterol and high blood pressure in check. Children should only be getting ear infections and scrapes and bruises from falling off a scooter. Beta blockers and diuretics for a kid? That seems absurd.

Ian Paul, an associate professor of pediatrics at Penn State University Children's Hospital, says he's not surprised by the increase. It's the result of the increasing number of children and teens living at an unhealthy weight, including 25 percent of all children between the ages of 2 and 5.

He thinks the increased number of prescriptions has more to do with the varied ways in which pediatricians are trying to deal with overweight and obese children. Changes to a child's diet and exercise routine are preferred methods of attacking the problem, but some may need additional help from drugs or bariatric surgery.

"You have to balance the risk of taking the drug with the risk of leaving the condition untreated. ... You want to make these kids as healthy as possible," says Paul, an expert in clinical pharmacology and therapeutics for the American Academy of Pediatrics.

As children lack the emotional and physical maturity to tackle weight-related health problems alone, parents play a critical role. That includes communicating to doctors your own observations about how your child's body is growing and changing, especially in puberty.

Also, before agreeing to a prescribed medication for a child's chronic ailments, Paul says parents should ask a few key questions:

•Why specifically is my child taking the drug?

•What are the side effects, risks and benefits?

•How long will my child need to take the drug?

•How long will it take or what else needs to change so my child can stop taking the drug?

Children who treat these chronic illnesses with lifestyle changes and whatever else their doctor recommends stand a good chance of seeing significant improvement, Paul says. Type 2 diabetes is chronic, but not incurable.

Those increases in prescriptions aren't a life sentence, as long as parents and their children take the threat of obesity seriously.

Want to share your health and fitness idea? Contact me at (813) 259-7365 or mshedden@tampatrib.com

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