Pediatric obesity pharmacotherapy: a practical guide for general pediatricians

PURPOSE OF REVIEW: Multimodal treatment approaches to pediatric obesity, including pharmacotherapy, are now recommended as part of an early intervention strategy to improve long-term health outcomes. However, barriers to prescribing obesity medications limit patient access to them. This review summarizes practical approaches to pediatric obesity pharmacotherapy tailored for the general pediatrician, based on evidence and expert opinion. RECENT FINDINGS: The American Academy of Pediatrics clinical practice guideline for the evaluation and management of pediatric obesity calls for early, individualized intervention, including consideration of pharmacotherapy. Available obesity medications include those that are Federal Drug Administration (FDA)-approved for this indication and those that are used "off-label" with FDA approval for other indications. SUMMARY: Obesity pharmacotherapy should be considered an adjunct to lifestyle interventions for pediatric obesity. Readiness to prescribe these medications is influenced by physician comfort, practice infrastructure, and access-related barriers. Specialty training (i.e., endocrinology, gastroenterology, obesity medicine) does not have to be a requirement for managing obesity.