Fifteen-year-old Jelainie is learning healthy eating habits at the Holyoke Health Center in Holyoke, Massachusetts, as part of a broader effort to combat childhood obesity, a growing concern in the United States.
Despite the increasing need, parents face significant hurdles in accessing effective weight-loss programs for their children. According to leading medical organizations, intensive behavioral counseling is the most recommended treatment. These programs educate children and their families on healthy eating and exercise habits. However, such programs are scarce, often have long waiting lists, and are typically not covered by health insurance.
Struggling to Access Care
Less than 1% of the nearly 15 million obese children in the U.S. receive the recommended care, as reported by the U.S. Centers for Disease Control and Prevention (CDC). This lack of accessibility is compounded by the extended wait times and the substantial time commitment required for these programs.
Efforts by the CDC and other organizations to expand insurance coverage for these behavioral counseling programs have so far been unsuccessful. Dr. Joseph Skelton, an obesity medicine specialist at Wake Forest University School of Medicine, stated, “The coverage for these programs was never good, and we’re not seeing any movement toward improvement.”
Rising Obesity Rates and New Treatments
The prevalence of obesity among U.S. children has surged from 5% in 1980 to nearly 20% today, according to CDC experts. Novo Nordisk’s weight-loss drug, Wegovy, approved for adults in 2021 and adolescents in late 2022, offers an effective weight-loss solution. However, the drug manufacturer has struggled to meet the high demand. Weekly, there are over 25,000 new adult users, with a growing but still small number of families seeking the drug for their teenagers.
Many doctors and parents remain cautious about using Wegovy for children due to potential long-term developmental impacts and other risks.
Programs Promoting Healthy Choices
In Holyoke, Massachusetts, Ruth Medina turned to the Holyoke Health Center’s healthy weight program for her daughter, Jelainie, who weighed over 90 kilograms at age 15. Concerned about a family history of type 2 diabetes, Medina sought preventive measures.
The Holyoke program involves children and their parents working with food experts and community health workers to set individual weight goals, cook healthy meals, read food labels, and discuss healthy lifestyle choices. Dr. Vinny Biggs, who runs the program, noted that there is a four-month wait to get in, but some costs are covered by the state Medicaid health insurance.
The Role of Behavioral Counseling
Dr. Thomas Robinson, director of the Center for Healthy Weight at Stanford Medicine Children’s Health in California, advocates combining behavioral counseling with weight-loss drugs. “These drugs are very effective at reducing weight and health risks, but you don’t suddenly adopt a healthy diet or become more physically active,” Robinson said.
Stanford’s program uses a traffic light system to teach healthy eating: high-calorie foods are “red light” and should be limited, vegetables are “green light” and can be eaten freely, and most other foods are “yellow light” and fall in between.
Insurance Barriers
Unfortunately, health insurance does not cover Stanford’s program, leaving families to pay the $3,500 cost out-of-pocket or seek financial assistance from the hospital. Efforts to improve insurance coverage for obesity counseling have faced resistance. In September, the American Medical Association (AMA) rejected a proposal to create a medical code for intensive obesity counseling, which would facilitate billing insurance companies for these services. The AMA cited that such programs often include non-clinical components, like cooking classes, which may not meet insurance providers’ criteria.
The CDC emphasized that ensuring fair access to both obesity medications and lifestyle treatment is crucial, providing families with more options to support their child’s health.
