Clinical Edge

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Identifying Obesity in Adolescents

Obstet Gynecol; 2017 Sep; ACOG Comm on Adolescent Health Care

The obstetrician-gynecologist should be able to identify obese adolescents, particularly those at risk of comorbid conditions, and may have the opportunity to initiate behavioral counseling, according to a new committee opinion from the American College of Obstetricians and Gynecologists (ACOG). Among the recommendations from the ACOG Committee on Adolescent Health Care:

  • The obstetrician–gynecologist should be able to identify obese adolescents, particularly those at risk of comorbid conditions. They may have the opportunity to initiate behavioral counseling, participate in multidisciplinary teams that care for overweight and obese adolescents, and advocate for community programs to prevent obesity.
  • Oral emergency contraception should not be withheld from adolescents or women who are overweight or obese because no research to date has been powered adequately to evaluate a threshold weight at which it would be ineffective.
  • The risks of all contraceptive methods are lower than the risks of pregnancy and the postpartum period for overweight and obese adolescents.
  • The obstetrician–gynecologist should screen overweight and obese adolescents for depression, bullying, and peer victimization and appropriately refer to school-based and community-based resources as well as psychiatric services.
  • There are currently no evidence-based guidelines for the use of pharmaceutical agents in the management of obesity in adolescents.
  • The obstetrician–gynecologist should caution against the use of weight loss supplements.
  • A multidisciplinary team, including an experienced bariatric surgeon, dietitian, and psychologist or psychiatrist, should be used to select appropriate candidates for surgical intervention and provide postoperative support.

Citation:

Obesity in adolescents. Committee Opinion No. 714. American College of Obstetricians and Gynecologists. Obstet Gynecol. 2017;130:e127–40.