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Concerns about independence of U.S. guidelines on childhood obesity treatment

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8 July 2025
The scientific basis appears limited, and the AAP has financial ties with pharmaceutical companies that produce these medications, ties that were not disclosed in the guidelines. These are the conclusions of researchers from Amsterdam UMC, Vrije Universiteit Amsterdam, and universities in California and Colorado.

These conclusions were drawn by researchers from Amsterdam UMC, Vrije Universiteit Amsterdam, and universities in California and Colorado. Obesity researcher and physician Bibian van der Voorn is involved in the study on behalf of VU Amsterdam.

In 2023, the AAP published a guideline recommending that pediatricians routinely prescribe weight-loss medication to children with obesity from the age of 12. The guideline also suggests that such treatment could be considered for children as young as 8. A study soon to be published in The British Medical Journal reveals that since 2012, the AAP has received at least 1.9 to 2.6 million dollars from pharmaceutical companies involved in developing these medications. This includes companies like Novo Nordisk (Wegovy, Ozempic) and Eli Lilly (Mounjaro, Zepbound), as well as 12 other firms working on obesity treatments.

Not only the organization itself, but also individual members within the AAP received payments. Researcher Luc Hagenaars (Amsterdam UMC), together with colleagues, examined various public sources, including tax filings and the U.S. Open Payments database. He found that at least 22 percent of AAP board members received personal payments from these pharmaceutical companies. Between 2017 and 2023, this amounted to more than 293,000 dollars across hundreds of transactions, including payments for travel, meals, and consulting work. Within the working group that developed the guideline, 37 percent of members had similar financial ties. None of these ties were disclosed in the AAP’s official publications.

Weak Scientific Basis for Recommendations
Other countries such as the United Kingdom, Sweden, and Australia advise against prescribing weight-loss medication to children under 12, except in exceptional cases. Researchers point out that the AAP’s recommendations are based on only one clinical trial, which was funded by the drug manufacturer itself. At the time the guideline was released, no clinical studies were available demonstrating the safety or effectiveness of these medications in children under 12. Nevertheless, the AAP states that doctors “may consider” the medication for children as young as 8. Physician and obesity researcher Bibian van der Voorn (VU Amsterdam) comments: “There is no clinical evidence to support this advice. That said, weight-loss medication can indeed be a solution for certain children. However, prescribing it up front to all children lacks a solid scientific foundation.”

The researchers warn that conflicts of interest pose significant risks, especially in pediatrics. “Guidelines form a crucial basis for medical decision-making,” says Luc Hagenaars. “If they are influenced by commercial interests, this undermines not only the quality of care but also public trust in the medical profession.” The researchers therefore call for stricter transparency rules in guideline development, a ban on commercial sponsorship, and more independent, publicly funded research into the use of weight-loss medication in children.

Read here the full article in Britisch Medical Journal

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