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AAP interim guidance addresses healthy lifestyles, obesity management during pandemic :

December 9, 2020

Editor's note:  The guidance on obesity has been updates since this article was published. Please see AAP interim guidance is based on current evidence and best data at the time of publication. Updates are provided to reflect changes in knowledge about the impact of the disease on children and adolescents. For the latest news on COVID-19, visit

Two new interim AAP guidance documents can help pediatricians support children struggling to access nutritious food and engage in physical activity during the COVID-19 pandemic, including those who have obesity.

Managing obesity is especially crucial as children with this disease are at higher risk for more severe COVID-19 disease.

“We are especially concerned about children and adolescents who already are more at risk based on economic, social and geographic disadvantages,” Sandra G. Hassink, M.D., M.S., FAAP, medical director for the Institute for Healthy Childhood Weight, said in a news release.

Guidance on nutrition and physical activity can be found at, while obesity guidance is at

Maintaining a healthy lifestyle has been difficult for many during the pandemic. Some children lost access to healthy meals when schools closed for in-person learning. Children’s screen time and emotional difficulties have increased, physical activity has decreased and family routines and sleep habits have been disrupted.

Pediatricians should assess all patients for onset or worsening of obesity, food insecurity, access to fresh food, disordered eating and physical activity, according to the interim guidance. They should provide tailored counseling to families on maintaining a healthy lifestyle and preventing obesity. In addition, they should educate patients about healthy nutrition such as increased fruit and vegetable consumption and scheduled meals and snacks.

For patients with obesity, pediatricians should continue treatment, including intensive lifestyle counseling, pharmacotherapy or metabolic and bariatric surgery. Care also should include counseling on the prevention of COVID-19, addressing patient/family stress, screening for disordered eating and addressing social determinants of health.

Dr. Hassink noted children and adolescents with obesity may face increased stigma.

“Pediatricians need to have a nonjudgmental approach with their patients and families and continue to advocate for reduction of weight bias,” she said.

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