Italy’s Childhood Obesity Crisis

For decades, Italy has been celebrated as the birthplace of the Mediterranean diet — a lifestyle centered on vegetables, legumes, whole grains, olive oil, fish, and fresh ingredients that has long been associated with good health and longevity. Today, however, many health experts say that image no longer reflects reality.

Italy is now facing a growing childhood obesity crisis, particularly in the country’s southern regions. The World Health Organization (WHO) reports that Italian children are among the most overweight in Europe, and communities around Naples have some of the highest childhood overweight rates in the country.

In a recent BBC article, 17-year-old Salvatore knows firsthand how devastating severe obesity can be. Weighing approximately 170 kilograms (375 pounds), even simple daily activities have become difficult. Walking is a struggle, tying his shoes is nearly impossible, and his scooter has repeatedly broken under the strain of his weight.

Doctors say his condition has become so severe that he cannot yet undergo bariatric surgery because the procedure would be too risky. Instead, physicians have prescribed a GLP-1 medication to help reduce his appetite and lower his weight enough to safely undergo surgery in the future.

His story reflects a larger trend that obesity specialists across Italy say they are seeing with increasing frequency. According to bariatric surgeon Dr. Sonja Chiappetta, the age of patients seeking treatment has dropped dramatically over the past decade.

Where severe obesity once primarily affected middle-aged adults, many patients are now teenagers, some as young as 16 years old. The increase has led to greater demand for bariatric procedures, which reduce stomach size and help patients eat less food.

For many young people, however, surgery is only one piece of treatment. Doctors often recommend weight-loss medications, nutrition counseling, and long-term lifestyle changes before surgery becomes an option.

So, what happened to the much-touted Mediterranean Diet? Researchers say Italy’s eating habits have changed substantially over the past several decades.

The traditional Mediterranean diet that once emphasized fresh produce, beans, seafood, whole grains, and olive oil has increasingly been replaced by highly processed foods, oversized portions, sugary drinks, and calorie-dense convenience meals.

Longevity researcher Dr. Valter Longo estimates that only a small percentage of Italians still consistently follow the traditional Mediterranean eating pattern.

Instead, he describes today’s diet as revolving around what he calls the “five Ps” — pizza, pasta, potatoes, protein, and pane, the Italian word for bread.

Even familiar foods have changed. Pizza, once relatively simple, is now commonly topped with fries, sausage, fried foods, and other calorie-rich ingredients that significantly increase its nutritional impact.

Pediatric obesity specialists say one of the biggest challenges is that many parents don’t realize their child has obesity. Children often arrive at medical appointments because of symptoms such as stomach pain, digestive problems, or chronic coughing, while excess weight goes largely unnoticed by their families.

Doctors explain that obesity usually develops gradually through everyday habits rather than one unhealthy meal. Frequent snacking, sugary beverages, highly processed foods, limited fruit and vegetable intake, and oversized portions can slowly contribute to unhealthy weight gain over time.

Many parents believe their children are active enough because they participate in sports or recreational activities. While physical activity is important, experts emphasize that exercise alone often cannot offset poor dietary habits.

Health professionals say cultural attitudes toward body weight can also delay intervention. In some Italian families, a child with rosy cheeks or extra weight may still be viewed as healthy rather than at risk for future medical problems.

Teachers have noticed this disconnect as well. Some educators report concerns about students whose weight may affect their health, yet conversations with families do not always lead to concern or action.

Experts believe schools can play an important role by teaching children about nutrition, hoping those lessons eventually influence family habits at home. Several regions of Italy have launched educational programs aimed at improving children’s nutrition knowledge.

One initiative in Naples will reach more than 17,000 students across dozens of schools while also providing resources for parents. The goal is to encourage healthier eating habits throughout the household rather than focusing solely on the child.

Not every student believes education alone will change behavior. Some teenagers acknowledge they already understand what foods are healthy but continue choosing junk food because it is convenient, appealing, and widely available.

Others believe nutrition education can still make a meaningful difference by helping young people understand the long-term consequences of their choices. Recognizing the complexity of obesity, Italy became the first country in 2025 to pass national legislation officially recognizing obesity as a chronic, progressive, and relapsing disease.

The law reflects a growing understanding that obesity is influenced by many factors beyond willpower, including genetics, biology, environment, food availability, culture, and socioeconomic conditions. This shift encourages healthcare providers to treat obesity as a medical condition requiring comprehensive care instead of simply blaming individuals for their weight.

For teenagers like Salvatore, these interventions represent more than weight loss; they offer the possibility of improved mobility, better health, and the opportunity to participate more fully in everyday life.

As Italy works to reclaim the healthy traditions that once defined its cuisine, healthcare professionals hope a renewed focus on nutrition, education, and comprehensive medical care can help reverse the growing childhood obesity epidemic before another generation is affected.

Your responses and feedback are welcome!

Source: “Pizza, pasta, potatoes, protein — how Italian children became so overweight,” BBC, 7/25/26
Source: “The country that inspired the Mediterranean diet is now battling a childhood obesity crisis. What went wrong?,” The Times of India, 7/26/26
Source: “Italy Faces Childhood Obesity Crisis Amidst Declining Mediterranean Diet,” Ratorarti.com, 7/27/26
Image by Klaus Nielsen/Pexels

Yes to Prevention, But Also Access to Care

In her opinion piece in El Paso Matters, Dr. Lourdes Asiain, a pediatrician with more than 20 years of experience, makes a case for insurance coverage for treatment of obesity. We’ve also emphasized multiple times the importance of access to the best tools possible, not just to treat already-existing obesity but also to prevent it.

Fat-shaming and creating stigma around childhood obesity helps no one, and is likely coming from misguided notions and ignorance. We don’t know that person’s struggle, or their family’s. It might be an unfortunate side effect of a medical condition, or a side effect of the medication a person is taking for that condition. It might be caused by the situation in the family, or at school, or anywhere.

For years, childhood obesity has often been viewed as a problem that can be solved simply by eating less and exercising more. However, pediatric obesity specialists say that understanding has changed dramatically. Today, obesity is recognized as a complex chronic disease influenced by genetics, biology, hormones, environmental factors, and lifestyle — not a lack of willpower.

Despite significant advances in treatment, many families still struggle to access effective medical care because insurance coverage remains limited. As a result, children who could benefit from evidence-based therapies are often left without the support they need until serious health complications develop.

Childhood obesity continues to affect millions of young people across the United States. In Texas alone (where the author of the opinion piece lives), approximately one in four children between the ages of 6 and 17 is living with obesity, placing the state among those with the highest childhood obesity rates in the country.

We might sound like a broken record, but it’s worth repeating. Obesity can have lifelong consequences, such as an increased risk of developing diabetes, high blood pressure, sleep apnea, and more.

The effects extend beyond physical health. Many children also experience bullying, social isolation, anxiety, depression, and lower self-esteem, which can affect academic performance and overall quality of life.

Medical organizations increasingly emphasize that obesity should be treated like other chronic diseases. Instead of assigning blame, physicians encourage families to understand the biological factors that contribute to weight gain.

Dr. Asiain writes:

We would never tell a child with asthma, diabetes or cancer to simply “try harder” to overcome their condition. Yet, children living with obesity routinely face blame, stigma and judgment rather than receiving medical care. This stigma is uniquely destructive for young people still developing their sense of identity, confidence and self-worth.

Recognizing obesity as a disease rather than a personal failure can be transformative for families. It shifts the conversation away from guilt and toward treatment, allowing children and parents to focus on managing a medical condition instead of carrying unnecessary shame.

Today’s approach to pediatric obesity, Dr. Asiain points out, is far more comprehensive than it was just a decade ago. She writes:

Fortunately, medical science has advanced. Comprehensive obesity care includes nutrition counseling, behavioral interventions, physical activity support, FDA-approved medications, and, when clinically appropriate, metabolic and bariatric surgery — supported by telehealth to reach our rural communities. These treatments are not shortcuts. They are evidence-based medical interventions for a serious, costly chronic disease.

When patients in my practice have coverage for modern obesity treatments, the results are remarkable. I see significant weight loss, normalized lipid profiles and reversal of prediabetes.

While effective treatments exist, affordability remains one of the biggest obstacles for many families. Critics argue that insurance policies often cover illnesses caused by obesity, such as diabetes or heart disease, while refusing to pay for treatments that could help prevent those conditions in the first place. This creates a frustrating situation where families may be forced to wait until a child’s health worsens before coverage becomes available.

According to Dr. Asiain:

As physicians, we should never have to tell a suffering family that an effective treatment exists but is denied to them by an insurance loophole.

Experts agree that prevention remains essential. Access to healthy foods, regular physical activity, safe neighborhoods, and nutrition education all play important roles in reducing childhood obesity rates. However, prevention alone cannot help children who are already living with obesity. Those children often require individualized medical care, just as they would for asthma, diabetes, or other chronic conditions.

In another opinion piece, Dr. Barry Ramo drives this point home (which is something we’ve been doing as well). Research shows that family-based weight management programs can improve children’s weight and body mass index (BMI). To support healthier lifestyles, the American Academy of Pediatrics recommends the “5-2-1-0” approach: eat at least five servings of fruits and vegetables daily, limit recreational screen time to two hours, get one hour of physical activity each day, and avoid sugary drinks. Together, these simple guidelines encourage better nutrition, more exercise, and healthier routines for the entire family.

Treating obesity early may reduce the risk of serious health complications later in life while helping children develop greater confidence, improved mental health, and a better overall quality of life.

Your responses and feedback are welcome!

Source: “Opinion: Children with obesity deserve access to treatment, not stigma,” El Paso Matters, 7/15/26
Source: “Family-focused plan offers simple steps to address childhood obesity,” KOAT.com, 7/15/26
Image by Yan Krukau/Pexels

How Young Is Too Young for GLP-1 Meds?

GLP-1 medications such as Wegovy and Zepbound have reshaped obesity treatment for adults and are increasingly being used to help adolescents with obesity. Now, a more challenging question is taking center stage: Should these medications be used in even younger children?

While the U.S. Food and Drug Administration (FDA) has approved some GLP-1 medications for adolescents ages 12 and older who meet specific criteria, a small but growing number of physicians are prescribing them off-label for elementary school-age children with severe obesity. The trend has sparked debate among healthcare providers, researchers, and parents over whether early intervention outweighs the unknown long-term risks.

Not all GLP-1 medications are approved for pediatric obesity treatment, and those that are have age restrictions. Wegovy, for example, is approved for chronic weight management in adolescents aged 12 and older who have obesity and meet certain medical requirements.

Doctors generally reserve these medications for children whose obesity has not improved despite comprehensive lifestyle interventions, including healthier eating habits, increased physical activity, and behavioral support.

The medications are not intended for children who simply want to lose weight. Instead, they are considered for young people with obesity who face increased risks for serious health conditions such as type 2 diabetes, high blood pressure, fatty liver disease, and cardiovascular disease.

Many obesity specialists argue that treating obesity early may prevent lifelong health complications. Clinical trials have shown that GLP-1 medications can produce significant weight loss in adolescents when combined with lifestyle changes. Physicians who support their use view obesity as a chronic disease that often requires medical treatment alongside healthy habits.

For some children with severe obesity, waiting until adulthood may allow health problems to progress. Dr. Jessica Reilly, medical director of the Strong4Life pediatric obesity clinic at Children’s Healthcare of Atlanta, sees the consequences firsthand:

I see kids who have developed Type 2 diabetes at 10, 11 years old… They need help so desperately.

Although GLP-1 medications are approved for obesity beginning at age 12, some physicians are prescribing them off-label for children as young as six. One widely reported example involves nine-year-old twins Ayden and Kayden Gatlin-Wright. After years of unsuccessful efforts with diet, exercise, and nutritional counseling, doctors discovered the brothers carried a genetic mutation that affects feelings of fullness and increases their risk of obesity.

Despite working closely with healthcare professionals, their body mass index (BMI) continued to rise, and by age seven, they showed elevated blood sugar levels, abnormal cholesterol, and signs of liver dysfunction.

Their parents decided to pursue off-label treatment with Wegovy, paying approximately $700 every four weeks out of pocket for both children.

The medication appears to be helping. According to reports, Ayden’s BMI has declined by about 5%, while Kayden’s has fallen by roughly 7%. Beyond the numbers, their parents say the boys are developing healthier habits and enjoying more energy.

Despite encouraging early results, many pediatric experts urge caution. One of the biggest concerns is the lack of long-term research on children who might remain on these medications for many years — or even decades.

Questions remain about:

  • How long children may need to stay on GLP-1 medications
  • Whether weight returns after treatment stops
  • The effects of long-term use on growth and development
  • Potential nutritional deficiencies if children eat significantly less
  • Whether medication could unintentionally replace healthy lifestyle habits

Common side effects include nausea, vomiting, diarrhea, and other gastrointestinal symptoms. Although uncommon, more serious complications can include pancreatitis and gallbladder disease.

Dr. Sarah Hampl, who works in the pediatric obesity program at Children’s Mercy Hospital in Kansas City, believes more research is needed before expanding treatment to younger children. She said:

We do not have enough evidence to safely prescribe under 12 at this point… I think that potential is there for positive impact, but there are not enough studies yet.

Drug manufacturers are also proceeding cautiously. Novo Nordisk, the maker of Wegovy, does not promote off-label prescribing, although it is studying the medication in children as young as six. Eli Lilly is conducting similar research with Zepbound.

Even among families who have seen success with GLP-1 medications, the goal is not lifelong dependence on the drugs. The parents of Ayden and Kayden hope the medication will provide a window of opportunity for their sons to establish sustainable habits that last well beyond treatment. As their father explained:

They can learn to manage themselves, the exercise, the healthy habits, read their bodies properly. The goal is for them to learn that, you know, as they grow, this is going to be their life.

This perspective reflects the broader approach recommended by obesity specialists, who generally view medication as one part of a comprehensive treatment plan that includes nutrition, physical activity, behavioral counseling, and family support.

Even for patients who qualify, obtaining GLP-1 medications can be difficult because of cost and insurance coverage. To improve access for eligible older adults, Medicare launched the temporary GLP-1 Bridge Program on July 1. The program allows qualifying Medicare Part D beneficiaries to receive eligible weight-loss medications, including Wegovy and certain formulations of Zepbound, for a $50 monthly copay while broader coverage policies continue to evolve.

Families with younger children, however, often face significant financial barriers. Off-label prescriptions are frequently not covered by insurance, leaving parents responsible for hundreds of dollars each month.

For now, experts remain divided. While some see early treatment as an opportunity to prevent serious disease, others believe the science has not yet caught up with the growing interest in prescribing these medications to children under 12.

Your responses and feedback are welcome!

Source: “Fact Check Team: How young is too young for GLP-1 medications?,” The National News Desk, 7/10/26
Source: “Kids as young as six are being given weight-loss drugs as a way to curb obesity before it gets too late,” The Independent, 06/22/26
Image by Tima Miroshnichenko/Pexels

Ways to Quiet Food Noise in Children

For many people, the term “food noise” became familiar through conversations about GLP-1 weight-loss medications such as Wegovy. However, health experts emphasize that food noise isn’t limited to adults. Children and teenagers can also experience persistent thoughts about food that affect their emotional well-being, relationships with eating, and overall quality of life.

Much has been written about food noise on this blog, but it doesn’t hurt to revisit this topic with emphasis on food noise in kids in particular and what parents can do to quiet it. But first, let’s briefly reiterate what food noise is, how it develops, and what signs to look for.

According to pediatrician Daniel Ganjian, M.D., FAAP, food noise is “the constant, intrusive chatter in a person’s mind regarding food, eating, and cravings.” (He is quoted in a recent article focusing on the topic in Parents magazine.) For some kids, it becomes challenging to focus on school, sports, friendships, or other daily activities.

So, how does food noise develop? Experts say that it doesn’t necessarily have one cause. Instead, it results from several factors working in tandem. Those can include genetics, hormonal changes, and exposure to food advertising targeted at kids. And because children’s brains are still maturing, they may have a harder time managing repetitive thoughts and cravings than adults.

For someone who has never experienced food noise, it can be difficult to understand. Therapist and certified eating disorders specialist Alli Spotts-De Lazzer, LMFT, LPCC, CEDS-C, compares it to having a song endlessly repeating in your head. Just as a catchy holiday tune can play on repeat long after you’ve left the store, food-related thoughts can continually return throughout the day.

She explains:

There’s nearly always food close by, available, or purchasable, and there can feel like an urgency to act on the noise to quiet it.

While food noise is frequently discussed alongside obesity, experts caution that its effects go well beyond body weight. According to Gabriella Clarke, RD, LD, CEDS-C, persistent thoughts about food can take an emotional toll:

Some children may feel as though their thoughts about food are out of control, and this has the potential to increase feelings of guilt or shame with eating.

While parents cannot eliminate food noise entirely, they can create habits and routines that help reduce its intensity. Those include sticking to eating routines, for one. Regular meals and snacks help children know when food will be available, reducing anxiety and uncertainty.

Pediatric endocrinologist Michelle Maresca, M.D., says:

When a child can anticipate when they will next eat, they are less likely to obsess over it.

Eating consistently throughout the day also helps prevent extreme hunger, which can lead to overeating before fullness cues have time to register. Experts generally recommend offering three balanced meals along with two or three planned snacks, rather than allowing long gaps between eating opportunities.

Another example is to keep meals distraction-free: no screens at the table (TV, tablets, phones, etc.). This will ideally result in children focusing on eating, conversation, and recognizing when they feel full.

Unfortunately, completely banning favorite foods may unintentionally make them even more appealing. To reduce feelings of deprivation and lessen the urge to overeat them later, parents can occasionally allow desirable foods but overall consistently offer balanced, healthy meals.

Nutrition experts also recommend not labeling food as “good” or “bad.” Giving foods moral labels may increase a child’s preoccupation with eating and give their food choices unnecessary emotional weight. So avoid terms like “junk food,” “cheat foods,” or calling desserts “treats.”

Finally, mind how you talk about people’s bodies in front of your kids, and with your kids, including their own. Children learn from what they hear at home. Conversations about dieting, weight, or criticizing your own body can influence how they think about themselves. Experts encourage parents to avoid assigning value to bodies based on size, shape, or appearance. Focusing instead on health, strength, enjoyment, and self-care helps build a more positive body image.

Easier said than done, we know. But parents can play an instrumental role in shaping their kids’ relationship with food early on. Knowing this should be (ideally) encouragement enough.

Your responses and feedback are welcome!

Source: “Why ‘Food Noise’ Can Start in Childhood — and 5 Ways Parents Can Help,” Parents, 7/3/26
Source: “The Impact of Social Media on Adolescent Body Image: A Comprehensive Review,” NIH.gov, 8/26/25
Image by Nadine Sh/Pexels

Some Doctors Are Prescribing GLP-1 Weight-Loss Drugs to Children Under 12

How young is too young for GLP-1 meds? The use of GLP-1 weight-loss medications in children continues to expand, but a growing number of physicians are raising questions about whether these drugs should be prescribed to children younger than 12 years old.

Although medications such as Wegovy (semaglutide) are approved by the U.S. Food and Drug Administration (FDA) for treating obesity in adolescents ages 12 and older, some physicians are prescribing them off-label to younger children with severe obesity. The practice reflects the difficult choices doctors face as childhood obesity rates rise and obesity-related health complications appear at increasingly younger ages.

At the same time, many pediatric specialists caution that there is still too little research to understand the long-term effects of these medications on young children’s growth and development.

As has been established, GLP-1 receptor agonists, including Wegovy, help regulate appetite by slowing stomach emptying and increasing feelings of fullness, often leading to significant weight loss. For children under 12, however, these medications have not been approved by the FDA for obesity treatment. Physicians who prescribe them are doing so off-label, which is a legal and common medical practice in some circumstances when a doctor believes the potential benefits outweigh the risks.

According to reporting by The Wall Street Journal, some pediatric obesity specialists say they are seeing severe obesity-related complications in children at increasingly younger ages. Conditions that were once considered adult diseases, including high blood pressure, elevated blood sugar, and fatty liver disease, are now appearing in children as young as four years old. Four! Just think about that.

Doctors who support earlier use of GLP-1 medications argue that traditional interventions often do not produce enough weight loss for children with severe obesity. While intensive nutrition counseling, physical activity programs, and behavioral therapy remain the foundation of treatment, many children continue to struggle despite these efforts. For some families, physicians believe medication may offer another tool to reduce health risks before permanent complications develop.

Despite the potential benefits, many experts urge caution. One of the biggest concerns is the lack of long-term research involving younger children. Scientists still do not fully understand how years of GLP-1 treatment might affect a child’s bone growth, brain development, nutritional status, and future weight regulation after stopping medication.

Because children are still growing physically and neurologically, specialists say more evidence is needed before these medications can be widely recommended for elementary school-aged patients. Some physicians also worry about whether children who stop taking the medications could rapidly regain weight, potentially creating additional health challenges later in life.

Current recommendations from the American Academy of Pediatrics (AAP) continue to emphasize intensive, family-based behavioral treatment as the first-line approach for childhood obesity. The AAP recommends intensive health behavior and lifestyle treatment for children six years and older with obesity.

Another recommendation is to consider weight-loss medications beginning at age 12, when appropriate, as an addition to lifestyle treatment. The organization does not currently recommend routine use of anti-obesity medications in children younger than 12 because there is insufficient evidence regarding safety and effectiveness in this age group.

Dr. Sarah Hampl, who chaired the development of the AAP’s obesity treatment guideline, has stated that more research is needed before these medications can be safely recommended for younger children. Although these medications are not yet approved for younger children, research continues.

Drug manufacturers, including Novo Nordisk, are conducting clinical trials evaluating medications such as Wegovy and Saxenda in children as young as six years old. These studies aim to determine whether the medications are both safe and effective in younger pediatric populations. The results could eventually influence future FDA approvals and pediatric treatment guidelines.

The debate highlights the difficult decisions physicians and families face when treating severe childhood obesity. On one hand, delaying effective treatment may allow obesity-related diseases to progress during critical developmental years. On the other hand, introducing medications before long-term safety is fully understood raises legitimate concerns about children’s growth, development, and lifelong health.

For now, experts generally agree that healthy nutrition, increased physical activity, behavioral support, and family involvement remain the cornerstone of pediatric obesity care. Whether GLP-1 medications will become a standard treatment for children under 12 will likely depend on the results of ongoing clinical research.

Your responses and feedback are welcome!

Source: “Wegovy and other GLP-1s are reaching kids,” NewsNation, 6/28/26
Source: “When Diets Don’t Work: Parents Turn to Wegovy for Elementary School Kids,” The Wall Street Journal, 6/22/26
Source: “Efficacy and Safety of GLP-1 RAs in Children and Adolescents With Obesity or Type 2 Diabetes: A Systematic Review and Meta-Analysis,” NIH.gov, 12/1/25
Image by Atlantic Ambience/Pexels

Chile’s Food Policies Linked to Lower Childhood Obesity Rates

Over the years, our head writer, Pat Hartman, has tirelessly covered how advertising to children, along with questionable food additives designed to appeal to kids’ palates, can lead to increased obesity rates. Here’s just one of the many snippets:

Weird stuff inside the food, and enticing, persuasive words about the food: Both in their own distinctive ways are responsible for the overwhelming wave of obesity that has engulfed society…

When it comes to pouring enormous amounts of money into the economy, visual and auditory stimuli both play their parts. Every little purchase of a convenience-store doughnut, glimpsed by someone who just went in there to pay for gas, performs its role in the overall ascendency of food.

Now, a major new study suggests that comprehensive food policies designed to limit children’s exposure to unhealthy foods may help reduce childhood obesity.

Researchers found that Chile’s nationwide strategy, which combines front-of-package (FOP) warning labels, restrictions on food marketing, and regulations governing foods sold in schools, was associated with measurable declines in excess weight among young children. Published in The Lancet, the observational study provides some of the strongest evidence to date that a coordinated policy approach can positively influence children’s health population-wide.

Apparently, Chile has long struggled with high rates of childhood overweight and obesity. In response, the country implemented the Food Labelling and Advertising Law (FLAL) in 2016, a sweeping set of regulations often described as one of the world’s most ambitious food policy initiatives.

The law introduced highly visible front-of-package warning labels on foods and beverages high in sugar, sodium, saturated fat, or calories. It also restricted the marketing of these products to children and prohibited their sale in schools. How impressive is that?

Researchers examined data from more than 321,000 children enrolled in prekindergarten, kindergarten, and first grade between 2012 and 2017. Their analysis found that children exposed to the policy had a lower likelihood of developing excess weight.

Among children between six and 18 months of age, exposure to the regulations was associated with approximately a 2% reduction in the probability of excess weight. While that number may appear modest, researchers note that even small improvements during early childhood can produce meaningful health benefits later in life.

According to the study’s authors, the greatest strength of Chile’s approach lies in the way multiple policies reinforce one another.

Dr. Guillermo Paraje, professor of Economics at the Adolfo Ibáñez University Business School and the study’s lead author, believes countries considering similar measures should avoid relying on a single intervention. He said:

This is because integrated policies usually work better than single ones… It makes no sense to have a good FOP labels system and to allow food companies to target children with their advertisements, giving them toys with their products or luring them with cartoons.

The study found that children who experienced the first phase of the FLAL demonstrated meaningful reductions in overweight risk. The strongest effects were observed among children exposed during kindergarten and first grade. Girls experienced a 2.85% lower probability of excess weight, while boys saw a 2.4% reduction.

Even children with shorter periods of exposure benefited. Girls who were exposed for only six months or during first grade alone had a 1.91% lower probability of excess weight, while boys showed a 2.24% reduction. (Researchers used data from Chile’s Nutritional Map and Vulnerability Survey to evaluate the law’s impact.)

Despite growing evidence supporting food labeling and marketing restrictions, implementation efforts often face opposition from industry groups. One common argument is that stricter regulations could negatively affect employment or economic growth. Dr. Paraje says the available evidence does not support those concerns:

Quite often, industry claims that these policies affect employment. But these claims are unfounded… There are studies published for Chile, Peru, and Mexico showing that, after labeling policies, there were no changes in employment or wages attributable to them.

Dr. Paraje also pointed to recent debates in Argentina, where efforts have emerged to repeal front-of-package labeling regulations adopted in 2022. Critics of repeal efforts argue that the labels have already helped consumers identify less healthy products and make more informed purchasing decisions.

As childhood obesity continues to rise globally, Chile’s experience may provide a useful roadmap for policymakers looking to create healthier food environments and improve children’s long-term health outcomes.

Your responses and feedback are welcome!

Source: “The impact of Chile’s multipronged food labelling and advertising law on early childhood excess weight: a cohort difference-in-differences study,” The Lancet, 6/11/26
Source: “From Chile to the world: Food policy package linked to lower childhood obesity risk,” Nutrition Insight, 6/19/26
Source: “Combined Food Policies, Including Labeling and Advertising Bans, Plausibly Reduce Childhood Obesity,” Pharmacy Times, 6/17/26
Image by Marcia Salido/Pexels

Medicare Opens the Door to GLP-1 Weight-Loss Medications

Beginning July 1, 2026, millions of Medicare beneficiaries living with obesity will gain access to GLP-1 weight-loss medications through a new federal program, marking a significant change in how obesity treatment is covered for older Americans. This is a major step to provide access to weight-loss meds for those who cannot afford them. We can only hope that Medicaid will do the same eventually for all ages, including children.

The initiative, known as the “Medicare GLP-1 Bridge,” was announced by the Centers for Medicare & Medicaid Services (CMS) in May 2026. The temporary program will allow eligible Medicare Part D beneficiaries to obtain certain obesity medications, including semaglutide (Wegovy) and tirzepatide (Zepbound), for a fixed monthly cost of $50 through the end of 2027. For many patients, the program represents a long-awaited opportunity to access medications that were previously out of reach due to Medicare coverage restrictions.

Why this change matters

Although obesity affects millions of older adults, Medicare has historically been prohibited from covering medications prescribed solely for weight loss. Since the creation of Medicare Part D in 2006, federal law has excluded weight-loss drugs from routine prescription coverage, leaving many beneficiaries responsible for paying thousands of dollars out of pocket each year.

The Medicare GLP-1 Bridge is designed as a temporary demonstration program that operates outside of traditional Part D coverage rules. CMS will use the initiative to evaluate the effects of expanding access to obesity medications while lawmakers consider longer-term policy solutions. The launch marks the first time Medicare beneficiaries whose primary diagnosis is obesity will have a dedicated pathway to receive these medications at a significantly reduced cost.

Which medications are included?

CMS has indicated that the program will cover the obesity-specific versions of two widely used GLP-1 medications: Wegovy (semaglutide) and Zepbound (tirzepatide). Both drugs are approved by the U.S. Food and Drug Administration for chronic weight management and have demonstrated substantial weight-loss benefits in clinical trials.

Eligible participants will pay a flat $50 monthly copayment regardless of where they are in their Part D benefit cycle. However, unlike standard Part D prescriptions, these payments will not count toward Medicare’s annual out-of-pocket spending cap. CMS structured the program this way to help manage costs while testing broader access to obesity treatment.

Who may qualify?

The Bridge program is intended specifically for Medicare beneficiaries whose only reason for taking a GLP-1 medication is obesity treatment. Those who already receive GLP-1 medications through Medicare for other approved conditions, such as type 2 diabetes, cardiovascular risk reduction, or obstructive sleep apnea, will continue obtaining their medications through their existing Part D coverage rather than through the new demonstration program.

CMS is expected to provide additional details about eligibility requirements before the program launches. Those details may include body mass index (BMI) criteria, documentation requirements, and any prior authorization procedures that participating plans may require. Beneficiaries should watch for information from their Medicare Part D plans in the coming weeks and discuss potential eligibility with their healthcare providers.

A broader expansion of GLP-1 access

The Medicare GLP-1 Bridge is just one of several developments reshaping access to obesity medications in 2026. Another CMS initiative, the BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) Model, allows state Medicaid programs to voluntarily expand coverage for GLP-1 medications used to treat obesity. The program began accepting participating states in May 2026 and is intended to make obesity treatment more affordable for lower-income Americans.

At the same time, efforts to reduce out-of-pocket costs in the commercial market are also underway. Pricing agreements announced in late 2025 are expected to lower costs for cash-paying consumers purchasing GLP-1 medications outside of insurance coverage. Industry observers also anticipate the arrival of oral GLP-1 medications currently in late-stage development, which could further expand access and affordability in the coming years.

Cost remains a major challenge

Despite growing availability, affordability continues to be one of the biggest barriers to obesity treatment. Surveys consistently show that many patients struggle to pay for GLP-1 medications, especially when insurance coverage is unavailable or limited. Even with recent price reductions, monthly costs remain prohibitive for some individuals.

The Medicare GLP-1 Bridge addresses part of that challenge by offering eligible beneficiaries access to leading obesity medications for a predictable $50 monthly payment. While the program is temporary and does not solve all coverage issues, it represents a meaningful step toward making evidence-based obesity treatment more accessible.

Being cautiously optimistic

The launch of the Medicare GLP-1 Bridge on July 1 could serve as an important test case for future Medicare coverage of obesity medications. If the program demonstrates positive health outcomes and manageable costs, it may influence future policy decisions regarding permanent coverage options for a broader range of the population.

Your responses and feedback are welcome!

Source: “Medicare Is About to Cover Weight-Loss Drugs for the First Time — Here’s What the GLP-1 Bridge Program Means for Millions of Americans with Obesity,” Medical Daily, 6/10/26
Source: “Coming Soon: CMS to Provide $50 Monthly Access to GLP-1 Medications for Medicare Beneficiaries,” CMS.gov, 5/6/26
Source: “What to Know About the BALANCE Model for GLP-1s in Medicare and Medicaid and the Medicare GLP-1 Bridge,” KFF.org, 5/11/26
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Fathers Play a Big Role in Childhood Obesity Risk

When discussing childhood obesity, most conversations focus on mothers’ health during pregnancy and early childhood. However, emerging research suggests that fathers may have a significant influence on a child’s future weight and metabolic health long before conception even occurs.

A recent review published in Current Obesity Reports highlights the growing evidence that fathers contribute to obesity risk across generations through biological, behavioral, and environmental factors. The findings suggest that efforts to prevent childhood obesity may be more effective when both parents, not just mothers, are included in research, education, and intervention programs.

Research has consistently shown that children are more likely to develop obesity if one or both parents are affected. The risk becomes even greater when both parents have obesity. While genetics play a role, scientists now recognize that obesity is influenced by a complex combination of inherited traits, lifestyle habits, family behaviors, and environmental factors.

How do fathers influence health before conception?

Traditionally, scientists have focused on how maternal health affects a developing baby. The concept known as the Developmental Origins of Health and Disease (DOHaD) emphasizes that conditions around conception and pregnancy can shape a child’s lifelong health.

More recently, researchers have expanded this framework to include fathers through the Paternal Origins of Health and Disease (POHaD) model. This approach recognizes that a father’s health before conception may also affect a child’s future risk of obesity and metabolic disease.

According to the review, paternal obesity can influence offspring health through changes in sperm quality and function. Excess body weight in men has been linked to lower sperm concentration, reduced sperm movement, and increased DNA damage within sperm cells. These changes are thought to result from obesity-related disruptions in hormone regulation, inflammation, and metabolic function.

Researchers estimate that men with obesity face a 30% to 66% greater risk of infertility compared to men of healthier weight. Obesity has also been associated with an increased risk of pregnancy loss that cannot be explained by maternal factors alone.

Epigenetics may help explain the connection

Beyond genetics, researchers are investigating how epigenetic changes may influence obesity risk across generations. Epigenetics refers to modifications that affect how genes are expressed without altering the underlying DNA sequence. Obesity has been linked to changes in the epigenetic markers, and some of these alterations may be passed to future offspring.

Scientists believe these changes could affect biological pathways involved in appetite control, insulin function, and fat storage. Animal studies have shown that fathers consuming high-fat diets can pass obesity-related metabolic changes to their offspring.

While researchers are still working to fully understand these mechanisms in humans, one encouraging finding is that some obesity-related epigenetic changes appear to be reversible. Improvements in diet, exercise, and overall health before conception may help reduce potential risks.

Fathers also shape family health habits

A father’s influence extends well beyond biology. Research shows that fatherhood often brings changes in weight and lifestyle habits, and poor dietary habits may negatively affect reproductive health.

After a child is born, fathers continue to influence obesity risk through everyday behaviors and parenting practices. Children frequently model the habits they observe at home. Fathers who prioritize nutritious meals, regular exercise, and active lifestyles can help establish healthy routines for their children. Likewise, fathers who spend more time being sedentary or consuming unhealthy foods may unintentionally reinforce similar behaviors.

Environment and neighborhood matter too

The review emphasizes that obesity risk is not solely determined by individual choices. Social and environmental factors can strongly influence health outcomes for both fathers and children.

Income, education, neighborhood conditions, and food access all affect obesity risk. Families living in areas with limited access to affordable, nutritious foods may rely more heavily on calorie-dense processed foods. Food insecurity has been linked to higher obesity rates in both adults and children.

Access to safe parks, playgrounds, and recreational spaces can also influence physical activity levels. When opportunities for exercise are limited, sedentary behavior often increases.

… As does mental health

The review notes that fathers experiencing depression may be less likely to engage in positive parenting behaviors or prioritize preventive healthcare for themselves and their families. This can affect household routines related to nutrition, sleep, and physical activity.

Children who grow up in homes where a parent struggles with depression may also face a greater risk of adverse childhood experiences, which have been associated with long-term health challenges, including obesity.

Finally, the findings suggest that childhood obesity prevention should begin earlier than many people realize and should involve fathers from the start. This means including fathers in preconception counseling, pregnancy education programs, and family-based obesity prevention efforts.

Your responses and feedback are welcome!

Source: “Fathers shape childhood obesity risk long before birth,” News-Medical.net, 6/9/26
Source: “The Role of Fathers in the Intergenerational Transmission of Obesity,” Current Obesity Reports, 5/26/26
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Studies Suggest GLP-1 Medications May Help Slow Progression of Some Cancers

GLP-1 medications have become widely known for their role in treating type 2 diabetes and supporting weight loss. Now, emerging research suggests these drugs may offer another important benefit: helping slow the progression of certain obesity-related cancers, as well as breast cancer.

A new study presented at the 2026 annual meeting of the American Society of Clinical Oncology (ASCO) found that patients taking GLP-1 receptor agonists after a cancer diagnosis experienced significantly lower rates of cancer progression and death compared to patients taking other diabetes medications.

GLP-1 receptor agonists, which include medications commonly prescribed for diabetes and obesity management, have attracted growing scientific interest in recent years. Researchers have increasingly explored whether the drugs’ effects extend beyond controlling blood sugar and promoting weight loss.

According to Dr. Marcin Chwistek, chief of supportive oncology and palliative care at Fox Chase Cancer Center and an ASCO expert in supportive care, GLP-1 medications may influence several biological pathways linked to cancer development and progression. Researchers believe the drugs’ anti-inflammatory and immune-regulating effects could play a role in improving outcomes for cancer patients.

What the studies found

The research team analyzed health records from more than 12,000 patients diagnosed with one of seven obesity-related cancers at stages 1, 2, or 3. The investigators compared patients who began taking GLP-1 medications after their cancer diagnosis with similar patients who were treated with a different class of diabetes drugs known as DPP-4 inhibitors, or gliptins.

The results were notable. Patients using GLP-1 medications showed a meaningful reduction in cancer progression across several solid tumor types. The strongest benefits were observed among patients with lung, breast, colon, and liver cancers. In these groups, patients taking GLP-1 drugs were approximately 38% to 50% less likely to develop stage 4 or metastatic disease compared with those receiving alternative diabetes treatments.

The study also found that GLP-1 use was associated with a 33% lower risk of death from any cause. Among all cancer types examined, breast cancer patients appeared to experience the greatest survival benefit. Researchers reported that GLP-1 users with breast cancer had a 45% lower risk of death compared to similar patients taking other diabetes medications.

These findings suggest that the medications may have an impact not only on cancer progression but also on overall survival.

Scientists are still working to understand the mechanisms behind these results. One possibility is that GLP-1 medications help reduce chronic inflammation, which has long been linked to both obesity and cancer development. Inflammation can create an environment that supports tumor growth and spread.

Researchers also point to the drugs’ effects on the immune system. By influencing immune responses, GLP-1 medications may help the body better control cancer progression.

Weight loss itself may also contribute to improved outcomes, since excess body weight is a known risk factor for several types of cancer. However, additional research will be needed to determine exactly how these medications may influence cancer biology.

The study has been presented at ASCO’s annual meeting but has not yet been published in a peer-reviewed medical journal. Research presented at scientific conferences often undergoes additional review and validation before becoming part of standard medical practice.

Another study found that women who used GLP-1 medications had a significantly lower risk of developing breast cancer than those who did not use the drugs. The study reviewed health data from more than 110,000 women ages 45 to 80 and found that GLP-1 users were about 30% less likely to be diagnosed with breast cancer. The findings were also presented at the 2026 ASCO annual meeting by Dr. Elizabeth McDonald of the University of Pennsylvania’s Perelman School of Medicine and were simultaneously published in JCO Oncology Practice.

Dr. McDonald said:

GLP-1 medications are intriguing from a cancer research perspective because they weren’t designed for cancer therapy, but they do affect many different targets and pathways associated with cancer development, so we’re eager to study them in this context.

Your responses and feedback are welcome!

Source: “GLP-1 Meds May Help Slow the Spread of Certain Obesity-Related Cancers,” HealthDay, 5/27/26
Source: “GLP-1s May Reduce Metastatic Progression of Certain Obesity-Related Cancers,” ASCO, 5/21/26
Source: “GLP-1 use linked to lower breast cancer incidence in large cohort study,” PennMedicine.org, 6/2/26
Source: “GLP-1 Agonists Are Associated With a Significant Reduction in Breast Cancer Incidence in Women,” JCO Oncology Practice, 6/2/26
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Early-Life Junk Food Rewires the Brain

A growing body of research continues to show that what children eat can have lifelong consequences. Now, a new study published in Nature Communications suggests that eating a high-fat, high-sugar junk food diet during early life may permanently alter the brain’s appetite and reward systems, increasing the risk of overeating well into adulthood. The findings offer new insight into how childhood nutrition affects long-term health and reveal that the gut microbiome may hold the key to reversing some of the damage.

Researchers investigated how consuming a high-fat, high-sugar diet early in life impacts eating behaviors later on, even after switching to a healthier diet in adulthood. The study found that early exposure to junk food can leave a lasting imprint on the brain, essentially rewiring hunger and reward pathways in ways that persist over time.

Perhaps most concerning, the changes remained even after the subjects returned to a healthy weight and healthier eating patterns. This suggests that the effects of poor childhood nutrition go beyond temporary weight gain and may fundamentally influence how the brain regulates appetite.

One of the study’s most striking discoveries was that males and females responded differently to the unhealthy diet. Researchers found that females appeared to be more vulnerable to the long-term effects of junk food consumption. In females, the diet reduced leptin receptors in the brain.

Leptin is a hormone responsible for signaling fullness and helping regulate food intake. When leptin signaling is disrupted, the brain may struggle to recognize when enough food has been consumed, increasing the likelihood of overeating.

The unhealthy diet also interfered with how females processed essential amino acids such as tryptophan and arginine, which play important roles in mood, metabolism, and brain function. Males, on the other hand, experienced disruptions in immune-sensing pathways and steroid metabolism, showing that junk food can affect biological systems differently depending on sex. These findings may help researchers better understand why some individuals are more susceptible to obesity and eating disorders later in life.

While the long-term brain changes linked to junk food are concerning, the study also uncovered a promising possibility: targeted gut microbiome therapies may help reverse some of the damage. Researchers successfully used both probiotics and prebiotics to improve eating behaviors and restore gut-brain communication pathways.

Probiotics, including Bifidobacterium longum, appeared to directly reduce overeating behaviors while causing minimal disruption to the existing gut ecosystem. Meanwhile, prebiotics helped improve the overall gut environment and supported healthier communication between the gut and the brain.

The findings reinforce the growing understanding that the gut microbiome plays a major role in mental and physical health. Often referred to as the “gut-brain axis,” this communication network connects digestive health with brain function, appetite regulation, mood, and metabolism. Researchers suggest that targeting the microbiome could potentially serve as a “reset button” for unhealthy eating patterns that begin in childhood.

There are several reasons why limiting junk food during childhood is so important. One is nutritional deficiencies. Children require vitamins, minerals, protein, fiber, and healthy fats to support proper physical and cognitive development. Diets dominated by processed foods often fail to provide these essential nutrients, potentially impacting growth, immunity, and brain development.

Another reason is the increased risk of weight gain and obesity. Then there are effects on learning and behavior, as research has linked diets high in sugar and unhealthy fats with poorer concentration, mood swings, and behavioral difficulties in children. Let’s not forget dental health problems. Sugary snacks and beverages can increase the risk of cavities and tooth decay. Since children’s teeth are still developing, frequent exposure to sugary foods can have lasting consequences for oral health.

Finally, children who regularly consume junk food may become less interested in healthier options like fruits, vegetables, whole grains, and lean proteins. These habits can continue into adulthood, increasing the risk of chronic disease over time.

As scientists continue exploring the connection between nutrition, the gut, and the brain, one message is becoming increasingly clear: What children eat today may influence their health and eating behaviors for decades to come.

Your responses and feedback are welcome!

Source: “Childhood Junk Food May Rewire The Brain For Life, Reveals Study,” NDTV.com, 5/28/26
Source: “Bifidobacterium longum and prebiotic interventions restore early-life high-fat/high-sugar diet-induced alterations in feeding behavior in adult mice,” Nature Communications, 2/24/26
Source: New Study Discovers That a Junk-Food Diet Rewires the Brain,” Inc.com, 5/24/26
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About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:

Presentations

Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

Food & Health Resources