The New York Times recently reported that weight may be driving children to adult medication for a wide range of chronic conditions related to childhood obesity, according to prescription data from three large organizations. The numbers, from pharmacy plans Medco Health Solutions, Express Scripts and the marketing data collection company Verispan, indicate that hundreds of thousands of children are taking medication to treat Type 2 diabetes, high blood pressure, high cholesterol, and acid reflux — all problems linked to obesity that were unknown in children two decades ago. The data shows concerns that children taking adult medication are already a reality, regardless of the heightened attention due to the American Academy of Pediatrics suggesting more children (under age 8) should be given cholesterol-lowering drugs. Critics suggest that these physicians are avoiding the prescription of exercise and diet that would fix many of these problems.
Our own advisory board member, Dr. Fran Kaufman, testified before a Senate subcommittee meeting recently and described young patients with difficult lifestyles– imagine having no grocery store in your neighborhood or your school not offering any physical education program – already on medication. “They deserve to be treated,” Dr. Kaufman said. “I think the slant from most of the media is that pediatricians are jumping to put kids on medications. That’s not true at all. Since lifestyle is so difficult, we have no other choice but to go to pharmacotherapy.”
The pediatric market is not yet big enough for many companies to make special children’s formulas of drugs for disorders that go hand in hand with obesity and unhealthy high-fat lifestyles, but this may be changing. The most significant increase in the use of drugs for children has been in oral medication for Type 2 diabetes. Medco estimates a 151% increase from 2001 to 2007 (albeit from a small base, we would point out). Some doctors estimate many of these may be “off-label” use of metformin to treat pre-diabetes. Other doctors object to the use of metformin for pre-diabetes because there are no studies for children, only adults and effectiveness has also been shown for prevention of diabetes in young adults.