The integrity of the global evidence ecosystem is fundamental to evidence-informed policy and practice. Pollution of the ecosystem by commercial interests continues to damage this integrity and presents a barrier to universal access to reliable healthcare inforamtion: a world where every person has access to the information they need to protect their own health and the health of others. This paper in the BMJ illustrates how commercial interest pollute a key part of the global evidence ecosystem, namely component 3. Synthesis of evidence https://www.hifa.org/about-hifa/hifa-vision-mission-strategy
With thanks to Global Health Now: Over one-third of contributors to the development of 2023 American Academy of Pediatrics guidelines on evaluating and treating children and adolescents with obesity—which leaned toward the use of obesity medications—had undisclosed financial ties to obesity drugmakers, per a new analysis in BMJ. https://www.bmj.com/content/390/bmj-2025-084760.full?ijkey=GMlqMNPGvG5au...
CITATION: Caution is prescribed for American Academy of Paediatrics’ guidelines on weight loss medications for childhood obesity
BMJ 2025; 390 doi: https://doi.org/10.1136/bmj-2025-084760 (Published 07 July 2025)
Cite this as: BMJ 2025;390:e084760
EXTRACTS
Laura Schmidt and colleagues identify systemic financial conflicts of interest that serve as a cautionary tale for users of medical guidelines
Prescribing glucagon-like peptide 1 (GLP-1) receptor agonists such as semaglutide or tirzepatide for weight loss has created vigorous scientific debate...
Amid this uncertainty, the 2023 guidelines on treatment of childhood obesity from the American Academy of Paediatrics (AAP), the leading medical society for 67 000 US paediatricians, include a recommendation to use weight loss drugs...
The AAP guidelines take a different approach to those in the UK, Sweden, and Australia, which are currently out for consultation. These all recommend against prescribing weight loss medications for children under 12, barring exceptional circumstances... However, we have identified financial ties to GLP-1 developers throughout the AAP and its guideline process that, combined with irregularities in guideline development methods, suggest the AAP’s childhood obesity guidelines should be interpreted with caution...
KEY MESSAGES
The 2023 American Academy of Paediatrics’ (AAP) childhood obesity guidelines are the first to recommend offering weight loss drugs to adolescents ≥12 years old and permitting use in children aged 8-11 years
While the AAP claims its guidelines had “an independent review for bias,” since 2012, it has accepted around $2m in corporate sponsorship payments from companies developing GLP-1 drugs
Payments have also been made to AAP’s national leaders and members of its guideline and systematic review committee
The drug recommendation is based on limited evidence and guidelines deviated from established development standards
The AAP guidelines on weight loss drugs should be interpreted with caution
HIFA profile: Neil Pakenham-Walsh is coordinator of HIFA (Healthcare Information For All), a global health community that brings all stakeholders together around the shared goal of universal access to reliable healthcare information. HIFA has 20,000 members in 180 countries, interacting in four languages and representing all parts of the global evidence ecosystem. HIFA is administered by Global Healthcare Information Network, a UK-based nonprofit in official relations with the World Health Organization. Email: neil@hifa.org