The American Academy of Pediatrics has released new guidelines for treating childhood obesity that emphasize early intervention and intensive treatments, The Associated Press reports. The latest update, the group’s first in 15 years, recommends weight-loss medications and surgical procedures for children as young as 12 and 13.

Per the new guidelines published Monday, doctors should offer FDA-approved weight loss medications to adolescents 12 and older, in addition to recommended lifestyle changes, behavioral counseling, intensive diet, and exercise. Such medications include “orlistat, which blocks fat absorption; semaglutide, which decreases hunger; and metformin, a diabetes drug,” per The Wall Street Journal. The AAP also recommends that doctors screen severely obese children ages 13 and older to see if they qualify for bariatric surgery, and says pediatricians should assess obese children for high cholesterol, diabetes, and hypertension.

The new guidance is more aggressive than the AAP’s “watchful waiting” approach, which recommended waiting to see if kids and teens outgrew obesity on their own. It also comes as nearly 15 million young people in the U.S. struggle with childhood obesity, an upward trend worsened by the COVID pandemic, per data from the Centers for Disease Control and Prevention. Obesity could lead to lifelong, severe health complications, including high blood pressure, diabetes, and depression. Said Dr. Ihuoma Eneli, co-author of the new guidelines: “Waiting doesn’t work. What we see is a continuation of weight gain and the likelihood that they’ll have (obesity) in adulthood.”

Some pediatricians appreciate the update, including Dr. Claudia Fox, a weight loss specialist at the University of Minnesota. “What it offers patients is the possibility of even having an almost normal body mass index,” Fox said, per AP. “It’s like a whole different level of improvement.”

But another pediatric obesity expert — Dr. Robert Lustig from the University of California, San Francisco — worries that doctors may now begin turning to medication or surgery too quickly. “It’s not that I’m against the medications,” said Lustig. “I’m against the willy-nilly use of those medications without addressing the cause of the problem.”