EMPOWER

EMPOWER is a new program at Boston Children’s Hospital that uses modern tools and evidence to approach weight management.

Doctors and scientists now know that obesity is a disease, just like any other disease. Many factors can contribute to our body size and shape: including what we eat, how much we move our bodies, genetics, our environment, and even our experiences before we are born. We celebrate all body shapes and sizes. However, sometimes excess body fat can pose health risks, and our goal is to approach each patient as an individual to determine the best treatment plan.

Obesity can increase a child’s risk for chronic and serious medical conditions, such as type 2 diabetes, high blood pressure (hypertension), high cholesterol, orthopedic problems, and liver disease. Health experts don’t know why some people are more prone to obesity than others, but it’s believed to be caused by a combination of environment, genetics, nutrition, and energy expenditure.
 

As a patient in the EMPOWER program, you can expect to receive medical and nutritional counseling in a supportive and positive environment. Exercise, healthy nutrition, and counseling are usually prescribed treatments, but some children might also benefit from medication as a supplement to those measures. The EMPOWER Program can help incorporate lifestyle or medication — or both — into your child’s treatment plan and work with your family to improve their health and quality of life.

The anti-obesity medications we prescribe are created to help those with a body mass index (BMI) in the >95th percentile. We will walk your family through how these medications work, what they aim to achieve, and whether they might cause side effects. Medications include:

• Semaglutide and liraglutide. These act like the hormone GLP-1 (glucagon-like peptide), which tells your brain and stomach that you’ve eaten enough. The drugs act like the hormone by slowing the emptying of the stomach to help your child feel less hungry after meals. These medications are FDA-approved for use in children ages 12 and older.
• Tirzepatide. This medication combines the effects of GLP-1 and another hormone, GIP (gastric inhibitory peptide), to help patients feel less hungry by working in the brain and by slowing stomach emptying.
• Phentermine. This medication also stimulates areas of the brain that register feelings of fullness in the brain. This will help reduce hunger and reduce body weight.
• Topiramate. This also works in the brain to help reduce appetite and control body weight. It is often used in combination with phentermine.
• Qsymia. This medication is a combination of phentermine and topiramate, and has been FDA approved for use in children ages 12 and older.

We’ll determine which medication might work best for your child, prepare a treatment plan, and monitor how they respond. Medication is not the only answer to weight management, but in addition to lifestyle change, it can be an effective part of an overall plan. We’re here to help your family achieve the goals that can improve your child’s well-being.

In addition, Boston Children’s Optimal Wellness for Life (OWL) Program offers individualized health behavior education and counseling. Participation in the OWL program is available for established EMPOWER patients who are interested in this additional level of support.