About one in three kids in the U.S. is overweight or obese, which is nearly three times the number seen in the 1960s.

A team of researchers led by Claudia Fox, MD, MPH, associate professor of Pediatrics and co-director of the Center for Pediatric Obesity Medicine at the University of Minnesota, has received a five-year, $3.2 million grant to study treatments for severe obesity in adolescents. The grant is awarded by the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health.

Conventional strategies for treating pediatric obesity include lifestyle therapy, which entails changes in diet and exercise supported by behavior modification. However, most teens with severe obesity do not lose enough weight with lifestyle therapy alone. For those kids, anti-obesity medications may be helpful, yet there is currently very little guidance on when or how to use these medications in teens.

“Many people don’t recognize that obesity is a biological condition at its core,” Dr. Fox said. “A biological disease often requires a biological treatment, such as medications, to match it.”

In this study, Dr. Fox and her team will aim to determine the best time to start anti-obesity medications to help with weight loss for those teens with severe obesity who are not responding to lifestyle therapy. They are also examining different characteristics of teens, such as appetite, hormones and eating behaviors, which may guide the choice of what medication should be used.

“Currently, as physicians, we have to use a trial-and-error approach,” Dr. Fox said. “If one medication doesn’t work, then you try another. But, unfortunately, this means that the patient may be exposed to medications that are not helpful or have side effects.”

The results of this study will provide more evidence-based guidelines for the management of obesity in adolescents that are tailored to specific characteristics of the patient.

Just like there are different types of cancer that require different treatments, there are different types of obesity, and each patient may have a different response to a given medication. The unique research design of this study, called Sequential Multiple Assignment Randomized Trial (SMART), allows for changing of the intervention as you go, instead of a standard randomized controlled trial that compares one treatment arm to a different treatment arm. This SMART design helps determine the right treatment, for the right person, at the right time to create a personalized treatment plan for each individual.

The research is taking place at the University’s new Center for Pediatric Obesity Medicine (CPOM). CPOM is an interdisciplinary center focused on improving the outcomes of youth afflicted with obesity and related conditions by fostering research collaborations across the Medical School. Dr. Fox’s study is one of approximately 15 research studies currently underway at CPOM.