Doctors should consider treating childhood obesity with surgery for patients as young as 13, according to guidance issued Monday by the American Academy of Pediatrics.

Doctors previously used “watchful waiting,” or delaying treatment until it is clear whether the child will overcome obesity.

The medical association said that strategy can lead to “serious short and long-term health concerns.”

More than 14.4 million children and teens in the United States live with obesity, but it can be “treated successfully with the recognition that complex genetic, physiologic, socioeconomic, and environmental factors are at play,” the pediatric group said in its first comprehensive obesity guidance in 15 years.

Children as young as 12 may also be prescribed weight loss medication to supplicate behavioral and lifestyle treatments, according to the new guidance.

Metabolic and bariatric surgeries are recommended only for teenagers with “severe obesity,” the association said.

The academy called for new policies to improve children’s wellbeing. “Policy changes should address structural racism that drives alarming and persistent disparities in childhood obesity, according to the guideline’s executive report,” the group wrote.

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