Nearly 20% of children and adolescents in the United States are obese, and now a panel of national health experts has recommended an intensive, comprehensive set of behavioral interventions to combat the problem.

The U.S. Preventive Services Task Force posted final recommendations Tuesday for children and adolescents age 6 and older with high body mass index, also called obesity. To calculate BMI, a child’s height and weight is plotted on a growth chart. A BMI at or above the 95th percentile, based on age and sex, qualifies as obese.

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Children who are obese are at a higher risk for developing diabetes and cardiac problems at a younger age than the general population, tend to stay obese in adulthood and are at an increased risk for premature death, according to research. Obesity in children also increases the likelihood of developing breathing issues, such as sleep apnea and asthma, and psychological issues, such as depression and anxiety.

“We know that there are proven strategies to help kids who have a high BMI achieve a healthy weight,” Dr. Wanda Nicholson, who chairs the task force, said in a news release. “These interventions work best when both kids and parents are engaged, so it is important that healthcare professionals provide support in identifying which counseling interventions are available, accessible, and a good fit for the family.”

In 2017, the task force recommended clinicians screen for obesity in children and adolescents. This time, the task force took a step further, recommending a specific array of behavioral interventions, including education about healthy eating habits, counseling on behavioral change techniques, such as goal setting and problem-solving, and supervised exercise sessions. The interventions should include a minimum of 26 hours with a health care professional over the course of a year, in part to gain a larger commitment from children and their families, according to the recommendations.

Although the U.S. Food and Drug Administration approved the weight-loss drug Wegovy in 2022 for use in children 12 and older, the task force did not recommend the use of such medications at this time. More research is needed to determine the outcomes and possible dangers of long-term use of weight-loss medications, the task force said.