Pediatric Obesity
Key Points
Key Points
Pediatric obesity has its basis in genetic susceptibilities influenced by a permissive environment starting in utero and extending through childhood and adolescence.
Genetic screening for rare syndromes is indicated only in the presence of specific historical or physical features.
Endocrine etiologies for obesity are rare and usually are accompanied by attenuated growth patterns.
Pediatric comorbidities are common, and long-term health complications often result. Screening for comorbidities of obesity should be applied in a hierarchal, logical manner for early identification before more serious complications result.
The psychological toll of pediatric obesity on the individual and family necessitates screening for mental health issues and counseling as indicated.
The prevention of pediatric obesity by promoting healthful diet, activity, and environment should be a primary goal, since achieving effective, long-lasting results with lifestyle modification once obesity occurs is difficult.
Diagnosis
Diagnosis
...ng Overweight and Obesity...
...sing body mass index (BMI) and the Centers...
...mmends diagnosing a child or adolescent >2 ye...
...s that clinicians take into account that v...
ES suggests calculating, plotting, and reviewing...
...ests that a child
...recommends against routine laboratory evaluati...
...ds that children or adolescents with a...
...nds against measuring insulin concentrations...
...Obesity Syndromes...
...enetic testing in patients with extreme early...
...evalence of Pediatric Overweight and Ob...
...able 2. Screening for Comorbidities of Pediat...
Prevention
Preventi...
...s that clinicians promote and participate...
...hat clinicians prescribe and support health...
ES recommends that children and adolesc...
...tering healthy sleep patterns in childre...
...nds balancing unavoidable technology-rel...
...at a clinician’s obesity prevention ef...
...sts that clinicians assess family funct...
ES suggests using school-based programs and co...
...using comprehensive behavior-chang...
ES recommends breast-feeding in infants bas...
...nosis and Management Flowcharta Mea...
...e 3. Genetic Obesity Syndromes With and Wit...
Treatment
...atment...
...tyle: General Considerations...
...S recommends that clinicians prescribe and suppo...
ES recommends that clinicians pres...
...that clinicians prescribe and suppor...
...at clinicians encourage and support patients to...
...that the health care team identify m...
...gests that the health care team probe...
...suggests that the health care team eva...
...pharmacotherapy for children or adolescents wit...
...against using obesity medications in chil...
...that Food and Drug Administration (FDA)–approved...
...uggests that clinicians should discontinue medi...
...ariatric surgery only under the follow...
...sts against bariatric surgery in pre...
Figure 2. Change in Metabolic Outcome...
...able 4. Factors Associated With Preventi...
.... Medications Studied for the Long-Term...
.... Bariatric Surgical Procedure...