Pediatric Obesity
Key Points
Key Points
- Pediatric obesity remains an ongoing serious international health concern affecting ~17% of US children and adolescents, threatening their adult health and longevity.
- 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
Diagnosing Overweight and Obesi...
...using body mass index (BMI) and the Cent...
...commends diagnosing a child or ado...
ES suggests that clinicians take in...
...alculating, plotting, and reviewing a chil...
...ests that a child...
...against routine laboratory evaluations for e...
...at children or adolescents with a BMI of ≥85t...
...S recommends against measuring insulin con...
...etic Obesity Syndromes
...genetic testing in patients with extreme ea...
...Prevalence of Pediatric Overweight and Obesity...
...Screening for Comorbidities of Pe...
Prevention
...vention...
...gests that clinicians promote and partic...
...at clinicians prescribe and support...
...at children and adolescents engage in at least...
...fostering healthy sleep patterns in c...
ES recommends balancing unavoidable technology...
...a clinician’s obesity prevention efforts enli...
...at clinicians assess family function and mak...
...ing school-based programs and commu...
...ing comprehensive behavior-changing interventions...
...mends breast-feeding in infants based...
...1. Diagnosis and Management Flowcharta Measure...
...enetic Obesity Syndromes With and Without Develop...
Treatment
Treatment
...festyle: General Considerati...
ES recommends that clinicians prescribe and supp...
...ecommends that clinicians prescribe and...
...ds that clinicians prescribe and s...
...sts that clinicians encourage and support pa...
...S suggests that the health care team identi...
...that the health care team probe for and...
...that the health care team evaluate f...
...gests pharmacotherapy for children or adolescents...
...mends against using obesity medication...
...Food and Drug Administration (FDA)–approved ph...
...ests that clinicians should discontinue medicatio...
...ariatric surgery only under the following...
...suggests against bariatric surgery in prea...
Figure 2. Change in Metabolic Outcome Per Unit...
...s Associated With Prevention of Pediatric ObesityH...
...5. Medications Studied for the Long-Term Treatme...
...ure 3. Bariatric Surgical...