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Childhood Obesity (Print) Dec 2014A key challenge in managing pediatric obesity is the high degree of program attrition, which can reduce therapeutic benefits and contribute to inefficient health... (Review)
Review
BACKGROUND
A key challenge in managing pediatric obesity is the high degree of program attrition, which can reduce therapeutic benefits and contribute to inefficient health services delivery. Our aim was to document and characterize predictors of, and reasons for, attrition in pediatric obesity management.
METHODS
We searched literature published until January 2014 in five databases (CINAHL, EMBASE, MEDLINE, PsycINFO, and Scopus). Articles were included if they were English, included participants 0-18 years of age, focused on pediatric obesity management, incorporated lifestyle and behavioral changes without pharmacotherapy, provided attrition data, and reported information about predictors of, and/or reasons for, attrition from family-based interventions provided in research or clinical settings. Twenty-three articles (n=20 quantitative; n=2 qualitative; n=1 mixed methods) met our inclusion criteria. Clarity of study aims, objectives, methods, and data analysis were appraised using Bowling's checklist.
RESULTS
Attrition varied according to definition (minimum to maximum, 4-83%; median, 37%). There were few consistent predictors of attrition between studies, although dropout was higher among US-based families receiving public health insurance. Older children were also more likely to discontinue care, but sex and baseline weight status did not predict attrition. The most commonly reported reasons for attrition were logistical barriers and programs not meeting families' needs.
CONCLUSIONS
Developing and evaluating strategies designed to minimize the risk of attrition, especially among families who receive public health insurance and older boys and girls, are needed to optimize the effectiveness of pediatric obesity management.
Topics: Child; Delivery of Health Care; Humans; Medically Uninsured; Motivation; Patient Compliance; Pediatric Obesity; Program Evaluation; Social Class; United States; Weight Reduction Programs
PubMed: 25496035
DOI: 10.1089/chi.2014.0060 -
Current Opinion in Pediatrics Aug 2018Genetic obesity is responsible for up to 7% of severe childhood obesity. Although current Pediatric Endocrine Society guidelines recommend assessment of children with... (Review)
Review
PURPOSE OF REVIEW
Genetic obesity is responsible for up to 7% of severe childhood obesity. Although current Pediatric Endocrine Society guidelines recommend assessment of children with early-onset morbid obesity and hyperphagia for underlying genetic disorders, a vast majority of patients are not being appropriately screened for genetic obesity syndromes.
RECENT FINDINGS
With advances in genetic testing, more genetic causes of obesity are being identified. Treatments are likely to be individualized, depending on the cause of the obesity, and must be targeted at addressing the underlying cause. Investigational therapies include melanocortin-4 receptor antagonists, oxytocin and medications targeting the endocannabinoid system.
SUMMARY
Improved identification of patients with genetic obesity syndromes will lead to development of new treatments and personalized management of these diseases.
Topics: Child; Genetic Diseases, Inborn; Genetic Markers; Genetic Testing; Humans; Pediatric Obesity; Precision Medicine; Syndrome; Treatment Outcome
PubMed: 29771759
DOI: 10.1097/MOP.0000000000000641 -
Paediatric Respiratory Reviews Sep 2014Obesity has complex and incompletely understood effects upon the respiratory system in childhood, which differs in some aspects to those seen in adults. There is... (Review)
Review
Obesity has complex and incompletely understood effects upon the respiratory system in childhood, which differs in some aspects to those seen in adults. There is increasing evidence that excess adiposity will impact negatively upon static and dynamic respiratory function as measured through lung volumes, lung compartment mechanics, measures of airway function and exercise capability to varying degrees. Further information is needed to better understand the effects in children, and the importance of onset and duration of obesity on subsequent outcomes. Consensus about how best to express adiposity is also an essential part of this process and fat distribution is another important factor. From a clinical standpoint this creates challenges in distinguishing a deconditioned obese young person from a non-atopic asthmatic because of symptom overlap and lung function testing results, including responses seen during airway challenges. There is evidence to support the role of weight loss in achieving normalisation of lung function parameters, but as always with obesity there are enormous challenges in realising this goal for many subjects.
Topics: Child; Forecasting; Humans; Lung; Pediatric Obesity; Respiratory Tract Diseases
PubMed: 25092493
DOI: 10.1016/j.prrv.2014.06.003 -
Indian Journal of Pediatrics Dec 2022
Topics: Child; Humans; Pediatric Obesity; Hypertension
PubMed: 35925542
DOI: 10.1007/s12098-022-04346-2 -
Journal of Pediatric Nursing 2020
Topics: Child; Humans; Pediatric Obesity; Telemedicine
PubMed: 32980195
DOI: 10.1016/j.pedn.2020.09.006 -
Pediatric Research Dec 2023Studies have reported the relationship between functional constipation and obesity in pediatric population. However, the results are contradictory. The purpose of this... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Studies have reported the relationship between functional constipation and obesity in pediatric population. However, the results are contradictory. The purpose of this study is to evaluate the possible association between these two disorders in pediatric population.
METHODS
Four databases including PubMed, Embase, CENTRAL, and Web of Science were searched until 30 September 2022. The review was done in accordance with PRISMA guidelines and registered in PROSPERO (CRD42022328992) RESULTS: Nine studies met the eligibility criteria, including 7444 participants. Studies showed the risk of obesity was significantly increased in boys with functional constipation (CI: 1.12, 3.07; P = 0.016). Such an association was also observed in girls (CI: 1.42-4.47; P = 0.00). A statistically significant association was observed between overweight/obesity and increased risk of functional constipation in children and adolescents (CI: 1.14-3.97; P = 0.02). Especially in developed countries (CI: 1.49-3.46; P = 0.00); however, no significant association was observed in developing countries (CI: 0.81-5.3; P = 0.13).
CONCLUSIONS
There is a risk of obesity in either boys or girls with functional constipation. An association exists between the risk of functional constipation and children/adolescents with obesity, especially in developed countries, but not in developing countries.
IMPACT
Our study encourages further research in this field because early detection and intervention are crucial for both functional constipation and overweight/obesity in children, to better identify its complex biology and possibly optimize the treatment approaches.
Topics: Male; Adolescent; Female; Humans; Child; Overweight; Pediatric Obesity; Constipation
PubMed: 37422494
DOI: 10.1038/s41390-023-02711-1 -
Indian Journal of Pediatrics Jan 2015
Topics: C-Reactive Protein; Child; Early Medical Intervention; Humans; Metabolic Syndrome; Pediatric Obesity; Risk Factors; Serum Amyloid P-Component
PubMed: 25502797
DOI: 10.1007/s12098-014-1644-8 -
Current Obesity Reports Dec 2023Review latest data regarding the intersection of pediatric obesity epidemic with telemedicine expansion to meet the need of equitable obesity care in children. (Review)
Review
PURPOSE OF REVIEW
Review latest data regarding the intersection of pediatric obesity epidemic with telemedicine expansion to meet the need of equitable obesity care in children.
RECENT FINDINGS
Prevalence of pediatric obesity in the USA continues to worsen particularly in rural, underserved areas. Although there is an increasing number of obesity medicine specialists over the last decade, availability varies by geographic location. Pre-pandemic centers were limited, rarely located in rural areas, and required in-person visits for reimbursement. Telemedicine changes, responding to pandemic needs, provided increase in telemedicine utilization and acceptance with similar or improved obesity care outcomes. Given pediatric obesity prevalence and need for chronic, effective obesity care, leveraging telemedicine to expand reach and decrease access barriers provides a critical and creative remedy. Data cites similar outcomes between telemedicine and in-person care. The time to reimagine a full spectrum of care delivery for pediatric obesity is now.
Topics: Child; Humans; Pediatric Obesity; Telemedicine; Pandemics
PubMed: 37940835
DOI: 10.1007/s13679-023-00537-w -
Pediatrics International : Official... Jan 2022The circadian clock system is an evolutionarily conserved system by which organisms adapt their metabolic activities to environmental inputs, including nutrient... (Review)
Review
The circadian clock system is an evolutionarily conserved system by which organisms adapt their metabolic activities to environmental inputs, including nutrient availability. The disruption of this system has been pathogenically linked to the disintegration of metabolic homeostasis, leading to the development of metabolic complications, including obesity. Lifestyle factors that disrupt this system have been found to be associated with the development of metabolic disorder, which is most evidenced by the finding that shift workers are at an increased risk of developing various disorders, such as obesity and obesity-related complications. Lifestyle factors that contribute to a misalignment between the internal clock system and environmental rhythms have also been identified in children. A short sleep duration and skipping breakfast are prevalent in children and there is mounting evidence that these factors are associated with an increased risk of pediatric obesity; however, the underlying mechanisms have not yet been elucidated in detail. Our current understanding of the impact of lifestyle factors that cause a misalignment between the internal clock system and environmental rhythms on the development of pediatric obesity is summarized herein, with a discussion of potential mechanistic factors.
Topics: Child; Circadian Clocks; Circadian Rhythm; Homeostasis; Humans; Metabolic Diseases; Pediatric Obesity
PubMed: 34525248
DOI: 10.1111/ped.14992 -
Complementary Therapies in Medicine Dec 2023
Topics: Child; Humans; Adolescent; Public Health; Pediatric Obesity; Health Promotion; Educational Status
PubMed: 37949416
DOI: 10.1016/j.ctim.2023.103004