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Current Obesity Reports Dec 2018This review summarizes our current understanding of factors associated with childhood obesity, including latest prevalence rates, effectiveness of intervention... (Review)
Review
PURPOSE OF REVIEW
This review summarizes our current understanding of factors associated with childhood obesity, including latest prevalence rates, effectiveness of intervention strategies, and risk for concomitant disease later in life.
RECENT FINDINGS
Obesity has reached global dimensions, and prevalence of childhood obesity has increased eightfold since 1975. Interventions for obesity prevention have mainly focused on behavioral settings to date, i.e., interventions that have focused on behavioral changes of the individuum such as increasing daily physical exercise or optimizing diet. However, effects have been very limited worldwide and could not stop the increase of obesity prevalence so fare. Thus, community-based/environment-oriented measures are urgently needed, such as promotion of healthy food choices by taxing unhealthy foods, mandatory standards for meals in kindergarten and schools, increase of daily physical activity at kindergartens, and schools as well as ban on unhealthy food advertisement for children. Restructuring obesity interventions towards community-based/environment-oriented measures to counteract an obesogenic environment is mandatory for sustainable success and to stop the obesity epidemy. There is need to move fast, as already moderate overweight before the start of puberty is associated with significantly increased risk for type 2 diabetes and cardiovascular disease in midlife.
Topics: Adolescent; Cardiovascular Diseases; Child; Child, Preschool; Diabetes Mellitus, Type 2; Female; Humans; Male; Pediatric Obesity; Prevalence; Risk Factors
PubMed: 30315490
DOI: 10.1007/s13679-018-0320-0 -
Nutrients Nov 2021Obesity, eating disorders and unhealthy dieting practices among children and adolescents are alarming health concerns due to their high prevalence and adverse effects on... (Review)
Review
Obesity, eating disorders and unhealthy dieting practices among children and adolescents are alarming health concerns due to their high prevalence and adverse effects on physical and psychosocial health. We present the evidence that eating disorders and obesity can be managed or prevented using the same interventions in the pediatric age. In the presence of obesity in the pediatric age, disordered eating behaviors are highly prevalent, increasing the risk of developing eating disorders. The most frequently observed in subjects with obesity are bulimia nervosa and binge-eating disorders, both of which are characterized by abnormal eating or weight-control behaviors. Various are the mechanisms overlying the interaction including environmental and individual ones, and different are the approaches to reduce the consequences. Evidence-based treatments for obesity and eating disorders in childhood include as first line approaches weight loss with nutritional management and lifestyle modification via behavioral psychotherapy, as well as treatment of psychiatric comorbidities if those are not a consequence of the eating disorder. Drugs and bariatric surgery need to be used in extreme cases. Future research is necessary for early detection of risk factors for prevention, more precise elucidation of the mechanisms that underpin these problems and, finally, in the cases requiring therapeutic intervention, to provide tailored and timely treatment. Collective efforts between the fields are crucial for reducing the factors of health disparity and improving public health.
Topics: Adolescent; Behavior Therapy; Child; Feeding Behavior; Feeding and Eating Disorders; Female; Humans; Male; Nutrition Therapy; Pediatric Obesity; Weight Reduction Programs
PubMed: 34959873
DOI: 10.3390/nu13124321 -
Current Opinion in Endocrinology,... Feb 2021Approximately 2.6 million people die each year secondary to obesity related diseases. The risk of developing serious comorbidities depends on the age of onset as well as... (Review)
Review
PURPOSE OF REVIEW
Approximately 2.6 million people die each year secondary to obesity related diseases. The risk of developing serious comorbidities depends on the age of onset as well as duration of obesity. In this review, we discuss trends in BMI trajectories from early childhood to adulthood with latest evidence on comorbidities in adulthood stemming from pediatric obesity and benefits of early intervention and treatment in childhood obesity.
RECENT FINDINGS
Childhood obesity poses high risk of metabolic and cardiovascular disorders like type 2 diabetes, hypertension, atherosclerosis, coronary artery disease, and some types of cancer in adulthood. Early life obesity also increases risks of developing menstrual irregularities, infertility, and pregnancy complications. Several grave concerns including malignancies, autoimmune disorders, higher asthma morbidity, and psychiatric implications are found to be associated with childhood obesity. Disease outcomes can be transgenerational, causing suboptimal health in children of mothers with obesity. Encouragingly, many risks associated with childhood obesity can be reduced, delayed, or even reversed by early resolution of obesity necessitating close BMI monitoring and treatment early.
SUMMARY
Early identification and aggressive management of childhood obesity is critical in prevention of debilitating comorbidities in adult life.
VIDEO ABSTRACT
http://links.lww.com/COE/A19.
Topics: Adult; Child; Comorbidity; Humans; Pediatric Obesity; Risk Factors
PubMed: 33229926
DOI: 10.1097/MED.0000000000000592 -
Gastroenterology Clinics of North... Jun 2023Obesity in the pediatric population is increasing in the United States and globally. Childhood obesity is associated with cardiometabolic and psychosocial comorbidities... (Review)
Review
Obesity in the pediatric population is increasing in the United States and globally. Childhood obesity is associated with cardiometabolic and psychosocial comorbidities and decreased overall life span. The cause of pediatric obesity is multifactorial and includes genetic predisposition, lifestyle, behavioral patterns, and consequences of social determinants of health. Routine screening of BMI and comorbid conditions is essential to identifying patients who require treatment. The AAP recommends immediate Intensive Health Behavior and Lifestyle Treatment for children with obesity, encompassing lifestyle changes, behavioral changes, and mental health treatments. Pharmacologic interventions and metabolic and bariatric surgery are also available when indicated.
Topics: Child; Humans; Adolescent; United States; Pediatric Obesity; Obesity Management; Bariatric Surgery; Life Style
PubMed: 37197885
DOI: 10.1016/j.gtc.2023.03.011 -
Current Opinion in Pediatrics Aug 2022In this review, we discuss new medical and surgical options for the treatment of children and adolescents with obesity. We review the impact of COVID-19 on this... (Review)
Review
PURPOSE OF REVIEW
In this review, we discuss new medical and surgical options for the treatment of children and adolescents with obesity. We review the impact of COVID-19 on this vulnerable population. We also discuss the recent availability of screening tests for rare genetic causes of obesity.
RECENT FINDINGS
COVID-19 increased the prevalence of obesity among children and adolescents. This population is at increased risk for severe disease. The field of pediatric obesity has benefited from the approval of two new antiobesity medications: liraglutide and setmelanotide. We discuss indications for their use. New guidelines for surgical options for the treatment of children and adolescents with obesity are reviewed. These options are increasingly used as part of the comprehensive care for these children.
SUMMARY
The epidemic of childhood obesity continues. COVID-19 and the associated isolation contributed to the problem. However, promising new medical and surgical therapies and screening tests for rare genetic causes of obesity are available. These new diagnostic and therapeutic options bring renewed enthusiasm to the treatment of children and adolescents with obesity and increased recognition that obesity is a chronic disease starting in childhood deserving intervention to prevent consequences.
Topics: Adolescent; COVID-19; Child; Humans; Pediatric Obesity; Prevalence
PubMed: 35797460
DOI: 10.1097/MOP.0000000000001150 -
Journal of Clinical Pharmacology Oct 2018Obesity is an ongoing global health concern and has only recently been recognized as a chronic disease of energy homeostasis and fuel partitioning. Obesity afflicts 17%... (Review)
Review
Obesity is an ongoing global health concern and has only recently been recognized as a chronic disease of energy homeostasis and fuel partitioning. Obesity afflicts 17% of U.S. children and adolescents. Severe obesity (≥120% of the 95th percentile of body mass index (BMI) for age, or a BMI ≥ 35 kg/m ) is the fastest-growing subgroup and now approaches 6% of all U.S. youth. Health consequences (eg, type 2 diabetes, coronary heart disease) are related in a dose-dependent manner to severity of obesity. Because therapeutic interventions are less effective in severe obesity, prevention is a high priority. Treatment plans involving combinations of behavioral therapy, nutrition, and exercise achieve limited success. Only one drug, orlistat, is U.S. Food and Drug Administration approved for long-term obesity management in adolescents 12 years and older. As part of comprehensive medication management, clinicians should consider the propensity for a given drug to aggravate weight gain and to consider alternatives that minimize weight impact. Medication management must take into account developmental changes as well as the pathophysiology of obesity and comorbidities. Despite expanding insight into obesity pathophysiology, there are gaps in its translation to therapeutic application. The historical construct of obesity as simply a fat-storage disorder is fundamentally inaccurate. The approach to adjusting doses based solely on body size and extrapolating from therapeutic knowledge of adult obesity may be based on assumptions that are not fully substantiated. Classes of drugs commonly prescribed for comorbidities associated with obesity should be prioritized for clinical research evaluations aimed at optimizing dosing regimens in pediatric obesity.
Topics: Adolescent; Anti-Obesity Agents; Body Weight; Child; Comorbidity; Hospitalization; Humans; Pediatric Obesity; Prevalence
PubMed: 30248198
DOI: 10.1002/jcph.1092 -
Jornal de Pediatria 2022To describe the participation of the environment in the childhood obesity epidemic, since childhood obesity currently represents a great challenge, with high prevalence... (Review)
Review
OBJECTIVE
To describe the participation of the environment in the childhood obesity epidemic, since childhood obesity currently represents a great challenge, with high prevalence worldwide, including in Brazil.
DATA SOURCE
Survey of articles published in the last 10 years in PubMed, evaluating the interface between the environment and childhood obesity.
DATA SYNTHESIS
Recent studies show that the environment is very important in the etiopathogenesis of obesity and its comorbidities. Therefore, factors such as air pollution, exposure to chemical substances that interfere with the metabolism, excessive consumption of ultra-processed foods, changes in the intestinal microbiota, and sedentary lifestyle are associated with increased obesity, insulin resistance, type 2 diabetes, and changes in lipid metabolism. These factors have a greater impact on some stages of life, such as the first thousand days, as they affect the expression of genes that control the adipogenesis, energy expenditure, and the mechanisms for hunger/satiety control.
CONCLUSIONS
Environmental aspects must be taken into account in the prevention and treatment of childhood obesity, both from the individual and the population point of view, with adequate and comprehensive public health policies.
Topics: Child; Diabetes Mellitus, Type 2; Energy Metabolism; Fast Foods; Humans; Pediatric Obesity; Sedentary Behavior
PubMed: 34780713
DOI: 10.1016/j.jped.2021.10.002 -
Pharmacological Research Feb 2023Asthma affects more than 300 million people of all ages worldwide, including about 10-15% of school-aged children, and its prevalence is increasing. Severe asthma (SA)... (Review)
Review
Asthma affects more than 300 million people of all ages worldwide, including about 10-15% of school-aged children, and its prevalence is increasing. Severe asthma (SA) is a particular and rare phenotype requiring treatment with high-dose inhaled corticosteroids plus a second controller and/or systemic glucocorticoid courses to achieve symptom control or remaining "uncontrolled" despite this therapy. In SA, other diagnoses have been excluded, and potential exacerbating factors have been addressed. Notably, obese asthmatics are at higher risk of developing SA. Obesity is both a major risk factor and a disease modifier of asthma in children and adults: two main "obese asthma" phenotypes have been described in childhood with high or low levels of Type 2 inflammation biomarkers, respectively, the former characterized by early onset and eosinophilic inflammation and the latter by neutrophilic inflammation and late-onset. Nevertheless, the interplay between obesity and asthma is far more complex and includes obese tissue-driven inflammatory pathways, mechanical factors, comorbidities, and poor response to corticosteroids. This review outlines the most recent findings on SA in obese children, particularly focusing on inflammatory pathways, which are becoming of pivotal importance in order to identify selective targets for specific treatments, such as biological agents.
Topics: Humans; Pediatric Obesity; Asthma; Comorbidity; Adrenal Cortex Hormones; Inflammation
PubMed: 36642111
DOI: 10.1016/j.phrs.2023.106658 -
Current Obesity Reports Dec 2021The study aims to highlight the clinical importance of assessing and managing neuromusculoskeletal health in pediatric obesity and to support translation of evidence... (Review)
Review
PURPOSE OF REVIEW
The study aims to highlight the clinical importance of assessing and managing neuromusculoskeletal health in pediatric obesity and to support translation of evidence into practice.
RECENT FINDINGS
A growing evidence base suggests that children with obesity experience neuromusculoskeletal impairments and physical complications including increased pain, reduced muscle strength, impaired balance and motor skill, gait deviations, postural malalignment, greater fatigue, and potentially reduced flexibility and sub-optimal bone health. Such evidence supports the need to screen, assess, and optimize neuromusculoskeletal health as part of pediatric obesity management. The likelihood of children with obesity experiencing neuromusculoskeletal impairments is high and can impact the way a child moves, and their interest or capacity to engage in physical activity and exercise. Barriers to movement should be minimized to promote optimal development of the neuromusculoskeletal system and to support engagement in sufficient physical activity for weight management. Healthcare professionals should screen for neuromusculoskeletal impairments as well as personalize interventions and modify standardized exercise interventions to optimize obesity treatment. Further research should explore whether neuromusculoskeletal impairments influence the success of obesity treatment or whether they improve following obesity treatment.
Topics: Child; Exercise; Humans; Pediatric Obesity
PubMed: 34958437
DOI: 10.1007/s13679-021-00463-9 -
Pediatric Annals Feb 2023
Topics: Child; Humans; Pediatric Obesity
PubMed: 36779878
DOI: 10.3928/19382359-20230102-01