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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 -
Pediatric Annals Nov 2021With the rapidly increasing numbers of children diagnosed with obesity, pediatricians are facing more and more challenges regarding the complex care of these patients....
With the rapidly increasing numbers of children diagnosed with obesity, pediatricians are facing more and more challenges regarding the complex care of these patients. Pediatric nonalcoholic fatty liver disease (NAFLD) is now the most prevalent cause of pediatric chronic liver disease, given its association with obesity. As NAFLD increases a child's risk of developing long-term complications including cirrhosis and hepatocellular carcinoma, efficient diagnosis and effective management is paramount. This article aims to provide a brief overview of NALFD, and discuss the updated diagnosis and management approach for pediatric NAFLD, with a particular focus on the role of the pediatrician. .
Topics: Carcinoma, Hepatocellular; Child; Humans; Liver Cirrhosis; Liver Neoplasms; Non-alcoholic Fatty Liver Disease; Pediatric Obesity
PubMed: 34757877
DOI: 10.3928/19382359-20211019-02 -
Pediatric Dermatology Sep 2022Data on skin manifestations associated with pediatric obesity are limited. We conducted a prospective study to evaluate the association of pediatric obesity with skin...
Data on skin manifestations associated with pediatric obesity are limited. We conducted a prospective study to evaluate the association of pediatric obesity with skin dermatoses and dermatologic quality of life. Our findings suggest that ongoing monitoring of skin problems is recommended for children with obesity.
Topics: Child; Humans; Pediatric Obesity; Prospective Studies; Quality of Life; Skin; Skin Diseases
PubMed: 35644875
DOI: 10.1111/pde.15048 -
Current Opinion in Pediatrics Feb 2024This article outlines what is currently known regarding the relationship between neighborhood deprivation and pediatric obesity. It discusses the intersectionality... (Review)
Review
PURPOSE OF REVIEW
This article outlines what is currently known regarding the relationship between neighborhood deprivation and pediatric obesity. It discusses the intersectionality between neighborhood deprivation, race, ethnicity, and pediatric obesity. We conclude by proposing several potential solutions to disparities in pediatric obesity related to neighborhood deprivation.
RECENT FINDINGS
Neighborhood deprivation, independent of individual socioeconomic status, is a risk factor for pediatric obesity. The obesogenic characteristics of high deprivation neighborhoods (e.g., lack of safe spaces to be active, easy access to fast food) and the psychological aspects of residing within high deprivation neighborhoods may also contribute to this risk. Intervention strategies and policies designed to address neighborhood related risk for pediatric obesity are needed.
SUMMARY
Pediatric obesity is a growing problem of complex etiology. Neighborhood risk factors should be considered when assessing risk burden and when designing intervention strategies.
Topics: Child; Humans; Pediatric Obesity; Socioeconomic Factors; Residence Characteristics; Risk Factors; Ethnicity
PubMed: 38001559
DOI: 10.1097/MOP.0000000000001317 -
Journal of Pediatric Nursing 2020
Topics: Child; Humans; Pediatric Obesity; Telemedicine
PubMed: 32980195
DOI: 10.1016/j.pedn.2020.09.006 -
Gastroenterology Clinics of North... Jun 2023Genetic forms of obesity contribute to ∼7% of severe obesity in children and adolescents. The exact global prevalence of monogenic and syndromic forms of obesity is... (Review)
Review
Genetic forms of obesity contribute to ∼7% of severe obesity in children and adolescents. The exact global prevalence of monogenic and syndromic forms of obesity is not well established, most likely due to missed or delayed diagnosis. The challenge in determining the prevalence can be attributed to the lack of consensus on identifying and evaluating symptoms of genetic defects in a timely manner and hence a vastly undertested patient population. Further large-scale and long-term studies are needed to advance the understanding of this unique phenotype of obesity and effective treatment options."
Topics: Humans; Pediatric Obesity; Phenotype; Prevalence
PubMed: 37197876
DOI: 10.1016/j.gtc.2023.03.005 -
Journal of Developmental and Behavioral... Oct 2013
Topics: Child; Child Development; Humans; Pediatric Obesity
PubMed: 24131875
DOI: 10.1097/01.DBP.0000436477.92552.86 -
Current Diabetes Reviews 2020The prevalence of type 2 diabetes (DM) in children is disturbingly increasing in parallel with the increasing childhood obesity. Better knowledge regarding the...
BACKGROUND
The prevalence of type 2 diabetes (DM) in children is disturbingly increasing in parallel with the increasing childhood obesity. Better knowledge regarding the pathophysiology of type 2 DM in children is paramount to devise an effective management plan.
OBJECTIVE
Discuss the pathophysiology of type 2 DM in children and adolescents.
METHODS AND RESULTS
This is a comprehensive review of the literature on this topic. Type 2 DM in childhood is viewed as a continuum of insulin resistance (IR) which is determined by an underlying genetic predisposition, intrauterine environment, excessive food consumption, continued rapid weight gain, and poor lifestyle. Besides IR, this is compounded by multiple metabolic defects including β-cell dysfunction and inadequate insulin secretion, α-cell dysfunction, hyperglucagonemia and increased hepatic glucose production, lipotoxicity, inflammation, deficiencies in incretin production and action, and increased renal glucose reabsorption. The confluence of genetic and environmental factors underscores the complexity in disease progression.
CONCLUSION
A consistent single risk factor for type 2 DM is obesity and related IR and therefore it is essential to curtail the progression of obesity. It is important to investigate the role of stringent dietary and nutritional approaches, medications that enhance β-cell function and insulin sensitivity.
Topics: Adolescent; Child; Diabetes Mellitus, Type 2; Humans; Insulin Resistance; Pediatric Obesity; Risk Factors
PubMed: 29879890
DOI: 10.2174/1573399814666180608074510 -
Clinical Pediatrics Mar 2022While discussing obesity with pediatric patients and their families can be difficult, it is an essential step toward appropriate weight management. There is paucity of...
While discussing obesity with pediatric patients and their families can be difficult, it is an essential step toward appropriate weight management. There is paucity of data regarding language preferences when discussing obesity in this population. In this pilot qualitative study, we interviewed 8 parents of patients diagnosed with obesity to identify language and communication preferences for discussing their child's weight. Interviews were analyzed for emerging themes. Important trends appeared revealing that parents prefer neutral, medical terms discussed at well-child checks or obesity-specific visits. Providers should frame lifestyle changes as positive for all patients and set achievable goals with the help of visual aids. Our analysis uncovered several important communication strategies that can better equip providers to discuss obesity with their pediatric patients. This research may serve as a foundation for larger studies into the topic.
Topics: Adult; Chicago; Female; Humans; Male; Middle Aged; Pediatric Obesity; Pilot Projects; Professional-Family Relations; Qualitative Research; Surveys and Questionnaires
PubMed: 35001640
DOI: 10.1177/00099228211070390 -
Pediatrics in Review Nov 2022Child obesity is widely prevalent, and general pediatricians play an important role in identifying and caring for patients with obesity. Appropriate evaluation and...
Child obesity is widely prevalent, and general pediatricians play an important role in identifying and caring for patients with obesity. Appropriate evaluation and treatment require an understanding of the complex etiology of child obesity, its intergenerational transmission, and its epidemiologic trends, including racial/ethnic and socioeconomic disparities. The American Academy of Pediatrics has published screening, evaluation, and treatment guidelines based on the best available evidence. However, gaps in evidence remain, and implementation of evidence-based recommendations can be challenging. It is important to review optimal care in both the primary care and multidisciplinary weight management settings. This allows for timely evaluation and appropriate referrals, with the pediatrician playing a key role in advocating for patients at higher risk. There is also a role for larger-scale prevention and policy measures that would not only aid pediatricians in managing obesity but greatly benefit child health on a population scale.
Topics: Child; Humans; United States; Pediatric Obesity; Pediatricians; Referral and Consultation; Mass Screening
PubMed: 36316265
DOI: 10.1542/pir.2021-005095