Pediatric severe obesity is a major threat to health and longevity. Around 7% of children worldwide have early onset severe obesity before the age of 7. Pediatric obesity is caused by an interplay of multiple factors: lifestyle, environmental, sociocultural, psychological, biological and genetic factors. Endocrine, monogenetic or syndromal causes are rare, but currently underdiagnosed and important to identify for the need of specific treatment. Cardiovascular risk factors and other weight related comorbidities are common in children with obesity and early detection and treatment is necessary before long-term health complications result. The complexity of causes and complications of pediatric obesity warrant a structured diagnostic approach. When is endocrine or genetic screening indicated? Treatment should be tailored to the need and situation of the child and its family. How to find which barriers play a role in behavioral change towards a healthy lifestyle? What other factors besides diet and exercise are important? What can you do as a healthcare provider? To tackle obesity in children, integrated care in a multidisciplinary setting is needed. Combined lifestyle interventions (CLI) aim at obtaining a healthier lifestyle and reducing BMI. But once severely obese, long-lasting weight loss with lifestyle modification is rare. How to define success? And what are the next steps if treatment fails? In recent years, several novel pharmacotherapeutic drugs have been approved and come to market for use in children and adolescents. Bariatric surgery has been shown to be effective in the most seriously affected, mature adolescents. Pediatric obesity is a complex disease, needing care by a specialized multidisciplinary team of health care professionals. Children and adolescent with severe obesity undergoing lifestyle therapy, medication regimens, or bariatric surgery need a structured diagnostic and therapeutic approach with long term follow up and monitoring.
Weblinks and open access references
• Pediatric Obesity—Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline (https://academic.oup.com/jcem/article/102/3/709/2965084?login=true)
• The epidemiological burden of obesity in childhood: a worldwide epidemic requiring urgent action. BMC 2019. Di Cesare et al. (https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-019-1449-8)
• Identifying underlying medical causes of obesity in children. Results of a systematic diagnostic approach.PlosOne 2020 Abawi et al. (https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0232990)
• Erasmus MC Obesity center CGG (https://www.youtube.com/watch?v=uByJKC63apQ)
15 Sep 2022 - 17 Sep 2022