Childhood obesity: A review of current and future management options

Abstract

Obesity is becoming increasingly prevalent in paediatric populations worldwide. In addition to increasing prevalence, the severity of obesity is also continuing to rise. Taken together, these findings demonstrate a worrying trend and highlight one of the most significant challenges to public health. Childhood obesity affects multiple organs in the body and is associated with both significant morbidity and ultimately premature mortality. The prevalence of complications associated with obesity, including dyslipidaemia, hypertension, fatty liver disease and psychosocial complications are becoming increasingly prevalent within the paediatric populations. Treatment guidelines currently focus on intervention with lifestyle and behavioural modifications, with pharmacotherapy and surgery reserved for patients who are refractory to such treatment. Research into adult obesity has established pharmacological novel therapies, which have been approved and established in clinical practice; however, the research and implementation of such therapies in paediatric populations have been lagging behind. Despite the relative lack of widespread research in comparison to the adult population, newer therapies are being trialled, which should allow a greater availability of treatment options for childhood obesity in the future. This review summarizes the current evidence for the management of obesity in terms of medical and surgical options. Both future therapeutic agents and those which cause weight loss but have an alternative indication are also included and discussed as part of the review. The review summarizes the most recent research for each intervention and demonstrates the potential efficacy and limitations of each treatment option.

Childhood obesity and depression: 2020–2022

“…Representing an enormous global challenge of increasing proportion, obesity in general, and childhood obesity in particular, which may predate adult obesity, and which is on the rise, may predictably and progressively induce multiple adverse health impacts, including depression and poor mental health, even among very young children 34,35 and especially if it persists unabated into adolescence. 36,37 As well, even though mental health attributes of childhood obesity have been discussed for some time, the failure to detect or resolve mental health problems or mitigate these early on may be expected to have marked adverse life long effects. Moreover, even if therapy prevails, this can be impeded in the presence of undetected or untreated parental depression that may not be a treatment focus.…”

Application of The FODMAP Diet in a Paediatric Setting

“…Assess the nutritional quality of the habitual diet: This is an important first step in which nutritional deficiencies and excesses will be documented and eating patterns defined. Such dietary evaluation is important for general health, particularly given the rising prevalence of childhood obesity in most Western countries, driven largely by excessive intakes of discretionary food items such as sweetened beverages and highly processed foods [ 92 , 93 ]. FODMAPs are found across the whole food supply and, outside of a few foods that are particularly concentrated in certain FODMAPs, portion size ultimately determines whether most foods are deemed to be ‘low’ or ‘high’ FODMAP according to established cut-off values [ 94 ].…”

Metabolic and hormonal changes after laparoscopic sleeve gastrectomy in pediatric population: An observational study

“…Childhood obesity is associated with several complications such as type 2 diabetes mellitus (T2DM), hyperlipidemia, hypertension, fatty liver disease, psychosocial problems, and premature mortality ( 1 ). The worldwide prevalence of obesity increased by 10-fold between 1975 and 2016 among children and adolescents aged 5–19 ( 2 ), and in 2016, an estimated 340 million in this age group were overweight or obese globally ( 3 ).…”