Chronic care treatment of obese children and adolescents

Holm, Jens Christian; Gamborg, Michael; Bille, Dorthe S.; Grønbæk, Helle Nergaard; Ward, Leigh C.; Færk, Jan

doi:10.3109/17477166.2011.575157

Cited by 97 publications

(177 citation statements)

References 25 publications

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“…maintain children/adolescents at a lower or normal weight, and stay physically active and healthy over longer periods of time. A recent study in our clinic [63] showed that it is possible to reduce the degree of obesity in 62.5% of children and youths in up to 2 years of obesity treatment with a relatively high retention irrespective of baseline adiposity, age, puberty, and social class and with no initial eligibility criteria. …”

Section: Treatmentmentioning

confidence: 99%

Development of Obesity and Polycystic Ovary Syndrome in Adolescents

Vilmann¹,

Thisted²,

Baker³

et al. 2012

Horm Res Paediatr

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Obesity in adolescents is prevalent worldwide. Polycystic ovary syndrome (PCOS) is often associated with obesity in women, and it has serious metabolic and reproductive health implications. Although PCOS does not become clinically visible until early adolescence, its origins are likely much earlier. Therefore, we reviewed the recent literature regarding the mechanisms linking the development of PCOS and obesity in adolescent girls. We found that excess abdominal adipose tissue (AT) initiates metabolic and endocrine aberrations that are central in the progression of PCOS. As an example, abdominal AT impairs insulin action, which interacts with the progression of hyperandrogenism. In addition, excessive androgen levels lead to impaired glucose uptake, which also contributes to insulin resistance, which again increases the deposition of visceral fat. The body composition is influenced by testosterone, which decreases subcutaneous fat lipolysis and influences adipocyte distribution. These mechanisms may explain why PCOS girls have an increased visceral adipose mass independent of body mass index. Therefore, first-line treatment in adolescent PCOS is often lifestyle intervention to prevent the damaging effects of obesity. Pharmacological treatment of adolescent PCOS is not standardized because the long-term effects in adolescents have not yet been evaluated; therefore, drugs should be prescribed cautiously. Although the complex metabolic interrelationships between obesity and PCOS have yet to be fully understood, the co-occurrence of these conditions in adolescent girls tends to increase the severity of the negative health consequences of each condition.

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Section: Treatmentmentioning

confidence: 99%

Development of Obesity and Polycystic Ovary Syndrome in Adolescents

Vilmann¹,

Thisted²,

Baker³

et al. 2012

Horm Res Paediatr

Self Cite

View full text Add to dashboard Cite

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“…However, in younger patients, factors of importance for the dropout rate are basically unknown. A few earlier studies have investigated potential correlates to dropout in pediatric obesity and reported conflicting results [9,10,11,12]. …”

Section: Introductionmentioning

confidence: 99%

Importance of Age for 3-Year Continuous Behavioral Obesity Treatment Success and Dropout Rate

et al. 2012

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Objective: To assess whether first year weight loss, age, and socioeconomic background correlate with the success rate of continuous long-term behavioral obesity treatment. Methods: In a 3-year longitudinal study, obese children (n = 684) were divided into three groups based on age at the start of treatment, age 6–9 years, 10–13 years, and 14–16 years. Results: The mean BMI standard deviation score (BMI-SDS) decline was age-dependent (p = 0.001), independently of adjustment for missing data: –1.8 BMI-SDS units in the youngest, –1.3 in the middle age group, and –0.5 in the oldest age group. SES and parental BMI status did not affect the results. 30% of the adolescents remained in treatment at year 3. There was only a weak correlation between BMI-SDS change after 1 and 3 years: r = 0.51 (p < 0.001). Among children with no BMI-SDS reduction during year 1 (n = 46), 40% had a clinically significantly reduced BMI-SDS after year 3. Conclusion: Behavioral treatment should be initiated at an early age to increase the chance for good results. Childhood obesity treatment should be continued for at least 3 years, regardless of the initial change in BMI-SDS.

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“…However, this subgroup consisted of only six children who furthermore were older than the controls, which may bias the results since they used BMI without adjustment for age and gender, which is important due to growth and development during childhood. Additionally, some of the studies are restricted only to the patient's parents, but since a familial predisposition is effected as a combination of an inherited as well as an environmental component, the general family history seems to be important [9,[11][12][13][14][15]20].…”

Section: Discussionmentioning

confidence: 99%

“…In order to treat childhood obesity effectively, an early intervention is of great importance, and a multidisciplinary approach involving the family combining counselling on diet, behaviour, and activity seems pivotal, but the response to treatment may be inadequate for some patients [8][9][10][11][12][13]. One explanation may be the metabolic state of the children and their families, since it has been shown that a familial predisposition to obesity is associated with a poorer response to treatment [9,10,12,14].…”

Section: Introductionmentioning

confidence: 99%