Drug interventions for the treatment of obesity in children and adolescents

Mead, Emma; Atkinson, Greg; Richter, Bernd; Metzendorf, Maria‐Inti; Baur, Louise A.; Finer, Nick; Corpeleijn, Eva; O’Malley, Claire; Ells, Louisa

doi:10.1002/14651858.cd012436

Cited by 89 publications

(80 citation statements)

References 196 publications

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“…We used the same random effects model to generate the overall size effects by computing the difference in means (Table S4) and compare these values to some of the reported effects of pharmacological, behavioral or dietary interventions on BMI, WC and lipid levels. Some of the most potent reducing effects on BMI can be achieved with restricted energy diet (−2.7 kg/m2) [160], pharmacological interventions (−1.3 kg/m 2 ) [161] or behavioral (diet, exercise) interventions (−0.9 to −1.2 kg/m 2 ) [162,163]. These reductions constitute between 5% and 10% of the WHO established limit values for overweight (BMI = 25.0–29.9 kg/m 2 ) and obesity (BMI ≥ 30.0 kg/m 2 ).…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of the Effects of Flavanol-Containing Tea, Cocoa and Apple Products on Body Composition and Blood Lipids: Exploring the Factors Responsible for Variability in Their Efficacy

et al. 2017

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Several randomized controlled trials (RCTs) and meta-analyses support the benefits of flavanols on cardiometabolic health, but the factors affecting variability in the responses to these compounds have not been properly assessed. The objectives of this meta-analysis were to systematically collect the RCTs-based-evidence of the effects of flavanol-containing tea, cocoa and apple products on selected biomarkers of cardiometabolic risk and to explore the influence of various factors on the variability in the responses to the consumption of these products. A total of 120 RCTs were selected. Despite a high heterogeneity, the intake of the flavanol-containing products was associated using a random model with changes (reported as standardized difference in means (SDM)) in body mass index (−0.15, p < 0.001), waist circumference (−0.29, p < 0.001), total-cholesterol (−0.21, p < 0.001), LDL-cholesterol (−0.23, p < 0.001), and triacylglycerides (−0.11, p = 0.027), and with an increase of HDL-cholesterol (0.15, p = 0.005). Through subgroup analyses, we showed the influence of baseline-BMI, sex, source/form of administration, medication and country of investigation on some of the outcome measures and suggest that flavanols may be more effective in specific subgroups such as those with a BMI ≥ 25.0 kg/m2, non-medicated individuals or by specifically using tea products. This meta-analysis provides the first robust evidence of the effects induced by the consumption of flavanol-containing tea, cocoa and apple products on weight and lipid biomarkers and shows the influence of various factors that can affect their bioefficacy in humans. Of note, some of these effects are quantitatively comparable to those produced by drugs, life-style changes or other natural products. Further, RCTs in well-characterized populations are required to fully comprehend the factors affecting inter-individual responses to flavanol and thereby improve flavanols efficacy in the prevention of cardiometabolic disorders.

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Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of the Effects of Flavanol-Containing Tea, Cocoa and Apple Products on Body Composition and Blood Lipids: Exploring the Factors Responsible for Variability in Their Efficacy

et al. 2017

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“…The use of metformin to prevent diabetes in pre-diabetic populations, as a cancer treatment, 7 8 and as a weight loss medication for non-diabetic obesity is also of interest. 9 10 Expansion of indications for metformin use will increase the risk of unintentional exposures during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

Metformin exposure in first trimester of pregnancy and risk of all or specific congenital anomalies: exploratory case-control study

Given

Loane

Garne

et al. 2018

BMJ

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ObjectiveTo investigate whether exposure to metformin during the first trimester of pregnancy, for diabetes or other indications, increases the risk of all or specific congenital anomalies.DesignPopulation based exploratory case-control study using malformed controls. Cases of 29 specific subgroups of non-genetic anomalies, and all non-genetic anomalies combined, were compared with controls (all other non-genetic anomalies or genetic syndromes).Setting11 EUROmediCAT European congenital anomaly registries surveying 1 892 482 births in Europe between 2006 and 2013.Participants50 167 babies affected by congenital anomaly (41 242 non-genetic and 8925 genetic) including live births, fetal deaths from 20 weeks’ gestation, and terminations of pregnancy for fetal anomaly.Main outcome measureOdds ratios adjusted for maternal age, registry, multiple birth, and maternal diabetes status.Results168 babies affected by congenital anomaly (141 non-genetic and 27 genetic) were exposed to metformin, 3.3 per 1000 births. No evidence was found for a higher proportion of exposure to metformin during the first trimester among babies with all non-genetic anomalies combined compared with genetic controls (adjusted odds ratio 0.84, 95% confidence interval 0.55 to 1.30). The only significant result was for pulmonary valve atresia (adjusted odds ratio 3.54, 1.05 to 12.00, compared with non-genetic controls; 2.86, 0.79 to 10.30, compared with genetic controls).ConclusionsNo evidence was found for an increased risk of all non-genetic congenital anomalies combined following exposure to metformin during the first trimester, and the one significant association was no more than would be expected by chance. Further surveillance is needed to increase sample size and follow up the cardiac signal, but these findings are reassuring given the increasing use of metformin in pregnancy.

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“…However, the weight loss drugs prescribed in conventional medicine induce many adverse reactions, primarily effecting monoamine neurotransmitters, and causing drug abuse or dependence [10]. For example, sibutramine has been reported to commonly cause adverse events, including dry mouth, insomnia, anorexia, constipation, formation of thrombi, and neurological symptoms [11, 12]. Surgery is commonly used in morbidly obese patients (BMI ≥ 40 kg/m 2 ) or in patients with comorbidities, such as hypertension, diabetes, and obstructive sleep apnea [13].…”

Section: Introductionmentioning

confidence: 99%

Herbal Medicine for the Treatment of Obesity: An Overview of Scientific Evidence from 2007 to 2017

Liu

Sun

Yao

et al. 2017

Evidence-Based Complementary and Alternative Medicine

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Obesity is a very common global health problem, and it is known to be linked to cardiovascular and cerebrovascular diseases. Western medical treatments for obesity have many drawbacks, including effects on monoamine neurotransmitters and the potential for drug abuse and dependency. The safety of these medications requires improvement. Herbal medicine has been used for treatment of disease for more than 2000 years, and it has proven efficacy. Many studies have confirmed that herbal medicine is effective in the treatment of obesity, but the mechanisms are not clear. This article will discuss the possible effects and mechanisms of herbal medicine treatments for obesity that have been reported in the past decade.

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Drug interventions for the treatment of obesity in children and adolescents

Cited by 89 publications

References 196 publications

A Systematic Review and Meta-Analysis of the Effects of Flavanol-Containing Tea, Cocoa and Apple Products on Body Composition and Blood Lipids: Exploring the Factors Responsible for Variability in Their Efficacy

A Systematic Review and Meta-Analysis of the Effects of Flavanol-Containing Tea, Cocoa and Apple Products on Body Composition and Blood Lipids: Exploring the Factors Responsible for Variability in Their Efficacy

Metformin exposure in first trimester of pregnancy and risk of all or specific congenital anomalies: exploratory case-control study

Herbal Medicine for the Treatment of Obesity: An Overview of Scientific Evidence from 2007 to 2017

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