Identifying underlying medical causes of pediatric obesity: Results of a systematic diagnostic approach in a pediatric obesity center

Kleinendorst, Lotte; Abawi, Ozair; Voorn, Bibian van der; Jongejan, Mieke H. T. M.; Brandsma, Annelies E.; Visser, Jenny A.; Rossum, Elisabeth F.C. van; Zwaag, Bert van der; Alders, Mariëlle; Boon, Elles M. J.; Haelst, Mieke M. van; Akker, Erica L T van den

doi:10.1371/journal.pone.0232990

Cited by 40 publications

(41 citation statements)

References 49 publications

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“…During the first month, between 2 April 2020 and 23 April 2020, when these measures were in full effect, we contacted all parents of children currently under treatment at Obesity Center CGG (Erasmus MC‐Sophia Children's Hospital), a national referral centre for obesity. Patients are referred to Obesity Center CGG for diagnostic evaluation and/or personalized therapeutic advice 14 . We approached parents of all patients who had completed the diagnostic workup of our obesity centre and whose last visit to the outpatient clinic was in 2019 or 2020.…”

Section: Methodsmentioning

confidence: 99%

COVID‐19 related anxiety in children and adolescents with severe obesity: A mixed‐methods study

et al. 2020

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Summary Recent studies report negative mental health effects of the COVID‐19 related lockdown measures in general paediatric cohorts. Since obesity is a risk factor for COVID‐19 in adults, children (including adolescents) with obesity might perceive themselves to be vulnerable. Using a combined quantitative and qualitative approach, we explored COVID‐19 related anxiety in paediatric patients with severe obesity in the Netherlands using semi‐structured telephone interviews and the Paediatric Quality of Life Inventory (PedsQL) questionnaire, which had also been completed by the study population at baseline in the year prior to the COVID‐19 outbreak. In total, 75 families participated in the semi‐structured telephone interviews during the lockdown, April 2020. Characteristics of included patients were: median age 10.5 years (interquartile range = 7.6‐15.2); 52% female; mean BMI standard deviation score 3.8 (SD = 1.0). COVID‐19 related anxiety was reported for 24/75 (32%) children. The mean decrease in PedsQL score between baseline visit and COVID‐19 outbreak did not differ between children for whom anxiety was reported vs those for whom it was not (mean change −10.3 ± 36.5 vs −3.3 ± 24.4, P = .54). Self‐imposed strict quarantine measures were taken by 19/75 (25%) families. During follow‐up, several families reported that the previous contact alleviated their anxiety. In conclusion, healthcare professionals should address possible COVID‐19 related anxiety in children with severe obesity. Addressing COVID‐19 related anxiety could mitigate its potential negative effects.

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Section: Methodsmentioning

confidence: 99%

COVID‐19 related anxiety in children and adolescents with severe obesity: A mixed‐methods study

et al. 2020

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“…Identifying genetic obesity requires a structured approach and diagnosis is crucial, not only for optimal treatment of the accompanying symptoms such as visual and hearing impairment and endocrinopathies, but also because the obesity accompanying these diseases requires a tailored and life-long approach [ 14 ]. For example, dietary expertise in the light of lowered resting energy expenditure or specific expertise on guidance of behavioural problems may be needed.…”

Section: Genetic Obesity: Definition Phenotype and Treatmentmentioning

confidence: 99%

“…The limited available evidence, however, does show a possible link between obesity and disease severity, even in this age group [ 30 ] and the risk of a severe disease course increases with increased severity of obesity [ 7 , 31 ], as was also shown in adolescent and young adult age categories [ 3 , 5 , 28 ]. The latter finding is of specific importance for monogenic and syndromic obesity since the majority suffers from severe obesity [ 14 ]. Furthermore it should be noted weight might play a role in the suggested link between SARS-CoV-2 and Kawasaki or Kawasaki like disease (recently named Paediatric Multi-system Inflammatory Syndrome temporally associated with COVID-19, PIMS-TS or Multi Inflammatory Syndrome in Children temporally related to COVID-19, MIS-C), with an unusual high incidence in the first months of 2020 and evidence of past or present infection with SARS-CoV-2 in most patients [ 32 ].…”

Section: The Link Between Obesity and Severe Course Of Covid-19mentioning

confidence: 99%

“…Recently, other variants of genes involved in or regulating the melanocortin pathway and leading to early and severe obesity such as MC4R regulatory protein, melanocortin receptor accessory protein 2 (MRAP2), adenylate cyclase 3 (ADCY3), steroid coreceptor activator-1 (SRC-1) or kinase suppressor of ras 2 (KSR2) [8]. This leads to a defective LEP-melanocortin pathway in the hypothalamus, which is a key regulator of body weight, satiety and energy expenditure (14,15). Although early onset severe obesity (<5 years) and hyperphagia are the most common presenting features in these diseases, these patients can be affected by complex somatic conditions, including obesity comorbidities.…”

Section: Genetic Obesity: Definition Phenotype and Treatmentmentioning

confidence: 99%

“…Syndromic genetic obesity differs from the non-syndromic diseases, as they have additional symptoms, apart from obesity [14][15][16], with intellectual disability, motor developmental delay and behavioural problems, such as autism being the most frequent features [14]. Both non-syndromic and syndromic obesity are more often diagnosed in children than in adult patient groups.…”

Section: Genetic Obesity: Definition Phenotype and Treatmentmentioning

confidence: 99%

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Clinical management of patients with genetic obesity during COVID-19 pandemic: position paper of the ESE Growth & Genetic Obesity COVID-19 Study Group and Rare Endo-ERN main thematic group on Growth and Obesity

et al. 2021

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This article aims to provide guidance on prevention and treatment of COVID-19 in patients with genetic obesity. Key principals of the management of patients with genetic obesity during COVID-19 pandemic for patients that have contracted COVID-19 are to be aware of: possible adrenal insufficiency (e.g., POMC deficiency, PWS); a more severe course in patients with concomitant immunodeficiency (e.g., LEP and LEPR deficiency), although defective leptin signalling could also be protective against the pro-inflammatory phenotype of COVID-19; disease severity being masked by insufficient awareness of symptoms in syndromic obesity patients with intellectual deficit (in particular PWS); to adjust medication dose to increased body size, preferably use dosing in m2; the high risk of malnutrition in patients with Sars-Cov2 infection, even in case of obesity. Key principals of the obesity management during the pandemic are to strive for optimal obesity management and a healthy lifestyle within the possibilities of the regulations to prevent weight (re)gain and to address anxiety within consultations, since prevalence of anxiety for COVID-19 is underestimated.

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Clinical phenotypes of adults with monogenic and syndromic genetic obesity

Welling,

Mohseni,

Meeusen

et al. 2024

Obesity

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ObjectiveConsidering limited evidence on diagnostics of genetic obesity in adults, we evaluated phenotypes of adults with genetic obesity. Additionally, we assessed the applicability of Endocrine Society (ES) recommendations for genetic testing in pediatric obesity.MethodsWe compared clinical features, including age of onset of obesity and appetite, between adults with non‐syndromic monogenic obesity (MO), adults with syndromic obesity (SO), and adults with common obesity (CO) as control patients.ResultsA total of 79 adults with genetic obesity (32 with MO, 47 with SO) were compared with 186 control patients with CO. Median BMI was similar among the groups: 41.2, 39.5, and 38.7 kg/m2 for patients with MO, SO, and CO, respectively. Median age of onset of obesity was 3 (IQR: 1–6) years in patients with MO, 9 (IQR: 4–13) years in patients with SO, and 21 (IQR: 13–33) years in patients with CO (p < 0.001). Patients with genetic obesity more often reported increased appetite: 65.6%, 68.1%, and 33.9% in patients with MO, SO, and CO, respectively (p < 0.001). Intellectual deficit and autism spectrum disorder were more prevalent in patients with SO (53.2% and 21.3%) compared with those with MO (3.1% and 6.3%) and CO (both 0.0%). The ES recommendations were fulfilled in 56.3%, 29.8%, and 2.7% of patients with MO, SO, and CO, respectively (p < 0.001).ConclusionsWe found distinct phenotypes in adult genetic obesity. Additionally, we demonstrated low sensitivity for detecting genetic obesity in adults using pediatric ES recommendations, necessitating specific genetic testing recommendations in adult obesity care.

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Identifying underlying medical causes of pediatric obesity: Results of a systematic diagnostic approach in a pediatric obesity center

Cited by 40 publications

References 49 publications

COVID‐19 related anxiety in children and adolescents with severe obesity: A mixed‐methods study

COVID‐19 related anxiety in children and adolescents with severe obesity: A mixed‐methods study

Clinical management of patients with genetic obesity during COVID-19 pandemic: position paper of the ESE Growth & Genetic Obesity COVID-19 Study Group and Rare Endo-ERN main thematic group on Growth and Obesity

Clinical phenotypes of adults with monogenic and syndromic genetic obesity

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