Lifestyle and Pharmacological Interventions and Treatment Indications for the Management of Obesity in Children and Adolescents

Abstract

Obesity is a multifactorial chronic impairment that further decreases quality of life and life expectancy. Worldwide, childhood obesity has become a pandemic health issue causing several comorbidities that frequently present already in childhood, including cardiovascular (hypertension, dyslipidemia), metabolic (Type 2 diabetes mellitus, fatty liver disease, metabolic syndrome), respiratory, gastrointestinal and musculoskeletal disorders. In addition, obese children frequently experience stress and psychosocial symptoms, including mood disorders, anxiety, prejudice and low self-esteem. Given that cardiovascular risk factors and pediatric obesity have the tendency to pertain into adulthood, obesity management, including weight control and physical activity, should start before the late teens and certainly before the first signs of atherosclerosis can be detected. This review aims to concisely present options for childhood obesity management, including lifestyle modification strategies and pharmacological treatment, as well as the respective treatment indications for the general practitioner.

Attendance-Based Adherence and Outcomes of Obesity Management Program in Arab Adolescents

“…Several intervention studies on obese and overweight pediatrics (aged 6–16 years) have demonstrated that weight loss was successful in decreasing BP in pediatrics [ 25 ]. These intervention studies (5- to 12-month) have incorporated education, physical activity, and diet and demonstrated that intervention was effective in decreasing SBP [ 27 , 28 ]. In a recent large retrospective study that recruited 101,606 of pediatrics (aged 3–17 years) who were followed for several years, authors found that obese and severely obese participants had increased BP at baseline and greater odds of developing hypertension in adulthood compared with pediatrics with normal BMI [ 37 ].…”

“…Despite the plethora of successful interventions to prevent and manage childhood obesity [ 27 , 28 ], most lifestyle modification programs done in Saudi Arabia focused on adult obesity and individuals at high risk for diabetes [ 29 , 30 ], while pediatric obesity studies are mostly observational [ 31 , 32 ]. The current study investigates the efficacy of attendance-based adherence to a lifestyle obesity management program and its association with changes in obesity indices and hypertension in a cohort of Arab children and adolescents.…”

Genetics, pharmacotherapy, and dietary interventions in childhood obesity

“…Hence, lifestyle interventions are usually combined with pharmacological or dietary interventions to enhance the efficacy of these treatments [1]. This integrative approach is especially crucial when obesity reaches severe levels, as lifestyle changes alone often become insufficient [128][129][130]. Thus, most clinical treatment approaches for childhood obesity include combined treatment with lifestyle interventions as an effective integrative approach.…”

The Ongoing Impact of COVID-19 on Pediatric Obesity

“…However, the reluctance of parents to be involved in PO prevention activities, a lack of adequate knowledge, and financial concerns are the most commonly described obstacles in this field [110]. Recently, the major options for PO management, such as lifestyle modification approaches and pharmacological therapies, as well as the treatment indications for the general practitioner, have been reviewed [111]. Medications, including orlistat, phentermine, phentermine/topiramate, and GLP1 receptor agonists (liraglutide and semaglutide), have also been approved for patients who are 12 years old and older.…”