Obesity in children and adolescents: epidemiology, causes, assessment, and management

Jebeile, Hiba; Kelly, Aaron S.; O’Malley, Grace; Baur, Louise A.

doi:10.1016/s2213-8587(22)00047-x

Cited by 431 publications

(324 citation statements)

References 189 publications

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“…Childhood obesity has become one of the major public health concerns not merely in the U.S. and in the Western countries but also in many other areas worldwide [ 11 ].…”

Section: Childhood Obesity and Non-alcoholic Fatty Liver Diseasementioning

confidence: 99%

“…Before the outbreak of the COVID-19 pandemic, obesity prevalence in children and adolescents had plateaued in many wealthy countries, while its levels had risen in low- and middle-income countries [ 11 ]. However, during the pandemic, academics have reported a different trend: obesity and overweight in children has started to increase in the richest countries as well.…”

Section: Childhood Obesity and Non-alcoholic Fatty Liver Diseasementioning

confidence: 99%

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Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

et al. 2022

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Non-alcoholic fatty liver disease (NAFLD) is an important health concern during childhood; indeed, it is the most frequent cause of chronic liver diseases in obese children. No valid pharmacological therapies for children affected by this condition are available, and the recommended treatment is lifestyle modification, usually including nutrition and exercise interventions. In this narrative review, we summarized up-to-date information on the benefits of physical exercise on NAFLD in children and adolescents with obesity. The role of exercise as non-pharmacological treatment was emphasized in order to provide recent advances on this topic for clinicians not deeply involved in the field. Several studies on obese children and adults confirm the positive role of physical activity (PA) in the treatment of NAFLD, but to date, there are no pediatric randomized clinical trials on exercise versus usual care. Among the pathogenic mechanisms involved in the PA effects on NAFLD, the main players seem to be insulin resistance and related inflammation, oxidative stress, and gut dysbiosis, but further evaluations are necessary to deeply understand whether these factors are correlated and how they synergistically act. Thus, a deeper research on this theme is needed, and it would be extremely interesting.

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“…Childhood obesity has become one of the major public health concerns not merely in the U.S. and in the Western countries but also in many other areas worldwide [ 11 ].…”

Section: Childhood Obesity and Non-alcoholic Fatty Liver Diseasementioning

confidence: 99%

Section: Childhood Obesity and Non-alcoholic Fatty Liver Diseasementioning

confidence: 99%

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

et al. 2022

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“…Obesity and overweight compromise the health and wellbeing of children worldwide, with global prevalence estimated at 240 million children affected, the majority in low and middle income countries and with greater burden borne by those living in disadvantage (1,2). Childhood obesity affects children across diverse demographics and environments, often causing challenges to their health and wellbeing that persist into adulthood (3,4). Figure 1 depicts the range of health complications and impairments that present in children and adolescents with obesity and the related adult conditions where risk is increased with obesity during childhood .…”

Section: Introductionmentioning

confidence: 99%

“…Multi-component interventions are proven more effective than single interventions at reducing body size and improving health-related quality of life in children and adolescents with obesity (32,33). Multicomponent interventions are the first-line treatment for child and adolescent obesity with additional pharmacotherapy and surgical intervention required in more severe cases (3,4).…”

Section: Introductionmentioning

confidence: 99%

Evaluating 12 Years of Implementing a Multidisciplinary Specialist Child and Adolescent Obesity Treatment Service: Patient-Level Outcomes

Wyse¹,

Case

Walsh

et al. 2022

Front. Nutr.

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IntroductionChildhood obesity is a chronic disease that requires multidisciplinary and specialist intervention to address its complex pathophysiology, though access to treatment is limited globally. Evaluating the impact of evidence-based interventions implemented in real-world clinical settings is essential, in order to increase the translation of research into practice and enhance child health outcomes. In Ireland, the National Model of Care for Obesity highlighted the need to develop and improve healthcare services for children and adolescents with obesity.AimsThis study aims to evaluate the impact of a family-based, Tier 3 multi-disciplinary child and adolescent obesity outpatient service (www.w82go.ie) on standardized body mass index (BMI-SDS).MethodsFollowing referral by pediatricians, patients were assessed by a pediatric multidisciplinary team (physiotherapist, dietician, and psychologist) and personalized obesity treatment plans were developed. Anthropometric and demographic information were recorded at baseline and final visit. Descriptive statistics were used to explore distribution, central tendency and variation in the demographic data, change in BMI-SDS over time was assessed using a t-test, and multiple linear regression analysis was used to investigate the association of demographic factors on the change in BMI-SDS.ResultsThe overall mean BMI-SDS reduction across the whole cohort (n = 692) was −0.17 (95% CI = −0.20, −0.13; P < 0.001). Younger age at admission and longer duration of treatment were associated with greater BMI-SDS reduction but there was no significant association between change in BMI-SDS and any of the other parameters (deprivation score, treatment type, sex, obesity category at admission or presence of comorbid condition).ConclusionEngagement in a specialist Tier 3 pediatric obesity service was associated with reductions in BMI-SDS in children and adolescents with obesity.

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“…14,18 Moreover, within the same countries, there are regional differences in prevalence trends, and in risk of developing obesity according to the socio-economic status. 18–20…”

Section: Introductionmentioning

confidence: 99%

Pharmacological Management of Obesity: A Century of Expert Opinions in Cecil Textbook of Medicine

Manu

Lǎcǎtusu²,

Rogozea

2022

American Journal of Therapeutics

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Background: Opioid use disorder continues to have a significant impact on public health morbidity and mortality throughout the United States and elsewhere. Managing opioid withdrawal is a critical treatment goal in individuals entering treatment with an active opioid use.Study Question: What are the milestones of the changes in the expert approach to the pharmacological management of heroin withdrawal syndrome in the past century?Study Design: To determine the changes in the expert approach to the management of heroin withdrawal syndrome, as presented in a widely used textbook in the United States.Data Sources: The chapters on opioid dependence in the 26 editions of Cecil Textbook of Medicine published from 1927 through 2020.Results: Opioid replacement taper with morphine (1927-1947), codeine (1931-1943), and methadone (1951-present) administered for 3-10 days has remained the main intervention. The anticholinergic drugs, scopolamine and atropine, were recommended from 1927 to 1943, but their use has never been backed by scientific evidence. Newer approaches relied on clonidine, an alpha-2 receptor agonist used since 1982, and buprenorphine, an opioid agonist/antagonist endorsed for the treatment of heroin withdrawal in 2000. Conclusions:The pharmacological management of heroin withdrawal syndrome in the past century has progressed from the introduction of methadone to the utilization of clonidine and buprenorphine. More recent advances in treating opioid use disorder have changed the goals of opioid withdrawal management to achievement of abstinence from all opioids to facilitation of long-term treatment with medications for opioid use disorder.

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Obesity in children and adolescents: epidemiology, causes, assessment, and management

Cited by 431 publications

References 189 publications

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

Benefits of Physical Exercise as Approach to Prevention and Reversion of Non-Alcoholic Fatty Liver Disease in Children and Adolescents with Obesity

Evaluating 12 Years of Implementing a Multidisciplinary Specialist Child and Adolescent Obesity Treatment Service: Patient-Level Outcomes

Pharmacological Management of Obesity: A Century of Expert Opinions in Cecil Textbook of Medicine

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