Pediatric Obesity: Etiology and Treatment

Abstract

Synopsis This paper reviews factors that contribute to excessive weight gain in children and outlines current knowledge regarding approaches for treating pediatric obesity. Virtually all of the known genetic causes of obesity primarily increase energy intake. Genes regulating the leptin signaling pathway are particularly important for human energy homeostasis. Obesity is a chronic disorder that requires long-term strategies for management. The foundation for all treatments for pediatric obesity remains restriction of energy intake with lifestyle modification. There are few long-term studies of pharmacotherapeutic interventions for pediatric obesity. Bariatric surgical approaches are the most efficacious obesity treatments but, because of their potential risks, are reserved for those with the most significant complications of obesity.

Risk-Taking Behaviors of Adolescents With Extreme Obesity: Normative or Not?

“…32 Documenting the prevalence of engagement in high-risk behaviors for this already vulnerable subpopulation of adolescents is not only timely but also imperative, especially given health care providers' conundrum of how best to intervene when such youth are under their care. 33,34 Unfortunately, the weight loss intervention literature (eg, behavioral [35][36][37] and pharmacotherapy 38,39 ) has not progressed sufficiently, and thus, the vast majority of today's youth with extreme obesity will carry their excess weight and associated medical and psychosocial burden into adulthood. 12 In addition, as bariatric surgery emerges as a potential and viable treatment option for this age and weight status group [40][41][42] it is critical to establish a most comprehensive picture of the health and mental health needs of this patient population.…”

Comparison of feeding habits and physical activity between eutrophic and overweight/obese children and adolescents: a cross sectional study

“…Generally speaking, it is unquestionable that the increase in fat storage is due to positive energy balance, situation where energy intake overcomes expenditure, part of the surplus energy being deposited. To explain why this phenomenon has been occurring in such a striking way for the past few years, many explanations may be brought forward but, generally speaking, all of them fit in three possibilities: 16 • Energy intake increased.…”

“…27 In fact, studies of association in the whole genome have demonstrated a variety of genetic loci associated to the most common form of obesity, and more than 300 genetic loci potentially involved with obesity have been identified in human beings as well as in animals. 16 Polymorphisms in the FTO gene, for instance, are associated to human obesity, leading to an increase in food intake and the preference for high energy food. 28 2.…”

“…Therefore, natural selection favored polymorphisms that would determine more intake when there was more energy available. 16 Monogenic inheritance is rare, but helps in the identification of multiple genes. 27 In fact, studies of association in the whole genome have demonstrated a variety of genetic loci associated to the most common form of obesity, and more than 300 genetic loci potentially involved with obesity have been identified in human beings as well as in animals.…”

Evaluación Postural y Prevalencia de Hipercifosis e Hiperlordosis en Estudiantes de Enseñanza Básica

“…La obesidad, según Crocker & Yanovski (2009), es una enfermedad crónica de origen multifactorial, producida por un balance energético positivo mantenido en el tiempo, traduciéndose posteriormente en una acumulación excesiva de peso y masa grasa corporal, lo cual es perjudicial para la salud. El exceso de grasa en los niños se relaciona con riesgo cardiovascular y diabetes tipo 2 en la edad adulta, un buen método antropométrico para medir la adiposidad central es la relación cintura-estatura, cuando esta relación es ≥0,50, identifica a población de riesgo (Arnaiz et al, 2014).…”