Pediatric obesity – time to act as early as possible

Abstract

There has been a global increase in the average body mass index (BMI) in children and an alarming trend of increasing weight among the youngest children in recent decades. Childhood excess weight and obesity result in premature adult mortality and morbidity. Obesity is not only a risk factor for other diseases but is also a complex, multifactorial disease in its own right, linked to a genetic predisposition influenced by an increasingly permissive environment from intrauterine life throughout childhood and adolescence into adulthood. Knowledge of the prevalence of obesity from the earliest life stages and its trajectory is essential to raise awareness of the risks at each stage and to indicate the potential age of prevention and intervention. Taking effective anti-obesity measures in children, both preventive and therapeutic, is now a necessity, with successful interventions used to decrease body weight and thus reduce health consequences. Identified risk factors in the first 1,000 days of life and even earlier, before conception, suggest that this is a key period for the development of overweight and obesity, and it appears to be the best time for preventive action. The growing phenomenon of obesity among children requires not only prevention but also integral treatment. Lifestyle change intervention programs are considered key to the treatment of childhood obesity. Obesity trajectories, the higher effectiveness of applied interventions observed in younger age groups, and the dependence of the risk of developing complications on the duration of obesity confirm the need for early diagnosis and treatment of obesity in children from an early age. The main aim should be to prevent the onset of obesity, thus reducing the future health, social, and financial consequences.

Special considerations for the child with obesity: An Obesity Medicine Association (OMA) clinical practice statement (CPS) 2024

“…As health care clinicians, we make clinical decisions with the health of the child as our primary concern. Early discussion with families that obesity requires long-term care can create a supportive partnership with improved health for children [ 30 , 32 , 115 ]. Growing literature supports the need to address even our youngest patients with obesity with early, intensive, and effective comprehensive care [ [115] , [116] , [117] ].…”

“…Early discussion with families that obesity requires long-term care can create a supportive partnership with improved health for children [ 30 , 32 , 115 ]. Growing literature supports the need to address even our youngest patients with obesity with early, intensive, and effective comprehensive care [ [115] , [116] , [117] ]. Severe obesity in the child is unlikely to remit [ 68 , 86 ].…”

Association between late bedtime and obesity in children and adolescents: a meta-analysis

“…The findings of the 2019/2020 English National Child Measurement Program indicate that 9.9% of children aged 4-5 were classified as obese (5). Upon conducting a subsequent assessment of the same cohort at age 10-11, it was observed that the prevalence of obesity had escalated to 21% (5). Similarly, a recent systematic review conducted in China revealed a persistent and heterogeneous prevalence of overweight and obesity among children and adolescents in the country (6).…”

“…The escalating prevalence of childhood obesity is indicative of an ongoing trend (3,4). The findings of the 2019/2020 English National Child Measurement Program indicate that 9.9% of children aged 4-5 were classified as obese (5). Upon conducting a subsequent assessment of the same cohort at age 10-11, it was observed that the prevalence of obesity had escalated to 21% (5).…”

Association between Childhood Overweight and Altered Concentrations of Circulating Amino Acids

“…Childhood overweight and obesity significantly predispose to metabolic disease at the adult age, indicating that preventive actions to curb obesity at a young age or preventing it altogether will have positive consequences on health later in life [ 1 ].…”