Severe childhood obesity: an under-recognised and growing health problem

Postgraduate Medical Journal - Tập 91 Số 1081 - Trang 639-645 - 2015
Rosara Bass1, Ihuoma Eneli2
1The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania USA
2Center for Healthy Weight and Nutrition, Nationwide Children’s Hospital , Columbus, Ohio, USA

Tóm tắt

ABSTRACT Childhood obesity is a serious and urgent public health problem. In the last 10 years, there has been a concerted effort in the USA and globally to develop and implement educational, medical and public health interventions designed to attenuate its growth. The success of these efforts was probably responsible for the plateau in the prevalence rate of childhood obesity noted in the last two years. While the attenuation of the overall prevalence of childhood obesity is promising, data from the same cohort reveal a concerning upward trend in the number of children with severe obesity. The consequences of severe childhood obesity can be devastating. When compared to their moderately obese peers, children with severe obesity are at greater risk for adult obesity, early atherosclerosis, hypertension, type 2 diabetes, metabolic syndrome, fatty liver disease and premature death. The determinants for severe obesity include the same lifestyle, environmental, familial and societal risk factors reported for overweight or obesity. While all these risk factors must be screened for, genetic influences are distinct considerations that may have greater bearing especially with early-onset obesity. Treatments for severe childhood obesity include lifestyle intervention, specialised low-calorie diets and bariatric surgery. Outcomes of these treatments vary, with bariatric surgery clearly the most successful of the three for both short-term and long-term weight loss. Severe obesity in children and adolescents remains a challenging health condition. The enormous medical, emotional and financial burden these children and their families endure signals an urgent need to further investigate and standardise treatment modalities and improve outcomes.

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Tài liệu tham khảo

Ogden, 2014, Prevalence of childhood and adult obesity in the United States, 2011–2012, JAMA, 311, 806, 10.1001/jama.2014.732

Skinner, 2014, Prevalence and trends in obesity and severe obesity among children in the United States, 1999–2012, JAMA Pediatr, 168, 561, 10.1001/jamapediatrics.2014.21

Kelly, 2013, Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches: a scientific statement from the American Heart Association, Circulation, 128, 1689, 10.1161/CIR.0b013e3182a5cfb3

Barlow, 2007, Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report, Pediatrics, 120, S164, 10.1542/peds.2007-2329C

Valerio, 2013, Severe obesity and cardiometabolic risk in children: comparison from two international classification systems, PLoS ONE, 8, e83793, 10.1371/journal.pone.0083793

Flegal, 2009, Characterizing extreme values of body mass index–for-age by using the 2000 Centers for Disease Control and Prevention growth charts, Am J Clin Nutr, 90, 1314, 10.3945/ajcn.2009.28335

Gulati, 2012, Clinical Tracking of Children With Severe Obesity: A New Growth Chart, Pediatrics, 130, 1136, 10.1542/peds.2012-0596

Choquet, 2011, Molecular basis of obesity: current status and future prospects, Curr Genomics, 12, 154, 10.2174/138920211795677921

Lim, 2011, The ghrelin/GOAT/GHS-R system and energy metabolism, Rev Endocr Metab Disord, 12, 173, 10.1007/s11154-011-9169-1

Farooqi, 2015, Genetic, molecular and physiological mechanisms involved in human obesity, Clin Endocrinol, 82, 23, 10.1111/cen.12588

Jacobsson, 2012, The impact of intronic single nucleotide polymorphisms and ethnic diversity for studies on the obesity gene FTO, Obes Rev, 13, 1096, 10.1111/j.1467-789X.2012.01025.x

Cecil, 2012, Obesity and eating behaviour in children and adolescents: contribution of common gene polymorphisms, Int Rev Psychiatry, 24, 200, 10.3109/09540261.2012.685056

Flores, 2013, Factors predicting severe obesity in kindergarteners, Int J Obes, 37, 31, 10.1038/ijo.2012.168

Calcaterra, 2008, Prevalence of metabolic syndrome (MS) in children and adolescents with varying degrees of obesity, Clin Endocrinol, 68, 868, 10.1111/j.1365-2265.2007.03115.x

Griffiths, 2010, Self-esteem and quality of life in children with obesity and adolescents: a systematic review, Int J Pediatr Obes, 5, 282, 10.3109/17477160903473697

Schwimmer, 2003, Health-related quality of life of children with severe obesity and adolescents, JAMA, 289, 1813, 10.1001/jama.289.14.1813

Lo, 2014, Severe obesity in children: prevalence, persistence and relation to hypertension, Int J Pediatr Endocrinol, 2014, 3, 10.1186/1687-9856-2014-3

Freedman, 2007, Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study, J Pediatr, 150, 12, 10.1016/j.jpeds.2006.08.042

Rank, 2013, The cardio-metabolic risk of moderate and severe obesity in children and adolescents, J Pediatr, 163, 137, 10.1016/j.jpeds.2013.01.020

Kohler, 2009, Differences in the association between obesity and obstructive sleep apnea among children and adolescents, J Clin Sleep Med, 5, 506, 10.5664/jcsm.27649

Beebe, 2006, Neurobehavioral morbidity associated with disordered breathing during sleep in children: a comprehensive review, Sleep, 29, 1115, 10.1093/sleep/29.9.1115

Kwok, 2008, Cardiovascular changes in children with snoring and obstructive sleep apnoea, Ann Acad Med Singapore, 37, 715, 10.47102/annals-acadmedsg.V37N8p715

Redline, 1999, Risk factors for sleep-disordered breathing in children. Associations with obesity, race, and respiratory problems, Am J Respir Crit Care Med, 159, 1527, 10.1164/ajrccm.159.5.9809079

Mager, 2006, Nonalcoholic fatty liver disease in children, Clin Liver Dis, 10, 109, 10.1016/j.cld.2005.10.007

Xanthakos, 2006, Histologic spectrum of nonalcoholic fatty liver disease in morbidly obese adolescents, Clin Gastroenterol Hepatol, 4, 226, 10.1016/S1542-3565(05)00978-X

Schwimmer, 2005, Influence of gender, race and ethnicity on suspected fatty liver disease in obese adolescents, Pediatrics, 115, 561, 10.1542/peds.2004-1832

Birch, 2013, Blount disease, J Am Acad Orthop Surg, 21, 408

Montgomery, 2010, Increased risk of Blount disease in children with obesity and adolescents with vitamin D deficiency, J Pediatr Orthop, 30, 879, 10.1097/BPO.0b013e3181f5a0b3

Novais, 2012, Slipped capital femoral epiphysis: prevalence, pathogenesis and natural history, Clin Orthop Relat Res, 470, 3432, 10.1007/s11999-012-2452-y

Bhatia, 2006, Body mass index in patients with slipped capital femoral epiphysis, J Pediatr Orthop, 26, 197, 10.1097/01.bpo.0000218526.36362.3f

Zeller, 2015, Severe obesity and comorbid condition impact on the weight-related quality of life of the adolescent patient, J Pediatr, 166, 651, 10.1016/j.jpeds.2014.11.022

Puhl, 2013, Weight-based victimization: bullying experiences of weight loss treatment-seeking youth, Pediatrics, 131, e1, 10.1542/peds.2012-1106

Bravata, 2003, Efficacy and safety of low-carbohydrate diets: a systematic review, JAMA, 289, 1837, 10.1001/jama.289.14.1837

Figueroa-Colon, 1996, Feasibility of a clinic-based hypocaloric dietary intervention implemented in a school setting for children with obesity, Obes Res, 4, 419, 10.1002/j.1550-8528.1996.tb00250.x

Figueroa-Colon, 1993, Comparison of two hypocaloric diets in children with obesity, Am J Dis Chil, 147, 160

Suskind, 2000, Recent advances in the treatment of childhood obesity, Pediatr Diabetes, 1, 23, 10.1034/j.1399-5448.2000.010105.x

Berkowitz, 2011, Meal replacements in the treatment of adolescent obesity: a randomized controlled trial, Obesity (Silver Spring), 19, 1193, 10.1038/oby.2010.288

Tershakovec, 1999, Insurance reimbursement for the treatment of obesity in children, J Pediatr, 134, 573, 10.1016/S0022-3476(99)70243-X

August, 2008, Prevention and treatment of pediatric obesity: an endocrine society clinical practice guideline based on expert opinion, J Clin Endocrinol Metab, 93, 4576, 10.1210/jc.2007-2458

Danielsson, 2007, Impact sibutramine therapy in children with hypothalamic obesity or obesity with aggravating syndromes, J Clin Endocrinol Metab, 92, 4101, 10.1210/jc.2007-0826

Chanoine, 2005, Effect of orlistat on weight and body composition in obese adolescents, JAMA, 293, 2873, 10.1001/jama.293.23.2873

McDonagh, 2014, Systematic review of the benefits and risks of metformin in treating obesity in children aged 18 years and younger, JAMA Pediatr, 168, 178, 10.1001/jamapediatrics.2013.4200

Kelly, 2012, Exenatide as a weight-loss therapy in extreme pediatric obesity: a randomized, controlled pilot study, Obesity (Silver Spring), 20, 364, 10.1038/oby.2011.337

Inge, 2004, Bariatric surgery for severely overweight adolescents: concerns and recommendations, Pediatrics, 114, 217, 10.1542/peds.114.1.217

Inge, 2010, Baseline BMI is a strong predictor of nadir BMI after adolescent gastric bypass, J Pediatr, 156, 103, 10.1016/j.jpeds.2009.07.028

O'Brien, 2010, Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial, JAMA, 303, 519, 10.1001/jama.2010.81

Boza, 2012, Laparoscopic sleeve gastrectomy in obese adolescents: results in 51 patients, Surg Obes Relat Dis, 8, 133, 10.1016/j.soard.2011.11.021