- Pediatric obesity: Causes, symptoms, prevention and treatment
- Prevention and Treatment of Overweight in Children and Adolescents - - American Family Physician
- Childhood Obesity Symptoms & Causes
These studies support some degree of optimism in thinking that diverse types of weight-loss interventions can be successful in achieving weight loss in children and adolescents. However, it is likely that some of the success demonstrated in these studies is attributable to volunteer bias, because those who volunteered for the studies may have had a different motivation level than average patients. In addition, a publication bias in this area of study may have prevented our awareness of interventions with negative results.
Pediatric obesity: Causes, symptoms, prevention and treatment
The interventions in most of these studies were intense, making them difficult to replicate in the standard outpatient setting. Therefore, although these studies support an optimistic attitude toward the treatment of overweight in children and adolescents, success in clinical settings is likely to be challenging. No evidence-based overweight prevention guidelines exist.
However, the CDC has issued guidelines for developing school and community programs to promote a physically active lifestyle and healthy eating habits beginning in childhood. Only one set of guidelines addressing treatment of overweight in children and adolescents was identified Table 4. The guidelines provide general recommendations for physicians and state that intervention for weight problems in children should not start until two years of age. Interventions should begin early in overweight children two years of age and older.
The family must be ready for change. If not, the intervention is likely to fail. Physicians should involve the family and all caregivers in the treatment program. A variety of experienced professionals can be involved in the weight management program. Obesity evaluation and treatment: The experimental evidence for the effectiveness of preventive strategies in reducing the prevalence of overweight at the child and adolescent population level is marginal.
Treatment strategies to reduce overweight at the level of the individual patient show promise in the framework of clinical trials, but the ability to generalize these results to the primary care setting has not been demonstrated. No single approach to the treatment of childhood overweight has been demonstrated to be more effective than another.
The conclusions of a Cochrane Database Systematic Review, 32 which was released after the authors' literature search on the treatment of childhood overweight, are similar to those in this review. Despite the limited quantity of conclusive data regarding treatment and prevention, childhood and adolescent overweight is of considerable public health concern and should remain of great clinical concern to family physicians. To address the problem of overweight, experts recommend that physicians determine the BMI for all children and adolescents in their practices and offer appropriate interventions to those who are overweight or at risk for overweight Figure 2.
Overweight children and adolescents in whom genetic or endocrine disorders are suspected should be evaluated further. In individual children and adolescents, the treatment goal should be weight maintenance or weight loss. Which goal to use depends on the child's BMI, age, and presence or absence of medical complications of overweight. Weight maintenance allows children to maintain current weight over time so that their BMI will gradually decrease as they grow taller.
Weight maintenance is appropriate for 1 all children who are at risk for being overweight BMI in the 85th to 95th percentile who are between two and seven years of age, and those older than seven years without medical complications, and 2 overweight children BMI in the 95th percentile or higher between two and seven years of age without medical complications. Weight loss is recommended for 1 all overweight children BMI in the 95th percentile or higher who are older than seven years and those between two and seven years of age with medical complications and 2 children at risk for being overweight BMI in the 85th to 95th percentile who are older than seven years with medical complications.
Finally, children and adolescents with a BMI below the 85th percentile are not considered to be overweight or at risk for being overweight. Physicians should reinforce healthy behaviors and monitor BMI periodically. This strategy starts with the physician increasing efforts to identify the problem of overweight in each patient by monitoring BMI at every opportunity, including acute visits and visits for physical evaluations for school, sports participation, and summer camps.
The recently revised CDC growth charts for children and adolescents should be used to track BMI; they are available online at http: Algorithm for assessing and managing overweight in children and adolescents.
Prevention and Treatment of Overweight in Children and Adolescents - - American Family Physician
Information from reference One challenge physicians encounter when assisting patients with weight management is selecting an approach that can and will be adhered to on a long-term basis. Fortunately, data suggest that several weight-loss interventions can be effective in treating overweight in children and adolescents. One approach has not been conclusively demonstrated to be superior over another.
Therefore, physicians should elicit the preferences and interests of the patient and family to develop a weight control plan that can be integrated into the lifestyle of the patient and the family and that considers the patient's age, sex, and cultural background. Physicians also should be aware of school- and community-based resources that support the pursuit of healthy lifestyles and weight control. Although surgical and pharmaceutical therapies may be effective treatments, they are reserved for use in severe cases where the risks are clearly outweighed by the benefits.
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Childhood Obesity Symptoms & Causes
She received a master's degree in public health from the University of North Carolina at Chapel Hill and a medical degree from Harvard Medical School, Boston, and completed an internal medicine residency at Massachusetts General Hospital, also in Boston. Address correspondence to Leila C. Reprints are not available from the authors. The authors indicate that they do not have any conflicts of interest.
The authors thank Russ Harris, Linda Kinsinger, and Margaret Gourlay for assistance in the preparation of the manuscript.
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But what exactly does it mean to be an obese child? There are many reasons why a child may be obese, including medical or genetic ones. In most cases, though, children are overweight because they eat unhealthful foods and lead a sedentary lifestyle. If you think your child is overweight because of a medical condition, consult your pediatrician who can perform tests to check.
The rate of childhood obesity has more than tripled in the past 30 years. There are several tools your doctor might use to determine if your child is at risk for obesity, including:. Patient Resources Patient Story Two life-threatening conditions. Notes Blog Read clinical updates and the latest insights from Boston Children's specialists. Flu Season is Here Talk to your healthcare provider about getting your child immunized today.
Contact the Optimal Weight for Life Program Request an Appointment Request a Second Opinion. Causes What are the causes of childhood obesity?