Pediatric Obesity
Key Points
Key Points
Pediatric obesity has its basis in genetic susceptibilities influenced by a permissive environment starting in utero and extending through childhood and adolescence.
Genetic screening for rare syndromes is indicated only in the presence of specific historical or physical features.
Endocrine etiologies for obesity are rare and usually are accompanied by attenuated growth patterns.
Pediatric comorbidities are common, and long-term health complications often result. Screening for comorbidities of obesity should be applied in a hierarchal, logical manner for early identification before more serious complications result.
The psychological toll of pediatric obesity on the individual and family necessitates screening for mental health issues and counseling as indicated.
The prevention of pediatric obesity by promoting healthful diet, activity, and environment should be a primary goal, since achieving effective, long-lasting results with lifestyle modification once obesity occurs is difficult.
Diagnosis
...iagnosis
...gnosing Overweight and Obesity...
...recommends using body mass index (BMI) an...
...ds diagnosing a child or adolescent >2 years of ag...
ES suggests that clinicians take into acco...
...suggests calculating, plotting, a...
...S suggests that a child
...gainst routine laboratory evaluation...
...commends that children or adolescents with...
...ecommends against measuring insuli...
...ic Obesity Syndromes
...gests genetic testing in patients with ex...
Table 1. Prevalence of Pediatric Ove...
...ing for Comorbidities of Pediatric Ove...
Prevention
Preventio...
ES suggests that clinicians promote and...
...recommends that clinicians prescr...
...ecommends that children and adolescents engage...
...suggests fostering healthy sleep patterns in...
...nds balancing unavoidable technology-rela...
...at a clinician’s obesity preventio...
...uggests that clinicians assess family f...
...ts using school-based programs and community...
...ommends using comprehensive behavior-chang...
...mends breast-feeding in infants based on...
...re 1. Diagnosis and Management Flowcharta Measure...
...able 3. Genetic Obesity Syndromes W...
Treatment
...atment...
...ity Lifestyle: General Considerati...
ES recommends that clinicians prescr...
...nds that clinicians prescribe and support...
...ds that clinicians prescribe and support the red...
...ggests that clinicians encourage and support...
...s that the health care team identify ma...
...t the health care team probe for and diagnose...
...ts that the health care team evaluate for psycho...
...rmacotherapy for children or adolescent...
...against using obesity medications in children a...
...that Food and Drug Administration (F...
...clinicians should discontinue medic...
...suggests bariatric surgery only under the...
...ggests against bariatric surgery in preadolesce...
...e in Metabolic Outcome Per Unit Change in BMI or...
...tors Associated With Prevention of Pediat...
...ications Studied for the Long-Term...
.... Bariatric Surgical Procedures...