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
...agnosi...
Diagnosing Overweight...
...s using body mass index (BMI) and the C...
...ecommends diagnosing a child or adolescent >...
...sts that clinicians take into account that varia...
...ests calculating, plotting, and reviewing...
...suggests that a child
...ecommends against routine laboratory evaluation...
...that children or adolescents with a BMI of â‰...
...mmends against measuring insulin co...
...etic Obesity Syndromes...
ES suggests genetic testing in patients with extr...
...Prevalence of Pediatric Overweight and Ob...
...le 2. Screening for Comorbidities of Pediatric O...
Prevention
...vention
...uggests that clinicians promote and participat...
...hat clinicians prescribe and support healthy e...
...ommends that children and adolescents engage...
...suggests fostering healthy sleep patterns in chil...
...commends balancing unavoidable techn...
...ggests that a clinician’s obesit...
...gests that clinicians assess family function a...
...ests using school-based programs and...
...ommends using comprehensive behavior-changin...
...breast-feeding in infants based on...
...1. Diagnosis and Management Flowcharta Measure...
...Obesity Syndromes With and Without...
Treatment
...atment...
...Lifestyle: General Considerat...
...that clinicians prescribe and support intensive,...
...that clinicians prescribe and suppo...
ES recommends that clinicians prescrib...
...gests that clinicians encourage and support patie...
...s that the health care team identify maladap...
...sts that the health care team probe for and...
...ests that the health care team evalu...
...armacotherapy for children or adoles...
...S recommends against using obesity medic...
...s that Food and Drug Administration (FD...
...ggests that clinicians should disconti...
...atric surgery only under the following con...
...ainst bariatric surgery in preadolescent chil...
...e in Metabolic Outcome Per Unit Change in BMI or...
...e 4. Factors Associated With Prevention of Pedia...
...e 5. Medications Studied for the Long-Term T...
Figure 3. Bariatric Surgical Procedures