Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Obesity Surgery
Published in: Obesity Surgery 8/2018

Open Access 01-08-2018 | Review Article

Treatment of Obesity in Young People—a Systematic Review and Meta-analysis

Published in: Obesity Surgery | Issue 8/2018

Login to get access

Abstract

Obesity in the young is increasingly prevalent. Early, effective intervention is paramount. Treatment options are lifestyle modifications, pharmacological therapies, endoscopic treatments and bariatric surgery. However, the relative effectiveness of these treatments in young patients remains unclear. We systematically identify and meta-analyse studies evaluating weight loss treatments in young people (< 21 years) with obesity. From 16,372 identified studies, 83 were eligible for meta-analysis. Bariatric surgery resulted in high short/medium-term weight loss (pooled estimate 14.04 kg/m2). Lifestyle and pharmacological therapies impacted weight more moderately (pooled estimate 0.99 and 0.94 kg/m2 respectively). Due to its high efficacy, bariatric surgery should be considered earlier when treating obesity in young people. However, due to the invasiveness and inherent risks of bariatric surgery, all other weight loss routes should be exhausted first.
Appendix
Available only for authorised users
Literature
1.
2.
Craig R, Mindell J, Boodhna G. Health survey for England, 2013. 2014.
3.
Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of obesity among adults and youth: United States, 2011–2014. NCHS Data Brief 2015;(219):1–8.
4.
Suchindran C, North KE, Popkin BM, et al. Association of adolescent obesity with risk of severe obesity in adulthood. JAMA. 2010;304(18):2042–7.PubMedPubMedCentral
5.
Welbourn R, le Roux CW, Owen-Smith A, et al. Why the NHS should do more bariatric surgery; how much should we do? BMJ. 2016;353:i1472.CrossRefPubMed
6.
Oude Luttikhuis H, Baur L, Jansen H, et al. Interventions for treating obesity in children. Cochrane Database Syst Rev. 2009;1(1)
7.
Schauer PR, Kashyap SR, Wolski K, et al. Bariatric surgery versus intensive medical therapy in obese patients with diabetes. N Engl J Med. 2012;366(17):1567–76.CrossRefPubMedPubMedCentral
8.
Moher D, Shamseer L, Clarke M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. System Rev. 2015;4(1):1.CrossRef
9.
Alves JGB, Galé CR, Souza E, et al. Effect of physical exercise on bodyweight in overweight children: a randomized controlled trial in a Brazilian slum. Cadernos de Saúde Pública. 2008;24:s353–9.CrossRefPubMed
10.
11.
Higgins J, Thompson SG. Quantifying heterogeneity in a meta-analysis. Stat Med. 2002;21(11):1539–58.CrossRefPubMed
12.
Taylor RW, Cox A, Knight L, et al. A tailored family-based obesity intervention: a randomized trial. Pediatrics. 2015;136(2):281–9.CrossRefPubMed
13.
Kokkvoll A, Grimsgaard S, Steinsbekk S, et al. Health in overweight children: 2-year follow-up of Finnmark Activity School—a randomised trial. Arch Dis Child. 2015;100(5):441–8.CrossRefPubMed
14.
Shalitin S, Ashkenazi-Hoffnung L, Yackobovitch-Gavan M, et al. Effects of a twelve-week randomized intervention of exercise and/or diet on weight loss and weight maintenance, and other metabolic parameters in obese preadolescent children. Horm Res. 2009;72(5):287–301.CrossRefPubMed
15.
Okely AD, Collins CE, Morgan PJ, et al. Multi-site randomized controlled trial of a child-centered physical activity program, a parent-centered dietary-modification program, or both in overweight children: the HIKCUPS study. J Pediatr. 2010;157(3):388–94. e1CrossRefPubMed
16.
Ebbeling CB, Leidig MM, Sinclair KB, et al. A reduced–glycemic load diet in the treatment of adolescent obesity. Arch Pediatr Adolesc Med. 2003;157(8):773–9.CrossRefPubMed
17.
Kalarchian MA, Levine MD, Arslanian SA, et al. Family-based treatment of severe pediatric obesity: randomized, controlled trial. Pediatrics. 2009;124(4):1060–8.CrossRefPubMedPubMedCentral
18.
Weigel C, Kokocinski K, Lederer P, et al. Childhood obesity: concept, feasibility, and interim results of a local group-based, long-term treatment program. J Nutr Educ Behav. 2008;40(6):369–73.CrossRefPubMed
19.
Nwosu BU, Maranda L, Cullen K, et al. A randomized, double-blind, placebo-controlled trial of adjunctive metformin therapy in overweight/obese youth with type 1 diabetes. PLoS One. 2015;10(9):e0137525.CrossRefPubMedPubMedCentral
20.
Wilson DM, Abrams SH, Aye T, et al. Metformin extended release treatment of adolescent obesity: a 48-week randomized, double-blind, placebo-controlled trial with 48-week follow-up. Arch Pediatr Adolesc Med. 2010;164(2):116–23.PubMed
21.
Chanoine J, Hampl S, Jensen C, et al. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA. 2005;293(23):2873–83.CrossRefPubMed
22.
Ozkan B, Bereket A, Turan S, et al. Addition of orlistat to conventional treatment in adolescents with severe obesity. Eur J Pediatr. 2004;163(12):738–41.CrossRefPubMed
23.
Vandenplas Y, Bollen P, De Langhe K, et al. Intragastric balloons in adolescents with morbid obesity. Eur J Gastroenterol Hepatol. 1999;11(3):243–5.CrossRefPubMed
24.
Curran J, Kalic R, Sherrington C, et al. RCT of intragastric balloons in adolescents: preliminary data. Obes Res Clin Pract. 2011;5:24–5.CrossRef
25.
De Peppo F, Adorisio O, Melissa B, et al. BioEnterics Intragastric Balloon for the treatment of pathologic obesity in Prader–Willi patients. Paediatr Child Health. 2009;19:S38–42.CrossRef
26.
Kotnik P, Homan M, Battelino T. Initial experience with endoscopically placed duodenal-jejunal bypass liner (Endobarrier) in morbidly obese adolescents. 2015.
27.
Holterman A, Browne A, Tussing L, et al. A prospective trial for laparoscopic adjustable gastric banding in morbidly obese adolescents: an interim report of weight loss, metabolic and quality of life outcomes. J Pediatr Surg. 2010;45(1):74–9.CrossRefPubMed
28.
Nadler EP, Youn HA, Ginsburg HB, et al. Short-term results in 53 US obese pediatric patients treated with laparoscopic adjustable gastric banding. J Pediatr Surg. 2007;42(1):137–42.CrossRefPubMed
29.
Nadler EP, Youn HA, Ren CJ, et al. An update on 73 US obese pediatric patients treated with laparoscopic adjustable gastric banding: comorbidity resolution and compliance data. J Pediatr Surg. 2008;43(1):141–6.CrossRefPubMed
30.
Nadler EP, Reddy S, Isenalumhe A, et al. Laparoscopic adjustable gastric banding for morbidly obese adolescents affects android fat loss, resolution of comorbidities, and improved metabolic status. J Am Coll Surg. 2009;209(5):638–44.CrossRefPubMed
31.
Silva GM, Osório A, Pereira F, et al. Effect of laparoscopic adjustable gastric banding on modifiable cardiovascular risk factors in extremely obese adolescents. Obes Surg. 2012;22(6):991–4.CrossRefPubMed
32.
Dillard 3rd BE, Gorodner V, Galvani C, et al. Initial experience with the adjustable gastric band in morbidly obese US adolescents and recommendations for further investigation. J Pediatr Gastroenterol Nutr. 2007;45(2):240–6.CrossRefPubMed
33.
Angrisani L, Favretti F, Furbetta F, et al. Obese teenagers treated by Lap-Band System: the Italian experience. Surgery. 2005;138(5):877–81.CrossRefPubMed
34.
Silberhumer GR, Miller K, Kriwanek S, et al. Laparoscopic adjustable gastric banding in adolescents: the Austrian experience. Obes Surg. 2006;16(8):1062–7.CrossRefPubMed
35.
Khen-Dunlop N, Dabbas M, De Filippo G, et al. Primordial influence of post-operative compliance on weight loss after adolescent laparoscopic adjustable gastric banding. Obes Surg. 2016;26(1):98–104.CrossRefPubMed
36.
DuCoin C, Moon RC, Mulatre M, et al. Safety and effectiveness of Roux-en-Y gastric bypass in patients between the ages of 17 and 19. Obes Surg. 2015;25(3):464–9.CrossRefPubMed
37.
Olbers T, Gronowitz E, Werling M, et al. Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS). Int J Obes. 2012;36(11):1388–95.CrossRef
38.
Teeple E, Teich S, Schuster D, et al. Early metabolic improvement following bariatric surgery in morbidly obese adolescents. Pediatr Blood Cancer. 2012;58(1):112–6.CrossRefPubMed
39.
Tsamis D, Plastiras A, Natoudi M, et al. Impact of laparoscopic sleeve gastrectomy on weight loss and associated comorbidities in adolescents and young adults. J Laparoendosc Adv Surg Tech. 2015;25(12):971–5.CrossRef
40.
Alqahtani AR, Antonisamy B, Alamri H, et al. Laparoscopic sleeve gastrectomy in 108 obese children and adolescents aged 5 to 21 years. Ann Surg. 2012;256(2):266–73.CrossRefPubMed
41.
Alqahtani A, Elahmedi M, Qahtani AR. Laparoscopic sleeve gastrectomy in children younger than 14 years: refuting the concerns. Ann Surg. 2016;263(2):312–9.CrossRefPubMed
42.
Alqahtani AR, Elahmedi MO. Pediatric bariatric surgery: the clinical pathway. Obes Surg. 2015;25(5):910–21.CrossRefPubMed
43.
Widhalm K, Fritsch M, Widhalm H, et al. Bariatric surgery in morbidly obese adolescents: long-term follow-up. Pediatr Obes. 2011;6(S1):65–9.CrossRef
44.
Widhalm K, Dietrich S, Prager G, et al. Bariatric surgery in morbidly obese adolescents: a 4-year follow-up of ten patients. Pediatr Obes. 2008;3(S1):78–82.CrossRef
45.
Olbers T, Beamish AJ, Gronowitz E, et al. Laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity (AMOS): a prospective, 5-year, Swedish nationwide study. Lancet Diabetes Endocrinol. 2017;5(3):174–83.CrossRefPubMedPubMedCentral
46.
Inge TH, Courcoulas AP, Jenkins TM, et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N Engl J Med. 2016;374(2):113–23.CrossRefPubMed
47.
Reisler G, Tauber T, Afriat R, et al. Sibutramine as an adjuvant therapy in adolescents suffering from morbid obesity. Isr Med Assoc J. 2006;8(1):30.PubMed
48.
Coles N, Birken C, Hamilton J. Emerging treatments for severe obesity in children and adolescents. BMJ. 2016;354:i4116.CrossRefPubMed
49.
Boland CL, Harris JB, Harris KB. Pharmacological management of obesity in pediatric patients. Ann Pharmacother. 2015;49(2):220–32.CrossRefPubMed
50.
Imaz I, Martínez-Cervell C, García-Álvarez EE, et al. Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg. 2008;18(7):841–6.CrossRefPubMed
51.
Schouten R, Rijs CS, Bouvy ND, et al. A multicenter, randomized efficacy study of the EndoBarrier Gastrointestinal Liner for presurgical weight loss prior to bariatric surgery. Ann Surg. 2010;251(2):236–43.CrossRefPubMed
52.
Black J, White B, Viner R, et al. Bariatric surgery for obese children and adolescents: a systematic review and meta-analysis. Obes Rev. 2013;14(8):634–44.CrossRefPubMed
53.
Malaki M. Sibutramine: a banned innocent antiobesity drug. J Pharm Negat Results. 2016;7(1):53.CrossRef
54.
James WPT, Caterson ID, Coutinho W, et al. Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects. N Engl J Med. 2010;363(10):905–17.CrossRefPubMed
55.
Shapira B, Goldstein L, Reshef A, et al. A rare case of psychomotor disturbances linked to the use of an adulterated dietary supplement containing sibutramine. Clin Neuropharmacol. 2016;39(3):154–6.CrossRefPubMed
56.
Gibson LJ, Peto J, Warren JM, et al. Lack of evidence on diets for obesity for children: a systematic review. Int J Epidemiol. 2006;35(6):1544–52.CrossRefPubMed
57.
Partsalaki I, Karvela A, Spiliotis BE. Metabolic impact of a ketogenic diet compared to a hypocaloric diet in obese children and adolescents. J Pediatr Endocrinol Metab. 2012;25(7–8):697–704.PubMed
58.
Reeves B, Deeks J, Higgins J, Wells G., on behalf of the Cochrane Non-Randomised Studies Methods Group. Chapter 13: including non-randomized studies. Cochrane handbook for systematic reviews of interventions.Version 2008;5(0).
59.
Freedman DS, Sherry B. The validity of BMI as an indicator of body fatness and risk among children. Pediatrics. 2009;124(Suppl 1):S23–34.CrossRefPubMed
60.
McGovern L, Johnson JN, Paulo R, et al. Treatment of pediatric obesity: a systematic review and meta-analysis of randomized trials. J Clin Endocrinol Metab. 2008;93(12):4600–5.CrossRefPubMed
61.
McDonagh MS, Selph S, Ozpinar A, et al. Systematic review of the benefits and risks of metformin in treating obesity in children aged 18 years and younger. JAMA Pediatr. 2014;168(2):178–84.CrossRefPubMed
62.
O’Brien PE, Sawyer SM, Laurie C, et al. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. JAMA. 2010;303(6):519–26.CrossRefPubMed
Metadata
Title
Treatment of Obesity in Young People—a Systematic Review and Meta-analysis
Publication date
01-08-2018
Published in
Obesity Surgery / Issue 8/2018
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-018-3285-x

Other articles of this Issue 8/2018

Obesity Surgery 8/2018 Go to the issue

Original Contributions

Displacement of the Intragastric Balloon from the Fundus to the Antrum Results in Enhanced Weight Loss

Original Contributions

Anemia and Bariatric Surgery: Results of a National French Survey on Administrative Data of 306,298 Consecutive Patients Between 2008 and 2016

Original Contributions

Contrasting Views of the Post-bariatric Surgery Experience between Patients and their Practitioners: a Qualitative Study

Review Article

The Effect of Bariatric Surgery on Patients with HIV Infection: a Literature Review

Original Contributions

Which Bariatric Procedure Is the Most Popular in the World? A Bibliometric Comparison

Original Contributions

Sleeve Gastrectomy Reversed Obesity-Induced Hypogonadism in a Rat Model by Regulating Inflammatory Responses in the Hypothalamus and Testis