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Published in: Current Treatment Options in Cardiovascular Medicine 11/2014

01-11-2014 | Pediatric Congenital Heart Disease (G Singh, Section Editor)

Current Approaches to the Management of Pediatric Overweight and Obesity

Authors: Jackson H. Coppock, PhD, Danielle R. Ridolfi, PhD, Jacqueline F. Hayes, BS, Michelle St. Paul, BS, Denise E. Wilfley, PhD

Published in: Current Treatment Options in Cardiovascular Medicine | Issue 11/2014

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Opinion statement

Family-based behavioral intervention has been demonstrated to be an effective and safe treatment for childhood obesity and should be considered a first-line treatment option. However, access to such intensive evidence-based treatment is limited and, currently, obesity care is dominated by high intensity behavioral treatment implemented in specialty clinics or less effective low intensity treatments implemented in primary care. However, capitalizing on the established and ongoing relationship between primary care providers and families, primary care providers have an invaluable role in early identification of overweight and obesity, and subsequent referral to an evidence-based treatment. Key aspects of effective treatment include: early intervention, moderate intensity to high intensity intervention of sufficient duration, multicomponent intervention targeting dietary modification, physical activity and behavioral strategies, family involvement and goals targeting family members, and follow-up contact during maintenance. The purpose of this review is to present the current empirically supported treatment options for pediatric obesity including primary care-based interventions and diagnostic tools, multicomponent behavioral intervention with a focus on family-based behavioral intervention, immersion treatment, and pharmacologic and surgical management.
Literature
1.
go back to reference Ogden CL et al. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806–14.PubMedCrossRef Ogden CL et al. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014;311(8):806–14.PubMedCrossRef
2.
go back to reference Skinner A, Skelton JA. Prevalence and trends in obesity and severe obesity among children in the United States, 1999-2012. JAMA Pediatr. 2014;168(6):561–6. Skinner A, Skelton JA. Prevalence and trends in obesity and severe obesity among children in the United States, 1999-2012. JAMA Pediatr. 2014;168(6):561–6.
3.
go back to reference Ogden CL, NCfH Statistics. Prevalence of obesity in the United States, 2009-2010, 2012, US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics. Ogden CL, NCfH Statistics. Prevalence of obesity in the United States, 2009-2010, 2012, US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics.
4.
5.
go back to reference Freedman DS et al. Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics. 2001;108(3):712–8.PubMedCrossRef Freedman DS et al. Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. Pediatrics. 2001;108(3):712–8.PubMedCrossRef
6.
8.
go back to reference Weiss R et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350(23):2362–74.PubMedCrossRef Weiss R et al. Obesity and the metabolic syndrome in children and adolescents. N Engl J Med. 2004;350(23):2362–74.PubMedCrossRef
9.
go back to reference August GP et al. Prevention and treatment of pediatric obesity: an endocrine society clinical practice guideline based on expert opinion. J Clin Endocrinol Metab. 2008;93(12):4576–99.PubMedCrossRef August GP et al. Prevention and treatment of pediatric obesity: an endocrine society clinical practice guideline based on expert opinion. J Clin Endocrinol Metab. 2008;93(12):4576–99.PubMedCrossRef
10.
go back to reference Daniels SR et al. Overweight in children and adolescents pathophysiology, consequences, prevention, and treatment. Circulation. 2005;111(15):1999–2012.PubMedCrossRef Daniels SR et al. Overweight in children and adolescents pathophysiology, consequences, prevention, and treatment. Circulation. 2005;111(15):1999–2012.PubMedCrossRef
11.
go back to reference Wang G, Dietz WH. Economic burden of obesity in youths aged 6 to 17 years: 1979–1999. Pediatrics. 2002;109(5):e81.PubMedCrossRef Wang G, Dietz WH. Economic burden of obesity in youths aged 6 to 17 years: 1979–1999. Pediatrics. 2002;109(5):e81.PubMedCrossRef
12.
go back to reference Finkelstein EA, Graham WCK, Malhotra R. Lifetime direct medical costs of childhood obesity. Pediatrics. 2014. Finkelstein EA, Graham WCK, Malhotra R. Lifetime direct medical costs of childhood obesity. Pediatrics. 2014.
13.
go back to reference Whitaker RC et al. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997;337(13):869–73.PubMedCrossRef Whitaker RC et al. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997;337(13):869–73.PubMedCrossRef
14.
go back to reference Singh AS et al. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008;9(5):474–88.PubMedCrossRef Singh AS et al. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008;9(5):474–88.PubMedCrossRef
15.
go back to reference Gordon‐Larsen P, The NS, Adair LS. Longitudinal trends in obesity in the United States from adolescence to the third decade of life. Obesity. 2010;18(9):1801–4.PubMedCrossRefPubMedCentral Gordon‐Larsen P, The NS, Adair LS. Longitudinal trends in obesity in the United States from adolescence to the third decade of life. Obesity. 2010;18(9):1801–4.PubMedCrossRefPubMedCentral
16.
go back to reference Kelsey MM, et al. Age-related consequences of childhood obesity. Gerontology, 2014;60(3):222–8. Kelsey MM, et al. Age-related consequences of childhood obesity. Gerontology, 2014;60(3):222–8.
17.
go back to reference Juonala M et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med. 2011;365(20):1876–85.PubMedCrossRef Juonala M et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med. 2011;365(20):1876–85.PubMedCrossRef
20.••
go back to reference Goldschmidt AB et al. Indicated prevention of adult obesity: how much weight change is necessary for normalization of weight status in children? JAMA Pediatr. 2013;167(1):21–6. Overweight and obese children aged 8-13 years participating in a family-based behavioral weight control treatment were shown to require relatively small weight changes, or slowing of weight gain, over one year in order to achieve nonoverweight status. Younger children with less severe overweight or obesity in many cases need only to maintain their weight or even slow weight gain to achieve normal weight status over a year. Demonstrates the importance of early intervention and the potential value of small changes.PubMedCrossRefPubMedCentral Goldschmidt AB et al. Indicated prevention of adult obesity: how much weight change is necessary for normalization of weight status in children? JAMA Pediatr. 2013;167(1):21–6. Overweight and obese children aged 8-13 years participating in a family-based behavioral weight control treatment were shown to require relatively small weight changes, or slowing of weight gain, over one year in order to achieve nonoverweight status. Younger children with less severe overweight or obesity in many cases need only to maintain their weight or even slow weight gain to achieve normal weight status over a year. Demonstrates the importance of early intervention and the potential value of small changes.PubMedCrossRefPubMedCentral
21.
go back to reference Reinehr T. Lifestyle intervention in childhood obesity: changes and challenges. Nat Rev Endocrinol. 2013;9(10):607–14.PubMedCrossRef Reinehr T. Lifestyle intervention in childhood obesity: changes and challenges. Nat Rev Endocrinol. 2013;9(10):607–14.PubMedCrossRef
22.•
go back to reference Danielsson P et al. Response of severely obese children and adolescents to behavioral treatment. Arch Pediatr Adolesc Med. 2012;166(12):1103–8. A 3-year longitudinal study examining the impact of degree of obesity and age on the efficacy of a behavioral weight loss treatment. Most importantly, while treatment produced clinically significant weight loss in a large percentage of the youngest severely obese children, severely obese adolescents were much less successful, highlighting the importance of early intervention.PubMedCrossRef Danielsson P et al. Response of severely obese children and adolescents to behavioral treatment. Arch Pediatr Adolesc Med. 2012;166(12):1103–8. A 3-year longitudinal study examining the impact of degree of obesity and age on the efficacy of a behavioral weight loss treatment. Most importantly, while treatment produced clinically significant weight loss in a large percentage of the youngest severely obese children, severely obese adolescents were much less successful, highlighting the importance of early intervention.PubMedCrossRef
23.
go back to reference Wilfley DE, Vannucci A, White EK. Family-based behavioral interventions. In: Pediatric obesity. New York: Springer; 2010. p. 281–301. Wilfley DE, Vannucci A, White EK. Family-based behavioral interventions. In: Pediatric obesity. New York: Springer; 2010. p. 281–301.
24.
go back to reference Paluch RA, Epstein LH, Roemmich JN. Comparisons of methods to evaluate changes in relative body mass index in pediatric weight control. Am J Hum Biol. 2007;19:487–94.PubMedCrossRef Paluch RA, Epstein LH, Roemmich JN. Comparisons of methods to evaluate changes in relative body mass index in pediatric weight control. Am J Hum Biol. 2007;19:487–94.PubMedCrossRef
25.
go back to reference Cole TJ et al. What is the best measure of adiposity change in growing children: BMI, BMI %, BMI z-score, or BMI centile? Eur J Clin Nutr. 2005;59:419–25.PubMedCrossRef Cole TJ et al. What is the best measure of adiposity change in growing children: BMI, BMI %, BMI z-score, or BMI centile? Eur J Clin Nutr. 2005;59:419–25.PubMedCrossRef
26.
go back to reference Gulati AK, Kaplan DW, Daniels SR. Clinical tracking of severely obese children: a new growth chart. Pediatrics. 2012;130(6):1136–40.PubMedCrossRef Gulati AK, Kaplan DW, Daniels SR. Clinical tracking of severely obese children: a new growth chart. Pediatrics. 2012;130(6):1136–40.PubMedCrossRef
27.
go back to reference Wing RR et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481–6.PubMedCrossRefPubMedCentral Wing RR et al. Benefits of modest weight loss in improving cardiovascular risk factors in overweight and obese individuals with type 2 diabetes. Diabetes Care. 2011;34(7):1481–6.PubMedCrossRefPubMedCentral
28.
go back to reference Ford AL et al. What reduction in BMI SDS is required in obese adolescents to improve body composition and cardiometabolic health? Arch Dis Child. 2010;95(4):256–61.PubMedCrossRef Ford AL et al. What reduction in BMI SDS is required in obese adolescents to improve body composition and cardiometabolic health? Arch Dis Child. 2010;95(4):256–61.PubMedCrossRef
29.
go back to reference Kolsgaard ML et al. Reduction in BMI z-score and improvement in cardiometabolic risk factors in obese children and adolescents. The Oslo Adiposity Intervention Study-a hospital/public health nurse combined treatment. BMC Pediatr. 2011;11(1):47.PubMedCrossRefPubMedCentral Kolsgaard ML et al. Reduction in BMI z-score and improvement in cardiometabolic risk factors in obese children and adolescents. The Oslo Adiposity Intervention Study-a hospital/public health nurse combined treatment. BMC Pediatr. 2011;11(1):47.PubMedCrossRefPubMedCentral
30.
go back to reference Plourde G. Preventing and managing pediatric obesity. Recommendations for family physicians. Can Fam Physician. 2006;52(3):322–8.PubMedPubMedCentral Plourde G. Preventing and managing pediatric obesity. Recommendations for family physicians. Can Fam Physician. 2006;52(3):322–8.PubMedPubMedCentral
31.
go back to reference Wilfley DE, Kass AE, Kolko RP. Counseling and behavior change in pediatric obesity. Pediatr Clin N Am. 2011;58(6):1403–24.CrossRef Wilfley DE, Kass AE, Kolko RP. Counseling and behavior change in pediatric obesity. Pediatr Clin N Am. 2011;58(6):1403–24.CrossRef
32.
go back to reference McCallum Z et al. Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. Int J Obes. 2007;31(4):630–6. McCallum Z et al. Outcome data from the LEAP (Live, Eat and Play) trial: a randomized controlled trial of a primary care intervention for childhood overweight/mild obesity. Int J Obes. 2007;31(4):630–6.
33.
35.
go back to reference Vannucci A, Wilfley DE. Behavioral interventions and cardiovascular risk in obese youth: current findings and future directions. Curr Cardiovasc Risk Rep. 2012;6(6):567–78.PubMedCrossRefPubMedCentral Vannucci A, Wilfley DE. Behavioral interventions and cardiovascular risk in obese youth: current findings and future directions. Curr Cardiovasc Risk Rep. 2012;6(6):567–78.PubMedCrossRefPubMedCentral
36.
go back to reference Wilfley DE, Vannucci A, White EK. Family-based behavioral interventions. Pediatr Obes Etiology Pathog Treat. 2010. p. 281. Wilfley DE, Vannucci A, White EK. Family-based behavioral interventions. Pediatr Obes Etiology Pathog Treat. 2010. p. 281.
37.
go back to reference Wilfley DE et al. Lifestyle interventions in the treatment of childhood overweight: a meta-analytic review of randomized controlled trials. Health Psychol. 2007;26(5):521–32.PubMedCrossRefPubMedCentral Wilfley DE et al. Lifestyle interventions in the treatment of childhood overweight: a meta-analytic review of randomized controlled trials. Health Psychol. 2007;26(5):521–32.PubMedCrossRefPubMedCentral
38.
go back to reference Wilfley DE et al. Efficacy of maintenance treatment approaches for childhood overweight: a randomized controlled trial. J Am Med Assoc. 2007;298(14):1661–73.CrossRef Wilfley DE et al. Efficacy of maintenance treatment approaches for childhood overweight: a randomized controlled trial. J Am Med Assoc. 2007;298(14):1661–73.CrossRef
39.
go back to reference McGovern L et al. Treatment of pediatric obesity: a systematic review and meta-analysis of randomized trials. J Clin Endocrinol Metab. 2008;93(12):4600–5.PubMedCrossRef McGovern L et al. Treatment of pediatric obesity: a systematic review and meta-analysis of randomized trials. J Clin Endocrinol Metab. 2008;93(12):4600–5.PubMedCrossRef
40.
go back to reference Snethen JA, Broome ME, Cashin SE. Effective weight loss for overweight children: a meta-analysis of intervention studies. J Pediatr Nurs. 2006;21(1):45–56.PubMedCrossRef Snethen JA, Broome ME, Cashin SE. Effective weight loss for overweight children: a meta-analysis of intervention studies. J Pediatr Nurs. 2006;21(1):45–56.PubMedCrossRef
41.
go back to reference Tsiros MD et al. Treatment of adolescent overweight and obesity. Eur J Pediatr. 2008;167(1):9–16.PubMedCrossRef Tsiros MD et al. Treatment of adolescent overweight and obesity. Eur J Pediatr. 2008;167(1):9–16.PubMedCrossRef
42.
go back to reference Force UPST. Screening for obesity in children and adolescents: US preventive services task force recommendation statement. Pediatrics. 2010;125(2):361–7.CrossRef Force UPST. Screening for obesity in children and adolescents: US preventive services task force recommendation statement. Pediatrics. 2010;125(2):361–7.CrossRef
43.
go back to reference Whitlock EP et al. Effectiveness of weight management interventions in children: a targeted systematic review for the USPSTF. Pediatrics. 2010;125(2):e396–418.PubMedCrossRef Whitlock EP et al. Effectiveness of weight management interventions in children: a targeted systematic review for the USPSTF. Pediatrics. 2010;125(2):e396–418.PubMedCrossRef
44.•
go back to reference Ho M et al. Impact of dietary and exercise interventions on weight change and metabolic outcomes in obese children and adolescents: a systematic review and meta-analysis of randomized trials. JAMA Pediatr. 2013;167(8):759–68. A systematic review and meta-analysis comparing the effects of diet-only or exercise-only interventions with those targeting both diet and exercise among overweight children. All interventions resulted in weight loss and metabolic improvements, and adding exercise to a dietary intervention resulted in more improvements in HDL and fasting insulin and glucose, highlighting efficacy of behavioral intervention for the treatment of pediatric obesity.PubMedCrossRef Ho M et al. Impact of dietary and exercise interventions on weight change and metabolic outcomes in obese children and adolescents: a systematic review and meta-analysis of randomized trials. JAMA Pediatr. 2013;167(8):759–68. A systematic review and meta-analysis comparing the effects of diet-only or exercise-only interventions with those targeting both diet and exercise among overweight children. All interventions resulted in weight loss and metabolic improvements, and adding exercise to a dietary intervention resulted in more improvements in HDL and fasting insulin and glucose, highlighting efficacy of behavioral intervention for the treatment of pediatric obesity.PubMedCrossRef
45.
go back to reference Blüher S et al. The one year exercise and lifestyle intervention program KLAKS: effects on anthropometric parameters, cardiometabolic risk factors and glycemic control in childhood obesity. Metab Clin Exp. 2014;63(3):422–30.PubMedCrossRef Blüher S et al. The one year exercise and lifestyle intervention program KLAKS: effects on anthropometric parameters, cardiometabolic risk factors and glycemic control in childhood obesity. Metab Clin Exp. 2014;63(3):422–30.PubMedCrossRef
46.
go back to reference Savoye M et al. Reversal of early abnormalities in glucose metabolism in obese youth: results of an intensive lifestyle randomized controlled trial. Diabetes Care. 2014;37(2):317–24.PubMedCrossRef Savoye M et al. Reversal of early abnormalities in glucose metabolism in obese youth: results of an intensive lifestyle randomized controlled trial. Diabetes Care. 2014;37(2):317–24.PubMedCrossRef
47.
go back to reference Association AH et al. Dietary recommendations for children and adolescents: a guide for practitioners. Pediatrics. 2006;117(2):544–59.CrossRef Association AH et al. Dietary recommendations for children and adolescents: a guide for practitioners. Pediatrics. 2006;117(2):544–59.CrossRef
48.
go back to reference Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120 Suppl 4:S164–92.PubMedCrossRef Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120 Suppl 4:S164–92.PubMedCrossRef
50.
go back to reference Strong WB et al. Evidence based physical activity for school-age youth. J Pediatr. 2005;146(6):732–7.PubMedCrossRef Strong WB et al. Evidence based physical activity for school-age youth. J Pediatr. 2005;146(6):732–7.PubMedCrossRef
51.
go back to reference Myer GD et al. Exercise deficit disorder in youth: a paradigm shift toward disease prevention and comprehensive care. Curr Sports Med Rep. 2013;12(4):248–55.PubMedCrossRefPubMedCentral Myer GD et al. Exercise deficit disorder in youth: a paradigm shift toward disease prevention and comprehensive care. Curr Sports Med Rep. 2013;12(4):248–55.PubMedCrossRefPubMedCentral
52.
go back to reference Epstein LH et al. Ten-year follow-up of behavioral, family-based treatment for obese children. J Am Med Assoc. 1990;264(19):2519–23.CrossRef Epstein LH et al. Ten-year follow-up of behavioral, family-based treatment for obese children. J Am Med Assoc. 1990;264(19):2519–23.CrossRef
53.
54.
go back to reference Wrotniak BH et al. Parent weight change as a predictor of child weight change in family-based behavioral obesity treatment. Arch Pediatr Adolesc Med. 2004;158(4):342–7.PubMedCrossRef Wrotniak BH et al. Parent weight change as a predictor of child weight change in family-based behavioral obesity treatment. Arch Pediatr Adolesc Med. 2004;158(4):342–7.PubMedCrossRef
55.
go back to reference Epstein LH et al. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol. 1994;13(5):373.PubMedCrossRef Epstein LH et al. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol. 1994;13(5):373.PubMedCrossRef
56.
go back to reference Boutelle KN, Cafri G, Crow SJ. Parent predictors of child weight change in family based behavioral obesity treatment. Obesity (Silver Spring). 2012;20(7):1539–43.CrossRef Boutelle KN, Cafri G, Crow SJ. Parent predictors of child weight change in family based behavioral obesity treatment. Obesity (Silver Spring). 2012;20(7):1539–43.CrossRef
57.
go back to reference Watson PM et al. A whole family approach to childhood obesity management (GOALS): relationship between adult and child BMI change. Ann Hum Biol. 2011;38(4):445–52.PubMedCrossRef Watson PM et al. A whole family approach to childhood obesity management (GOALS): relationship between adult and child BMI change. Ann Hum Biol. 2011;38(4):445–52.PubMedCrossRef
58.
go back to reference Nowicka P, Flodmark CE. Family therapy as a model for treating childhood obesity: useful tools for clinicians. Clin Child Psychol Psychiatry. 2011;16(1):129–45.PubMedCrossRef Nowicka P, Flodmark CE. Family therapy as a model for treating childhood obesity: useful tools for clinicians. Clin Child Psychol Psychiatry. 2011;16(1):129–45.PubMedCrossRef
59.
go back to reference Larson N et al. Home/family, peer, school, and neighborhood correlates of obesity in adolescents. Obesity. 2013;21(9):1858–69.PubMedPubMedCentral Larson N et al. Home/family, peer, school, and neighborhood correlates of obesity in adolescents. Obesity. 2013;21(9):1858–69.PubMedPubMedCentral
60.
go back to reference Young KM et al. A meta-analysis of family-behavioral weight-loss treatments for children. Clin Psychol Rev. 2007;27(2):240–9.PubMedCrossRef Young KM et al. A meta-analysis of family-behavioral weight-loss treatments for children. Clin Psychol Rev. 2007;27(2):240–9.PubMedCrossRef
61.
go back to reference Epstein LH et al. DEcreasing sedentary behaviors in treating pediatric obesity. Arch Pediatr Adolesc Med. 2000;154(3):220–6.PubMedCrossRef Epstein LH et al. DEcreasing sedentary behaviors in treating pediatric obesity. Arch Pediatr Adolesc Med. 2000;154(3):220–6.PubMedCrossRef
62.
go back to reference Wilfley DE et al. The use of biosimulation in the design of a novel multilevel weight loss maintenance program for overweight children. Obesity. 2010;18(S1):S91–8.PubMedCrossRefPubMedCentral Wilfley DE et al. The use of biosimulation in the design of a novel multilevel weight loss maintenance program for overweight children. Obesity. 2010;18(S1):S91–8.PubMedCrossRefPubMedCentral
63.
go back to reference Bouton ME. Context, ambiguity, and unlearning: sources of relapse after behavioral extinction. Biol Psychiatry. 2002;52(10):976–86.PubMedCrossRef Bouton ME. Context, ambiguity, and unlearning: sources of relapse after behavioral extinction. Biol Psychiatry. 2002;52(10):976–86.PubMedCrossRef
64.
go back to reference Bouton ME et al. Contextual and temporal modulation of extinction: behavioral and biological mechanisms. Biol Psychiatry. 2006;60(4):352–60.PubMedCrossRef Bouton ME et al. Contextual and temporal modulation of extinction: behavioral and biological mechanisms. Biol Psychiatry. 2006;60(4):352–60.PubMedCrossRef
65.
go back to reference Kirschenbaum DS. Weight-loss camps in the US and the immersion-to-lifestyle change model. Child Obes (Formerly Obes Weight Manag). 2010;6(6):318–23.CrossRef Kirschenbaum DS. Weight-loss camps in the US and the immersion-to-lifestyle change model. Child Obes (Formerly Obes Weight Manag). 2010;6(6):318–23.CrossRef
66.
go back to reference Kelly K, Kirschenbaum D. Immersion treatment of childhood and adolescent obesity: the first review of a promising intervention. Obes Rev. 2011;12(1):37–49.PubMedCrossRef Kelly K, Kirschenbaum D. Immersion treatment of childhood and adolescent obesity: the first review of a promising intervention. Obes Rev. 2011;12(1):37–49.PubMedCrossRef
67.
go back to reference Kirschenbaum DS, Gierut K. Treatment of childhood and adolescent obesity: an integrative review of recent recommendations from five expert groups. J Consult Clin Psychol. 2013;81(2):347.PubMedCrossRef Kirschenbaum DS, Gierut K. Treatment of childhood and adolescent obesity: an integrative review of recent recommendations from five expert groups. J Consult Clin Psychol. 2013;81(2):347.PubMedCrossRef
68.
go back to reference Kelly AS et al. Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches a scientific statement from the American Heart Association. Circulation. 2013;128(15):1689–712.PubMedCrossRef Kelly AS et al. Severe obesity in children and adolescents: identification, associated health risks, and treatment approaches a scientific statement from the American Heart Association. Circulation. 2013;128(15):1689–712.PubMedCrossRef
70.
go back to reference Sjöström L. Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. Int J Obes. 2008;32:S93–7.CrossRef Sjöström L. Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. Int J Obes. 2008;32:S93–7.CrossRef
71.
go back to reference Inge TH et al. Perioperative outcomes of adolescents undergoing bariatric surgery: the Teen–Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study. JAMA Pediatr. 2014;168(1):47–53.PubMedCrossRef Inge TH et al. Perioperative outcomes of adolescents undergoing bariatric surgery: the Teen–Longitudinal Assessment of Bariatric Surgery (Teen-LABS) study. JAMA Pediatr. 2014;168(1):47–53.PubMedCrossRef
72.
go back to reference Kelleher DC et al. Recent national trends in the use of adolescent inpatient bariatric surgery: 2000 through 2009. JAMA Pediatr. 2013;167(2):126–32.PubMedCrossRef Kelleher DC et al. Recent national trends in the use of adolescent inpatient bariatric surgery: 2000 through 2009. JAMA Pediatr. 2013;167(2):126–32.PubMedCrossRef
73.
go back to reference Inge TH et al. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics. 2004;114(1):217–23.PubMedCrossRef Inge TH et al. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics. 2004;114(1):217–23.PubMedCrossRef
74.•
go back to reference Inge TH et al. Baseline BMI is a strong predictor of nadir BMI after adolescent gastric bypass. J Pediatr. 2010;156(1):103–8. e1. A multisite observational study of severely obese adolescents aged 19 and younger undergoing laparoscopic Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and adjustable gastric banding. A favorable short-term safety profile was observed, with only 8 % of patients experiencing major complications within 30 days after surgery. Further longitudinal analyses will reveal long-term safety and efficacy data and will help determine whether recommendations for bariatric surgery are warranted in this population. Inge TH et al. Baseline BMI is a strong predictor of nadir BMI after adolescent gastric bypass. J Pediatr. 2010;156(1):103–8. e1. A multisite observational study of severely obese adolescents aged 19 and younger undergoing laparoscopic Roux-en-Y gastric bypass, vertical sleeve gastrectomy, and adjustable gastric banding. A favorable short-term safety profile was observed, with only 8 % of patients experiencing major complications within 30 days after surgery. Further longitudinal analyses will reveal long-term safety and efficacy data and will help determine whether recommendations for bariatric surgery are warranted in this population.
75.
go back to reference Olbers T 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 Olbers T 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
76.
go back to reference Oberbach A et al. Bariatric surgery in severely obese adolescents improves major comorbidities including hyperuricemia. Metabolism. 2014;63(2):242–9.PubMedCrossRef Oberbach A et al. Bariatric surgery in severely obese adolescents improves major comorbidities including hyperuricemia. Metabolism. 2014;63(2):242–9.PubMedCrossRef
77.
78.
go back to reference Chanoine J-P et al. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA. 2005;293(23):2873–83.PubMedCrossRef Chanoine J-P et al. Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA. 2005;293(23):2873–83.PubMedCrossRef
79.
go back to reference Maahs D et al. Randomized, double-blind, placebo-controlled trial of orlistat for weight loss in adolescents. Endocr Pract. 2006;12(1):18–28.PubMedCrossRef Maahs D et al. Randomized, double-blind, placebo-controlled trial of orlistat for weight loss in adolescents. Endocr Pract. 2006;12(1):18–28.PubMedCrossRef
80.
go back to reference McDuffie JR et al. Efficacy of orlistat as an adjunct to behavioral treatment in overweight African American and Caucasian adolescents with obesity-related co-morbid conditions. J Pediatr Endocrinol Metab. 2004;17(3):307–20.PubMedCrossRefPubMedCentral McDuffie JR et al. Efficacy of orlistat as an adjunct to behavioral treatment in overweight African American and Caucasian adolescents with obesity-related co-morbid conditions. J Pediatr Endocrinol Metab. 2004;17(3):307–20.PubMedCrossRefPubMedCentral
81.
go back to reference McDuffie JR et al. Three‐month tolerability of Orlistat in adolescents with obesity‐related comorbid conditions. Obes Res. 2002;10(7):642–50.PubMedCrossRef McDuffie JR et al. Three‐month tolerability of Orlistat in adolescents with obesity‐related comorbid conditions. Obes Res. 2002;10(7):642–50.PubMedCrossRef
82.
go back to reference Norgren S et al. Orlistat treatment in obese prepubertal children: a pilot study. Acta Paediatr. 2003;92(6):666–70.PubMedCrossRef Norgren S et al. Orlistat treatment in obese prepubertal children: a pilot study. Acta Paediatr. 2003;92(6):666–70.PubMedCrossRef
83.
go back to reference Ozkan B et al. Addition of orlistat to conventional treatment in adolescents with severe obesity. Eur J Pediatr. 2004;163(12):738–41.PubMedCrossRef Ozkan B et al. Addition of orlistat to conventional treatment in adolescents with severe obesity. Eur J Pediatr. 2004;163(12):738–41.PubMedCrossRef
84.
go back to reference Zhi J, Moore R, Kanitra L. The effect of short-term (21-day) orlistat treatment on the physiologic balance of six selected macrominerals and microminerals in obese adolescents. J Am Coll Nutr. 2003;22(5):357–62.PubMedCrossRef Zhi J, Moore R, Kanitra L. The effect of short-term (21-day) orlistat treatment on the physiologic balance of six selected macrominerals and microminerals in obese adolescents. J Am Coll Nutr. 2003;22(5):357–62.PubMedCrossRef
85.
go back to reference Godoy-Matos A et al. Treatment of obese adolescents with sibutramine: a randomized, double-blind, controlled study. J Clin Endocrinol Metab. 2005;90(3):1460–5.PubMedCrossRef Godoy-Matos A et al. Treatment of obese adolescents with sibutramine: a randomized, double-blind, controlled study. J Clin Endocrinol Metab. 2005;90(3):1460–5.PubMedCrossRef
86.
go back to reference Berkowitz RI et al. Behavior therapy and sibutramine for the treatment of adolescent obesity: a randomized controlled trial. JAMA. 2003;289(14):1805–12.PubMedCrossRef Berkowitz RI et al. Behavior therapy and sibutramine for the treatment of adolescent obesity: a randomized controlled trial. JAMA. 2003;289(14):1805–12.PubMedCrossRef
87.
go back to reference Kavey R-EW. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolscents: summary report. Amer Acad Pediatrics. 2011. Kavey R-EW. Expert panel on integrated guidelines for cardiovascular health and risk reduction in children and adolscents: summary report. Amer Acad Pediatrics. 2011.
88.
go back to reference Simpson LA, Cooper J. Paying for obesity: a changing landscape. Pediatrics. 2009;123(Supplement 5):S301–7.PubMedCrossRef Simpson LA, Cooper J. Paying for obesity: a changing landscape. Pediatrics. 2009;123(Supplement 5):S301–7.PubMedCrossRef
89.
go back to reference Koh HK, Sebelius KG. Promoting prevention through the affordable care act. N Engl J Med. 2010;363(14):1296–9.PubMedCrossRef Koh HK, Sebelius KG. Promoting prevention through the affordable care act. N Engl J Med. 2010;363(14):1296–9.PubMedCrossRef
90.
go back to reference McHugh RK, Barlow DH. The dissemination and implementation of evidence-based psychological treatments: a review of current efforts. Am Psychol. 2010;65(2):73.PubMedCrossRef McHugh RK, Barlow DH. The dissemination and implementation of evidence-based psychological treatments: a review of current efforts. Am Psychol. 2010;65(2):73.PubMedCrossRef
91.
92.
go back to reference Tanofsky-Kraff M et al. Eating-disordered behaviors, body fat, and psychopathology in overweight and normal-weight children. J Consult Clin Psychol. 2004;72(1):53–61.PubMedCrossRefPubMedCentral Tanofsky-Kraff M et al. Eating-disordered behaviors, body fat, and psychopathology in overweight and normal-weight children. J Consult Clin Psychol. 2004;72(1):53–61.PubMedCrossRefPubMedCentral
93.
go back to reference Tanofsky‐Kraff M et al. A prospective study of loss of control eating for body weight gain in children at high risk for adult obesity. Int J Eat Disord. 2009;42(1):26–30.PubMedCrossRefPubMedCentral Tanofsky‐Kraff M et al. A prospective study of loss of control eating for body weight gain in children at high risk for adult obesity. Int J Eat Disord. 2009;42(1):26–30.PubMedCrossRefPubMedCentral
94.
go back to reference Braet C. Patient characteristics as predictors of weight loss after an obesity treatment for children. Obesity. 2006;14(1):148–55.PubMedCrossRef Braet C. Patient characteristics as predictors of weight loss after an obesity treatment for children. Obesity. 2006;14(1):148–55.PubMedCrossRef
95.
go back to reference Wildes JE et al. Self-reported binge eating in severe pediatric obesity: impact on weight change in a randomized controlled trial of family-based treatment. Int J Obes. 2010;34(7):1143–8.CrossRef Wildes JE et al. Self-reported binge eating in severe pediatric obesity: impact on weight change in a randomized controlled trial of family-based treatment. Int J Obes. 2010;34(7):1143–8.CrossRef
96.
97.
go back to reference Luppino FS et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67(3):220–9.PubMedCrossRef Luppino FS et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67(3):220–9.PubMedCrossRef
98.
go back to reference Merikangas AK et al. The association between major depressive disorder and obesity in US adolescents: results from the 2001–2004 National Health and Nutrition Examination Survey. J Behav Med. 2012;35(2):149–54.PubMedCrossRefPubMedCentral Merikangas AK et al. The association between major depressive disorder and obesity in US adolescents: results from the 2001–2004 National Health and Nutrition Examination Survey. J Behav Med. 2012;35(2):149–54.PubMedCrossRefPubMedCentral
99.
go back to reference Nederkoorn C et al. Why obese children cannot resist food: the role of impulsivity. Eat Behav. 2006;7(4):315–22.PubMedCrossRef Nederkoorn C et al. Why obese children cannot resist food: the role of impulsivity. Eat Behav. 2006;7(4):315–22.PubMedCrossRef
101.
go back to reference Goodman E, Whitaker RC. A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics. 2002;110(3):497–504.PubMedCrossRef Goodman E, Whitaker RC. A prospective study of the role of depression in the development and persistence of adolescent obesity. Pediatrics. 2002;110(3):497–504.PubMedCrossRef
102.
go back to reference Nederkoorn C et al. Impulsivity predicts treatment outcome in obese children. Behav Res Ther. 2007;45(5):1071–5.PubMedCrossRef Nederkoorn C et al. Impulsivity predicts treatment outcome in obese children. Behav Res Ther. 2007;45(5):1071–5.PubMedCrossRef
103.
go back to reference Story MT et al. Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics. 2002;110(Supplement 1):210–4.PubMed Story MT et al. Management of child and adolescent obesity: attitudes, barriers, skills, and training needs among health care professionals. Pediatrics. 2002;110(Supplement 1):210–4.PubMed
104.
go back to reference Huang J et al. The health and obesity: prevention and education (HOPE) curriculum project—curriculum development. Pediatrics. 2009;124(5):1438–46.PubMedCrossRef Huang J et al. The health and obesity: prevention and education (HOPE) curriculum project—curriculum development. Pediatrics. 2009;124(5):1438–46.PubMedCrossRef
105.
go back to reference Rasmussen KM, Yaktine AL. Committee to reexamine IOM pregnancy weight guidelines. Food and Nutrition Board, Board on Children, Youth and Families, Institute of Medicine, National Research Council: Weight Gain During Pregnancy: Reexamining the Guidelines. Washington DC: The National Academies Press; 2009. Rasmussen KM, Yaktine AL. Committee to reexamine IOM pregnancy weight guidelines. Food and Nutrition Board, Board on Children, Youth and Families, Institute of Medicine, National Research Council: Weight Gain During Pregnancy: Reexamining the Guidelines. Washington DC: The National Academies Press; 2009.
106.
107.
go back to reference Weng SF et al. Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy. Arch Dis Child. 2012;97(12):1019–26.PubMedCrossRefPubMedCentral Weng SF et al. Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy. Arch Dis Child. 2012;97(12):1019–26.PubMedCrossRefPubMedCentral
108.
go back to reference Harvey‐Berino J, Rourke J. Obesity prevention in preschool native-American children: a pilot study using home visiting. Obes Res. 2003;11(5):606–11.PubMedCrossRef Harvey‐Berino J, Rourke J. Obesity prevention in preschool native-American children: a pilot study using home visiting. Obes Res. 2003;11(5):606–11.PubMedCrossRef
109.
go back to reference Skouteris H et al. Preventing excessive gestational weight gain: a systematic review of interventions. Obes Rev. 2010;11(11):757–68.PubMedCrossRef Skouteris H et al. Preventing excessive gestational weight gain: a systematic review of interventions. Obes Rev. 2010;11(11):757–68.PubMedCrossRef
Metadata
Title
Current Approaches to the Management of Pediatric Overweight and Obesity
Authors
Jackson H. Coppock, PhD
Danielle R. Ridolfi, PhD
Jacqueline F. Hayes, BS
Michelle St. Paul, BS
Denise E. Wilfley, PhD
Publication date
01-11-2014
Publisher
Springer US
Published in
Current Treatment Options in Cardiovascular Medicine / Issue 11/2014
Print ISSN: 1092-8464
Electronic ISSN: 1534-3189
DOI
https://doi.org/10.1007/s11936-014-0343-0

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