Skip to main content
Top
Published in: Pediatric Drugs 6/2001

01-06-2001 | Leading Article

Pharmacological Treatment of Obesity in Paediatric Patients

Author: Dr Stephen R. Daniels

Published in: Pediatric Drugs | Issue 6/2001

Login to get access

Abstract

The prevalence and severity of obesity appear to be increasing in the paediatric population. This has resulted in an increasing trend in outcomes related to obesity, such as type 2 diabetes mellitus.
The current clinical approach to management of obesity in paediatric patients is behavioural therapy directed at changing diet and physical activity. While there are no pharmacological agents currently approved for the treatment of paediatric obesity, there is hope that agents approved for use in adults will prove useful in adolescents and children. Therapeutic trials are currently under way to evaluate some agents, e.g. orlistat and sibutramine.
Controlled clinical trials are necessary to evaluate drugs for weight management in children and adolescents. It should not be assumed that the risks and benefits associated with these drugs are the same for children as for adults. It is also possible that as the understanding of the science of obesity advances, new agents will be developed which will have appropriate benefits and risks for use in children.
Literature
1.
go back to reference Dietz WH: Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101: 518–25 Dietz WH: Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998; 101: 518–25
2.
go back to reference Ogden CL, Troiano RP, Briefel RR, et al. Prevalence of overweight among preschool children in the United States, 1971 through 1994. Pediatrics 1997; 99: E1PubMedCrossRef Ogden CL, Troiano RP, Briefel RR, et al. Prevalence of overweight among preschool children in the United States, 1971 through 1994. Pediatrics 1997; 99: E1PubMedCrossRef
3.
go back to reference Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology and demographics. Pediatrics 1998; 191: 497–504 Troiano RP, Flegal KM. Overweight children and adolescents: description, epidemiology and demographics. Pediatrics 1998; 191: 497–504
4.
go back to reference Morrison JA, James FW, Sprecher DL, et al. Sex and race differences in cardiovascular risk factor changes in school children 1975–1990: the Princeton School Study. Am J Public Health 1999; 89: 1708–14PubMedCrossRef Morrison JA, James FW, Sprecher DL, et al. Sex and race differences in cardiovascular risk factor changes in school children 1975–1990: the Princeton School Study. Am J Public Health 1999; 89: 1708–14PubMedCrossRef
5.
go back to reference Pinhas-Hamiel O, Dolan LM, Daniels SR, et al. Increased incidence of non-insulin dependent diabetes mellitus among children and adolescents. J Pediatr 1996; 128: 608–15PubMedCrossRef Pinhas-Hamiel O, Dolan LM, Daniels SR, et al. Increased incidence of non-insulin dependent diabetes mellitus among children and adolescents. J Pediatr 1996; 128: 608–15PubMedCrossRef
6.
go back to reference Luepker RV, Jacobs DR, Prineas RJ, et al. Secular trends of blood pressure and body size in a multi-ethnic adolescent population: 1986 to 1996. J Pediatr 1999; 134: 668–74PubMedCrossRef Luepker RV, Jacobs DR, Prineas RJ, et al. Secular trends of blood pressure and body size in a multi-ethnic adolescent population: 1986 to 1996. J Pediatr 1999; 134: 668–74PubMedCrossRef
7.
go back to reference Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation 1998; 21: 2099–100CrossRef Eckel RH, Krauss RM. American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. Circulation 1998; 21: 2099–100CrossRef
8.
go back to reference Epstein LH, Valoski A, Wing RR, et al. Ten-year follow-up of behavioral family-based treatment for obese children. JAMA 1990; 264: 2519–23PubMedCrossRef Epstein LH, Valoski A, Wing RR, et al. Ten-year follow-up of behavioral family-based treatment for obese children. JAMA 1990; 264: 2519–23PubMedCrossRef
9.
go back to reference Epstein LH, Myers MD, Raynor HA, et al. Treatment of pediatric obesity. Pediatrics 1998; 101: 554–70PubMed Epstein LH, Myers MD, Raynor HA, et al. Treatment of pediatric obesity. Pediatrics 1998; 101: 554–70PubMed
10.
go back to reference Tershakovec AM, Watson MH, Wenner Jr WJ, et al. Insurance reimbursement for the treatment of obesity in children. J Pediatr 1999; 134: 573–8PubMedCrossRef Tershakovec AM, Watson MH, Wenner Jr WJ, et al. Insurance reimbursement for the treatment of obesity in children. J Pediatr 1999; 134: 573–8PubMedCrossRef
11.
go back to reference National task force on the prevention and treatment of obesity. Very low-calorie diets. JAMA 1993; 170: 967–74 National task force on the prevention and treatment of obesity. Very low-calorie diets. JAMA 1993; 170: 967–74
12.
14.
go back to reference Abenhaim L, Moride Y, Brenot F, et al. Appetite-suppressant drugs and the risk of primary pulmonary hypertension. International Primary Pulmonary Hypertension Study Group. N Engl J Med 1996; 335: 609–16PubMedCrossRef Abenhaim L, Moride Y, Brenot F, et al. Appetite-suppressant drugs and the risk of primary pulmonary hypertension. International Primary Pulmonary Hypertension Study Group. N Engl J Med 1996; 335: 609–16PubMedCrossRef
15.
go back to reference Bray GA. Efficacy and safety of pharmacologic interventions for the overweight patient. In: Fletcher GF, Grundy SM, Hayman LL, editors. Obesity: impact on cardiovascular disease. Armonk (NY): Futura Publishing Co., Inc., 1999: 295–315 Bray GA. Efficacy and safety of pharmacologic interventions for the overweight patient. In: Fletcher GF, Grundy SM, Hayman LL, editors. Obesity: impact on cardiovascular disease. Armonk (NY): Futura Publishing Co., Inc., 1999: 295–315
16.
go back to reference Roccella EJ, Anderson DE. Update on the task force report (1987) on high blood pressure in children and adolescents: a working group report from the national high blood pressure education program. Pediatrics 1996; 98: 649–58 Roccella EJ, Anderson DE. Update on the task force report (1987) on high blood pressure in children and adolescents: a working group report from the national high blood pressure education program. Pediatrics 1996; 98: 649–58
17.
go back to reference American Academy of Pediatrics. National cholesterol education program: report of the expert panel on blood cholesterol levels in children and adolescents. Pediatrics 1992; 89 (3 Pt 2): 525–84 American Academy of Pediatrics. National cholesterol education program: report of the expert panel on blood cholesterol levels in children and adolescents. Pediatrics 1992; 89 (3 Pt 2): 525–84
18.
19.
go back to reference Tuominen S, Hietola M, Kuusankoski M. Double-blind trial comparing fenfluramine, phentermine and dietary advice on treatment of obesity [abstract]. Int J Obes 1980; 14Suppl. 2: 138 Tuominen S, Hietola M, Kuusankoski M. Double-blind trial comparing fenfluramine, phentermine and dietary advice on treatment of obesity [abstract]. Int J Obes 1980; 14Suppl. 2: 138
20.
go back to reference Campbell C, Bhalla IP, Steel JM, et al. A controlled trial of phentermine in obese patients. Practitioner 1977; 218: 851–5PubMed Campbell C, Bhalla IP, Steel JM, et al. A controlled trial of phentermine in obese patients. Practitioner 1977; 218: 851–5PubMed
21.
go back to reference Allen GS. A double blind trial of diethylpropion hydrochloride, mazindol and placebo in the treatment of erogenous obesity. Curr Ther Res 1977; 22: 678–83 Allen GS. A double blind trial of diethylpropion hydrochloride, mazindol and placebo in the treatment of erogenous obesity. Curr Ther Res 1977; 22: 678–83
22.
go back to reference Sullivan AC, Comai K. Pharmacological treatment of obesity. Int J Obes 1979; 2: 167–89 Sullivan AC, Comai K. Pharmacological treatment of obesity. Int J Obes 1979; 2: 167–89
23.
go back to reference Bacon GE, Lowrey GH. A clinical trial of fenfluramine in obese children. Curr Ther Res Clin Exp 1967; 9: 626–30PubMed Bacon GE, Lowrey GH. A clinical trial of fenfluramine in obese children. Curr Ther Res Clin Exp 1967; 9: 626–30PubMed
24.
go back to reference Grugni G, Guzzaloni G, Moro D, et al. Study of the effects of d-fenfluramine on juvenile obesity [abstract]. Int J Obes Relat Metab Disord 1993; 17Suppl. 2: 71 Grugni G, Guzzaloni G, Moro D, et al. Study of the effects of d-fenfluramine on juvenile obesity [abstract]. Int J Obes Relat Metab Disord 1993; 17Suppl. 2: 71
25.
go back to reference Bray GA, Ryan DH, Gordon D, et al. A double-blind randomized placebo-controlled trial of sibutramine. Obes Res 1996; 4: 263–70PubMedCrossRef Bray GA, Ryan DH, Gordon D, et al. A double-blind randomized placebo-controlled trial of sibutramine. Obes Res 1996; 4: 263–70PubMedCrossRef
26.
go back to reference Weiser M, Frishman WH, Michaelson D, et al. The pharmacologic approach to the treatment of obesity. J Clin Pharmacol 1997; 37: 453–73PubMed Weiser M, Frishman WH, Michaelson D, et al. The pharmacologic approach to the treatment of obesity. J Clin Pharmacol 1997; 37: 453–73PubMed
27.
go back to reference Sjostrom L, Rissanen A, Andersen T, et al. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Lancet 1998; 352: 167–72PubMedCrossRef Sjostrom L, Rissanen A, Andersen T, et al. Randomised placebo-controlled trial of orlistat for weight loss and prevention of weight regain in obese patients. European Multicentre Orlistat Study Group. Lancet 1998; 352: 167–72PubMedCrossRef
28.
go back to reference Drent ML, Larsson I, William-Olsson T, et al. Orlistat (RO 18-0647), a lipase inhibitor in the treatment of human obesity: a multiple dose study. Int J Obes 1995; 19: 221–6 Drent ML, Larsson I, William-Olsson T, et al. Orlistat (RO 18-0647), a lipase inhibitor in the treatment of human obesity: a multiple dose study. Int J Obes 1995; 19: 221–6
29.
go back to reference Tonstad S, Pometta D, Erkelens DW, et al. The effect of the gastrointestinal lipase inhibitor, Orlistat, on serum lipids and lipoproteins in patients with primary hyperlipidaemia. Eur J Clin Pharmacol 1994; 46: 405–10PubMedCrossRef Tonstad S, Pometta D, Erkelens DW, et al. The effect of the gastrointestinal lipase inhibitor, Orlistat, on serum lipids and lipoproteins in patients with primary hyperlipidaemia. Eur J Clin Pharmacol 1994; 46: 405–10PubMedCrossRef
30.
go back to reference Connoley JP, Heal DJ. The thermogenic effects of sibutramine [abstract no. 52]. Proceedings of Pharmacologic Treatment of Obesity: Satellite Symposium of the Seventh International Congress on Obesity; 1994 Aug; Toronto. Connoley JP, Heal DJ. The thermogenic effects of sibutramine [abstract no. 52]. Proceedings of Pharmacologic Treatment of Obesity: Satellite Symposium of the Seventh International Congress on Obesity; 1994 Aug; Toronto.
31.
go back to reference Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000; 343: 1886–7CrossRef Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med 2000; 343: 1886–7CrossRef
32.
go back to reference Barlow SE, Dietz WH. Obesity evaluation and treatment: expert committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration, and the Department of Health and Human Services. Pediatrics 1998; 102: E29PubMedCrossRef Barlow SE, Dietz WH. Obesity evaluation and treatment: expert committee recommendations. The Maternal and Child Health Bureau, Health Resources and Services Administration, and the Department of Health and Human Services. Pediatrics 1998; 102: E29PubMedCrossRef
33.
go back to reference Rosner B, Prineas R, Loggie J, et al. Percentiles for body mass index in U.S. children age 5–17 years of age. J Pediatr 1998; 132: 211–22PubMedCrossRef Rosner B, Prineas R, Loggie J, et al. Percentiles for body mass index in U.S. children age 5–17 years of age. J Pediatr 1998; 132: 211–22PubMedCrossRef
Metadata
Title
Pharmacological Treatment of Obesity in Paediatric Patients
Author
Dr Stephen R. Daniels
Publication date
01-06-2001
Publisher
Springer International Publishing
Published in
Pediatric Drugs / Issue 6/2001
Print ISSN: 1174-5878
Electronic ISSN: 1179-2019
DOI
https://doi.org/10.2165/00128072-200103060-00001

Other articles of this Issue 6/2001

Pediatric Drugs 6/2001 Go to the issue

Adis Drug Evaluation

Ondansetron

Adis New Drug Profile

Rasburicase

Adis New Drug Profile

Rasburicase

Adis New Drug Profile

Rasburicase