麻豆果冻传媒影音

There has been a lack of clear, consensus-based guidelines for treatment of children with obesity, noted a new (CPS) from the Obesity Medicine Association.

"These children can have a significant disease burden that will predictably progress as they age," wrote Suzanne E. Cuda, MD, MFOMA, medical director of Alamo City Healthy Kids and Families in San Antonio, Texas, and co-authors. "More studies are needed to help limit the progression of disease, but studies we have now show promising results, including safe and efficacious use of anti-obesity medications."

"These youngest of our patients with obesity have a great deal to gain from intervention as soon as possible," the team continued. "Preventing the progression of obesity will provide benefits to both their psychosocial and medical health. This is the primary mission for those of us dedicated to the health of our children."

The statement defines overweight in children as a body mass index (BMI) at or above the 85th and below the 95th percentile, obesity as a BMI at or above the 95th percentile, and severe obesity as a BMI of 120% of the 95th percentile.

The CPS reviews current treatment trends and new research and is designed to serve as a roadmap to improving the health of the growing number of affected children – especially those with metabolic, physiological, and psychological complications and/or special healthcare needs. According to approximately 20% of U.S. children have obesity, and obesity prevalence for the years 2017-2020 was 12.7% among 2 to 5 year olds and 20.7% among 6 to 11 year olds.

Cuda elaborated on the statement in the following interview.

In years past, the lovable "chubby" child was accepted as a normal example of the varied body types of children, and "puppy fat" was a phase kids would grow out of. How has the thinking changed?

Cuda: These kinds of depictions are hopefully a thing of the past. Over the last decade, the prevalence of childhood obesity has increased, especially severe obesity. In addition, research shows that children with obesity are at high risk to become adolescents, and then adults, with obesity. The greater the obesity in the child, the higher the later risk.

What are the worst immediate and future sequelae of overweight and obesity in growing children?

Cuda: There are several complications of being a growing child with overweight or obesity, and it's difficult to identify "the worst." However, many children under age 5 with obesity have medical complications, including, for example, dyslipidemia, metabolic-associated fatty liver disease, obstructive sleep apnea, and glucose dysregulation.

These children are also more likely to develop precocious puberty, with its attendant social and psychological problems, and this is discussed in the CPS. Affected children also suffer from teasing, bullying, and reduced performance expectations. In short, the consequences could fill a book!

What does the CPS aim to do?

Cuda: We hope it will provide clinicians with a summary of the existing data so they can make their own decisions when managing children with obesity. I am always available for direct consultation and can be reached via .

Treatment of these deserving children can have a huge positive impact on their health. I hope physicians come away with the same sense of hope for the future that we have and the joy we have in caring for children with obesity.

Is enough emphasis placed in medical schools on childhood obesity?

Cuda: Very little emphasis is placed in medical training on childhood obesity – or obesity in adults for that matter. The Obesity Medical Association has been working on this problem.

What does the near future look like?

Cuda: For now, the early identification and management of children with obesity are critical. Lifestyle intervention has been the cornerstone of treatment, but many studies show it leads to only a small change in weight status, and the intensity needed to achieve this small gain is difficult to provide clinically. Use of anti-obesity medication in the child younger than 12 is growing, with data supporting its efficacy and safety. Research is ongoing for new therapeutic options.

In addition, it's clear that children with obesity and special healthcare needs need multidisciplinary management, and they have a right to the same treatment as their counterparts without special healthcare needs.

Read the Clinical Practice Statement here and expert commentary about it here.