Management of Severe Obesity in Children and Adolescents

Chung, Sochung

Abstract

The global epidemic of obesity is an important public health issue, as many serious health problems are associated with severe obesity. It is well known that overweight children and adolescents very often become obese adults. In children and adolescents, obesity is defined as a body mass index (BMI) for age greater than the 95th percentile of a reference population. The criteria of severe obesity (BMI for age greater than the 99th percentile, above 120% of the 95th percentile or above 35 kg/m2) was proposed, however it is not clarified. In this obesogenic environment, the prevalence of severe obesity is increasing at a much faster rate. Medications for childhood obesity and surgical procedures like gastric bypass and gastric banding were introduced as an effective option for the treatment of extremely obese adolescents. However, the basic solution is prevention, even though it is difficult. More efforts are needed to teach pediatricians and other providers how to more effectively initiate behavior change in children and their families, ensuring healthy behavior including eating and physical activity before weight gain occur. Weight gain can occur very early in life, and thus parental teaching and a family approach is necessary. The government should be working together with health providers, industry, and communities to initiate public health approaches.