J Korean Med Assoc.  2021 Jun;64(6):416-424. 10.5124/jkma.2021.64.6.416.

Management of severe pediatric obesity

Affiliations
  • 1Department of Pediatrics, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
  • 2Department of Pediatrics, Korea University College of Medicine, Seoul, Korea

Abstract

Background
Pediatric obesity has increased over the decades, and in particular, severe pediatric obesity has become a serious public health problem. A concern has arisen that the COVID-19 pandemic may exacerbate the incidence of childhood obesity.
Current Concepts
The consequences of severe pediatric obesity are more devastating than those of moderate obesity. Children with severe obesity are at a greater risk for hypertension, type 2 diabetes, metabolic syndrome, non-alcoholic fatty liver disease, atherosclerosis, and adult obesity. Correct assessment and diagnosis of a child with severe obesity is key to successful therapy. A thorough history and physical examination are important in identifying monogenic obesity or metabolic syndrome. Eating behaviors and psychosocial factors should be assessed to improve weight management outcomes. Treatment options for severe pediatric obesity include lifestyle modification, pharmacotherapy, and metabolic and bariatric surgery. Even though progress has been made with regard to the treatment of obesity, safe and effective treatment of severe pediatric obesity is challenging.
Discussion and Conclusion
More efforts and innovations are needed to find a solution for the huge medical and emotional burden the children with severe obesity and their families are enduring.

Keyword

Pediatric obesity; Morbid obesity; Disease management: Anti-obesity agents; 소아비만; 고도비만; 비만관리; 비만치료제
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