Evaluation and Treatment of Pediatric Obesity

2018 ◽  
Author(s):  
Nirav K Desai ◽  
Samir Softic
Keyword(s):  
Bariatric Surgery ◽  
Pediatric Obesity ◽  
Fatty Liver Disease ◽  
Weight Loss Surgery ◽  
Psychosocial Issues ◽  
Nonalcoholic Fatty Liver ◽  
Definition Of ◽  
Significant Health ◽  
Age And Sex

Obesity is one of the most significant health problems facing children and adolescents. The definition of overweight in children is a body mass index between the 85th and less than 95th percentile, whereas obesity is greater than or equal to the 95th percentile for age and sex. There are multiple comorbidities associated with obesity, including dyslipidemia, hypertension, type 2 diabetes, sleep apnea, and nonalcoholic fatty liver disease, as well as psychosocial issues.  This review contains 3 figures, 4 tables and 63 references. Key Words bariatric surgery, metabolic syndrome, obesity treatment, pediatric obesity, weight loss surgery

Evaluation and Treatment of Pediatric Obesity

2018 ◽  
Author(s):  
Nirav K Desai ◽  
Samir Softic
Keyword(s):  
Bariatric Surgery ◽  
Pediatric Obesity ◽  
Fatty Liver Disease ◽  
Weight Loss Surgery ◽  
Psychosocial Issues ◽  
Nonalcoholic Fatty Liver ◽  
Definition Of ◽  
Significant Health ◽  
Age And Sex

Obesity is one of the most significant health problems facing children and adolescents. The definition of overweight in children is a body mass index between the 85th and less than 95th percentile, whereas obesity is greater than or equal to the 95th percentile for age and sex. There are multiple comorbidities associated with obesity, including dyslipidemia, hypertension, type 2 diabetes, sleep apnea, and nonalcoholic fatty liver disease, as well as psychosocial issues.  This review contains 3 figures, 4 tables and 63 references. Key Words bariatric surgery, metabolic syndrome, obesity treatment, pediatric obesity, weight loss surgery

Evaluation and Treatment of Pediatric Obesity

2018 ◽  
Author(s):  
Nirav K Desai ◽  
Samir Softic
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Environmental Factors ◽  
Fast Food ◽  
Pediatric Obesity ◽  
Behavioral Interventions ◽  
Weight Loss Surgery ◽  
Pediatric Population ◽  
Nonalcoholic Fatty Liver ◽  
Sweetened Beverages

Obesity is one of the most significant health problems facing children and adolescents. The definition of overweight in children is a body mass index between the 85th and less than 95th percentile, whereas obesity is greater than or equal to the 95th percentile for age and sex. There are multiple comorbidities associated with obesity, including dyslipidemia, hypertension, type 2 diabetes, sleep apnea, and nonalcoholic fatty liver disease, as well as psychosocial issues. Contributors to obesity are multifactorial, including genetic and environmental factors. Environmental factors associated with obesity include increased availability of inexpensive fast food, sugar-sweetened beverages, and high-fat and -sugar convenience foods; decreased exercise; and increased screen time. Treatment begins with behavioral interventions focusing on dietary modifications and increasing physical activity. Although medications to treat obesity are an area of increased interest, options in the pediatric population are limited. Currently, orlistat is the only FDA-approved option. For the treatment of severe obesity, bariatric surgery should be considered, based on age, weight, and associated comorbidities. Weight loss associated with surgery is robust and long-lasting and results in improvement in/resolution of multiple comorbidities. However, benefits should also be weighed against the long-term risks of vitamin deficiency. This review contains 73 references, 3 figures, and 3 tables. Key words: bariatric surgery, metabolic syndrome, obesity treatment, pediatric obesity, weight loss surgery

scholarly journals Multidisciplinary Pharmacotherapeutic Options for Nonalcoholic Fatty Liver Disease

2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Kei Nakajima
Keyword(s):  
Type 2 Diabetes ◽  
Metabolic Syndrome ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Lipid Lowering ◽  
Nonalcoholic Fatty Liver ◽  
Ras Blockers

Nonalcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are multidisciplinary liver diseases that often accompany type 2 diabetes or metabolic syndrome, which are characterized by insulin resistance. Therefore, effective treatment of type 2 diabetes and metabolic syndrome should target not only the cardiometabolic abnormalities, but also the associated liver disorders. In the last decade, it has been shown that metformin, thiazolidinediones, vitamin E, ezetimibe, n-3 polyunsaturated fatty acids, renin-angiotensin system (RAS) blockers, and antiobesity drugs may improve hepatic pathophysiological disorders as well as clinical parameters. Accordingly, insulin sensitizers, antioxidative agents, Niemann-Pick C1-like 1 (NPC1L1) inhibitors, RAS blockers, and drugs that target the central nervous system may represent candidate pharmacotherapies for NAFLD and possibly NASH. However, the efficacy, safety, and tolerability of long-term treatment (potentially for many years) with these drugs have not been fully established. Furthermore, clinical trials have not comprehensively examined the efficacy of lipid-lowering drugs (i.e., statins, fibrates, and NPC1L1 inhibitors) for the treatment of NAFLD. Although clinical evidence for RAS blockers and incretin-based agents (GLP-1 analogs and dipeptidyl peptidase-4 inhibitors) is also lacking, these agents are promising in terms of their insulin-sensitizing and anti-inflammatory effects without causing weight gain.

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