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

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

Weight loss surgery

2015 ◽  
Vol 97 (1) ◽  
pp. 45-45
Author(s):  
Jo Revill
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Weight Loss Surgery ◽  
Love Affair

How our ongoing love affair with fad diet stories shapes the debate around bariatric surgery.

Trends in pediatric obesity management, a survey from the Pediatric Endocrine Society Obesity Committee

2020 ◽  
Vol 33 (4) ◽  
pp. 469-472 ◽  
Author(s):  
Ashley H. Shoemaker ◽  
Stephanie T. Chung ◽  
Amy Fleischman ◽  
_ _
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Pediatric Obesity ◽  
Online Survey ◽  
Treatment Options ◽  
The United States ◽  
Pediatric Endocrinology ◽  
Lifestyle Modifications ◽  
Endocrine Society ◽  
Weight Loss Medications

AbstractBackgroundIn the United States, 18.5% of children are obese. Dietary and lifestyle modifications are key, but often ineffective. There are limited approved pediatric pharmacotherapies. The objective of this study was to evaluate current treatment practices for pediatric obesity among members of the Pediatric Endocrine Society (PES, n = 1300) and the Pediatric Obesity Weight Evaluation Registry (POWER, n = 42) consortium.MethodsA 10-question online survey on treatment of children with obesity in clinical practice was conducted.ResultsThe response rates were 19% for PES and 20% for POWER members. The majority were female (65%) and board certified in pediatric endocrinology (81%). Most practitioners saw 5–10 patients with obesity/week and 19% prescribed weight-loss medications. POWER participants were more likely to prescribe weight-loss medications than PES participants (46% vs. 18%, p =  0.02). Metformin was the most commonly prescribed medication. Response to medication was poor. Use of dietary non-pharmacological treatment options was uncommon. Over half of the respondents (56%) referred patients for bariatric surgery and 53% had local access to pediatric bariatric surgery.ConclusionsMetformin was the most common drug prescribed among respondents, but successful weight-loss responses were uncommon. Among practitioners who are using pharmacological interventions, therapeutic strategies vary widely. Targeted research in pharmacologic and surgical treatment for pediatric obesity is urgently needed.

scholarly journals Readability of online patient-based information on bariatric surgery

2019 ◽  
Vol 9 (2) ◽  
pp. 156-160 ◽  
Author(s):  
Zoë Meleo-Erwin ◽  
Corey Basch ◽  
Joseph Fera ◽  
Danna Ethan ◽  
Philip Garcia
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Patient Education ◽  
Weight Loss Surgery ◽  
The Internet ◽  
Reading Levels ◽  
Web Based ◽  
Readability Score ◽  
Education Literature ◽  
Patient Comprehension

Background: Web-based patient education literature has been shown to be written at reading levels far above what is recommended. Little is known about the overall readability of current internet-based bariatric surgery information. The purpose of this study was to assess the readability of current bariatric material on the internet. Methods: The term "weight loss surgery" was searched using the Chrome browser on the first 15pages of URLs that appeared with content written in English. Using five readability measures, scores were generated using Readable.io for written content on a sample of 96 websites. Scores were sorted into the readability categories of "easy," "average," and "difficult." Results: Almost 93% of websites, both .com and .org, sampled received an unacceptable readability score on each assessment. Conclusion: Accurate and appropriate information about bariatric procedures is critical for patient comprehension and adherence to recommended protocols.

Support Groups and Behavioral Science

2018 ◽  
Author(s):  
Christina M. Rummell
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Substance Use ◽  
Behavioral Health ◽  
Support Groups ◽  
Behavioral Science ◽  
Weight Loss Surgery ◽  
Process Research ◽  
Health Interventions ◽  
Severely Obese

While a psychological evaluation is often a required part of a weight-loss surgery workup, providers are becoming aware of the need for behavioral health services during each phase of the surgery process. Research has documented a higher prevalence of psychiatric comorbidities in severely obese patient populations, with those who receive behavioral health interventions before surgery having better outcomes than those who do not. Common recommendations and interventions for pre- and postoperative behavioral health optimization are reviewed and discussed.Statistics indicate a greater lifetime prevalence of substance use disorders in weight-loss surgery patients than in the general population. Postoperative complications have been shown to result from substance abuse, making it one of the top-cited contraindications for surgery. Preliminary recommendations for assessing and addressing substance use in bariatric surgery candidates are discussed.

Diet Advancement after Weight Loss Surgery

2018 ◽  
Author(s):  
Laura Andromalos
Keyword(s):  
Bariatric Surgery ◽  
Weight Loss ◽  
Gastrointestinal Tract ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Postoperative Period ◽  
Reflux Disease ◽  
Weight Loss Surgery ◽  
Early Postoperative Period ◽  
Defecatory Dysfunction

Diet advancement after bariatric surgery has not been standardized across various bariatric programs. It is generally agreed that patients should advance through a textured progression while the gastrointestinal tract heals; however, the content of each diet stage is open for interpretation. The postoperative diet is intended to promote healing and weight loss while minimizing diet-related complications. This review presents the literature regarding the progression of patients through a postoperative bariatric surgery diet, macro- and micronutrient needs in the early postoperative period, and management of common diet-related complications, including nausea, dumping syndrome, gastroesophageal reflux disease, and defecatory dysfunction. This review contains 5 tables and 45 references Key words: Bariatric surgery, bariatric surgery diet, postoperative diet, macro-nutrient needs, micro-nutrient needs, diet-related complications

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