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Practice Guideline

. 2017 Mar 1;102(three):709-757.

doi: ten.1210/jc.2016-2573.

Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Do Guideline

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• PMID: 28359099
• PMCID: PMC6283429
• DOI: 10.1210/jc.2016-2573

Free PMC article

Practice Guideline

Pediatric Obesity-Assessment, Handling, and Prevention: An Endocrine Society Clinical Practice Guideline

Dennis M Styne  et al. J Clin Endocrinol Metab. 2017 .

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Abstruse

Cosponsoring associations: The European Society of Endocrinology and the Pediatric Endocrine Gild. This guideline was funded past the Endocrine Society.

Objective: To formulate clinical practice guidelines for the assessment, treatment, and prevention of pediatric obesity.

Participants: The participants include an Endocrine Club-appointed Task Force of 6 experts, a methodologist, and a medical writer.

Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Evolution, and Evaluation approach to describe the strength of recommendations and the quality of evidence. The Task Force commissioned 2 systematic reviews and used the best available prove from other published systematic reviews and individual studies.

Consensus process: 1 group coming together, several conference calls, and email communications enabled consensus. Endocrine Society committees and members and co-sponsoring organizations reviewed and commented on preliminary drafts of this guideline.

Conclusion: Pediatric obesity remains an ongoing serious international health business organisation affecting ∼17% of US children and adolescents, threatening their developed health and longevity. Pediatric obesity has its basis in genetic susceptibilities influenced by a permissive environment starting in utero and extending through childhood and adolescence. Endocrine etiologies for obesity are rare and usually are accompanied by attenuated growth patterns. Pediatric comorbidities are common and long-term health complications often result; screening for comorbidities of obesity should be practical in a hierarchal, logical way for early on identification earlier more serious complications event. Genetic screening for rare syndromes is indicated only in the presence of specific historical or physical features. The psychological toll of pediatric obesity on the individual and family unit necessitates screening for mental wellness problems and counseling as indicated. The prevention of pediatric obesity by promoting healthful nutrition, activity, and environs should be a primary goal, as achieving constructive, long-lasting results with lifestyle modification once obesity occurs is difficult. Although some behavioral and pharmacotherapy studies report modest success, additional research into attainable and effective methods for preventing and treating pediatric obesity is needed. The utilise of weight loss medications during babyhood and adolescence should be restricted to clinical trials. Increasing evidence demonstrates the effectiveness of bariatric surgery in the well-nigh seriously affected mature teenagers who have failed lifestyle modification, only the use of surgery requires experienced teams with resources for long-term follow-up. Adolescents undergoing lifestyle therapy, medication regimens, or bariatric surgery for obesity volition need cohesive planning to help them effectively transition to adult care, with connected necessary monitoring, back up, and intervention. Transition programs for obesity are an uncharted area requiring further research for efficacy. Despite a meaning increment in research on pediatric obesity since the initial publication of these guidelines 8 years ago, further study is needed of the genetic and biological factors that increase the run a risk of weight proceeds and influence the response to therapeutic interventions. Also needed are more studies to better understand the genetic and biological factors that cause an obese individual to manifest ane comorbidity vs another or to be gratuitous of comorbidities. Furthermore, connected investigation into the well-nigh effective methods of preventing and treating obesity and into methods for irresolute ecology and economic factors that volition pb to worldwide cultural changes in diet and activity should be priorities. Particular attention to determining ways to effect systemic changes in food environments and full daily mobility, as well every bit methods for sustaining healthy body mass alphabetize changes, is of importance.

Copyright © 2017 by the Endocrine Social club

Figures

Figure 1.

Diagnosis and direction flowchart. *Measure insulin and proinsulin in patients with clinical features of PCSK1 deficiency. [Adapted from August GP et al. (86) with permission, © Endocrine Society.] [Republished with permission of Springer Scientific discipline and Autobus Media BV from Farooqi S and O'Rahilly Due south (87); permission conveyed through Copyright Clearance Center, Inc.]

Effigy 2.

Change in metabolic issue per unit of measurement change in BMI or weight. Abbreviations: HDL, high-density lipoprotein; SBP, systolic blood pressure level; TG, triglyceride.

Figure 3.

Bariatric surgical procedures. (A) LAGB, (B) vertical banded gastroplasty, (C) RYGB, (D) biliopancreatic diversion, (East) biliopancreatic diversion with duodenal switch, (F) VSG, (G) ileal interposition with sleeve gastrectomy, and (H) Santoro Iii. (A), (C), and (F) are applicable to section 4 (Bariatric Surgery). [Reproduced from Nandagopal R et al. (372), with permission.]

Comment in

• Letter to the Editor: "Pediatric Obesity-Assessment, Treatment, and Prevention: An Endocrine Society Clinical Practice Guideline".

  Ball GDC, Perez A, Nobles JD, Spence ND, Skelton JA. Ball GDC, et al. J Clin Endocrinol Metab. 2017 Jun 1;102(6):2121-2122. doi: ten.1210/jc.2017-00351. J Clin Endocrinol Metab. 2017. PMID: 28586452 Gratis PMC commodity. No abstruse bachelor.

• Response to Alphabetic character: "Pediatric Obesity-Cess, Treatment, and Prevention: An Endocrine Social club Clinical Practice Guideline".

  Styne DM, Arslanian SA, Connor EL, Farooqi IS, Murad MH, Silverstein JH, Yanovski JA. Styne DM, et al. J Clin Endocrinol Metab. 2017 Jun 1;102(6):2123-2124. doi: 10.1210/jc.2017-00561. J Clin Endocrinol Metab. 2017. PMID: 28586453 Gratuitous PMC article. No abstract available.

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Source: https://pubmed.ncbi.nlm.nih.gov/28359099/

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