Management of childhood obesity

Shin-Hye Kim; Mi-Jung Park

doi:10.5124/jkma.2017.60.3.233

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Kim and Park: Management of childhood obesity

Continuing Education Column

Journal of the Korean Medical Association 2017; 60(3): 233-241.

Published online: 23 March 2017

DOI: https://doi.org/10.5124/jkma.2017.60.3.233

Management of childhood obesity

Shin-Hye Kim, MD

, Mi-Jung Park, MD

Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Corresponding author: Mi-Jung Park. PMJ@paik.ac.kr

Received 10 January 2017 Accepted 22 January 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Childhood obesity increases the risk of morbidity and mortality in adulthood. The epidemic of childhood obesity has become an important public health issue in Korea. Currently, the overall prevalence of obesity among Korean children and adolescents is approximately 10%, which is 5 times higher than in the late 1970s. In most cases, a positive energy balance (from excessive calorie intake and limited physical activity) combined with a genetic predisposition is considered the major cause of childhood obesity. The evaluation of obese children should focus on possible causes of weight gain, including lifestyle factors and underlying endocrine or genetic abnormalities. The assessment of obesity-related comorbidities, such as hyperglycemia, dyslipidemia, hypertension, and non-alcoholic fatty liver disease, is often needed in obese children, especially those who have a family history of comorbidities. Family-based lifestyle interventions including goal-setting, guidelines for eating habits and physical activity, self-monitoring, and stimulus control are fundamental to the management of childhood obesity. Medications and bariatric surgery are possible choices for patients with severe obesity and comorbidities, although the data on the long-term efficacy and safety of these treatments are limited. This article reviews practical assessments and interventions for childhood obesity.

Keywords: Child, Adolescent, Intervention, Medical assessment, Obesity

Figures and Tables

Table 1

Comorbidities of childhood obesity

LDL-C, low-density lipoprotein cholesterol; HDL-C, high-density lipoprotein cholesterol; SBP, systolic blood pressure; DBP, diastolic blood pressure; DM, diabetes mellitus; IDF, International Diabetes Federation; WC, waist circumference; γ-GTP, gamma-glutamyl transpeptidase; CT, computed tomography; MRI, magnetic resonance imaging; CSF, cerebrospinal fluid.

Table 2

Behavioral modification for childhood obesity

Table 3

EER for children and adolescents aged 3 to 18 years

EER, estimated energy requirement; PA, physical activity coefficient.

Table 4

Medications for the treatment of obesity

PO, per oral; TID, three times a day; BID, twice a day; SSRI, selective serotonin reuptake inhibitor; SNRI/MAOI, serotonin and norardrenaline reuptake inhibitor/monoamine oxidase inhibitor; GLP-1, glucagon like peptide-1; SC, subcutaneous; QD, once a day; BP, blood pressure; MAO, monoamine oxidase.

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ORCID iDs

Shin-Hye Kim
https://orcid.org/http://orcid.org/0000-0003-0413-122X

Mi-Jung Park
https://orcid.org/http://orcid.org/0000-0002-7202-500X

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