Srivastava Gitanjali, O'Hara Valerie, Browne Nancy
Section of Endocrinology, Diabetes, Nutrition & Weight Management, Department of Medicine, Boston University School of Medicine, 720 Harrison Avenue, Suite 801, Boston, MA 02114, USA.
Boston Medical Center, Nutrition and Weight Management Center, 720 Harrison Avenue, Suite 801, Boston, MA 02114, USA.
Children (Basel). 2019 Feb 4;6(2):22. doi: 10.3390/children6020022.
Approximately two-thirds of US children and adolescents have either obesity or overweight status, with almost 24% of adolescents (ages 12⁻19 years) afflicted with severe obesity, defined as >1.2 × the 95th BMI percentile for age/gender. Despite the increasing disproportionate rise in severe or extreme childhood obesity, many children in weight management programs do not achieve a healthy weight. Most often, these patients will go on to require metabolic and bariatric surgery (MBS), but challenges and limitations may prohibit MBS on adolescents. Thus, tertiary care pediatric weight management centers are compelled to treat select pediatric obesity subtypes presenting with disease progression and disability with the available adult FDA-approved therapeutic modalities, specifically pharmacotherapy, in order to alleviate the disease state and provide relief to the patient. Here, we describe a case of severe pediatric obesity where a dedicated multidisciplinary pediatric weight management team at a tertiary care center utilizes a progressive pharmacotherapeutic approach with enormous benefits to the patient, highlighting the urgent gap and clinical care needs of this special population niche of severe adolescent obesity.
大约三分之二的美国儿童和青少年存在肥胖或超重问题，近24%的青少年（12至19岁）患有严重肥胖症，定义为超过年龄/性别的BMI第95百分位数的1.2倍。尽管儿童严重或极度肥胖的比例在不断上升，但许多参加体重管理项目的儿童并未达到健康体重。这些患者通常最终需要进行代谢和减肥手术（MBS），但面临的挑战和限制可能会禁止对青少年进行MBS。因此，三级护理儿科体重管理中心不得不使用美国食品药品监督管理局（FDA）批准的现有成人治疗方法，特别是药物治疗，来治疗出现疾病进展和残疾的特定儿科肥胖亚型，以缓解病情并为患者提供缓解。在此，我们描述了一例严重儿科肥胖病例，一家三级护理中心的专业多学科儿科体重管理团队采用渐进性药物治疗方法，给患者带来了巨大益处，突出了严重青少年肥胖这一特殊人群细分领域的紧迫差距和临床护理需求。
