Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA.
Center on Obesity Management and Prevention, Mary Ann & J. Milburn Smith Child Health Research, Outreach, and Advocacy Center, Stanley Manne Children's Research Institute, Chicago, IL 60611, USA.
Int J Environ Res Public Health. 2019 Mar 14;16(6):927. doi: 10.3390/ijerph16060927.
The management of youth with severe obesity is strongly impacted by social determinants of health and family dynamics. We present case studies of three patients seen in our tertiary care obesity treatment clinic as examples of the challenges faced by these patients and their families, as well as by the medical team. We discuss how these cases illustrate potential barriers to care, the role of child protective services, and we reflect upon lessons learned through the care of these patients. These cases highlight the need for comprehensive care in the management of youth with severe obesity, which can include: visits to multiple medical specialists, and mental and behavioral health providers; school accommodations; linkage to community resources; and, potentially, child protective services involvement. Through the care of these youth, our medical team gained more experience with using anti-obesity medications and meal replacements. The care of these youth also heightened our appreciation for the integral role of mental health services and community-based resources in the management of youth with severe obesity.
青少年严重肥胖的管理受到健康社会决定因素和家庭动态的强烈影响。我们展示了三位在我们的三级肥胖治疗诊所就诊的患者的病例研究，作为这些患者及其家庭以及医疗团队所面临挑战的例子。我们讨论了这些病例如何说明潜在的护理障碍、儿童保护服务的作用，并反思了通过这些患者护理中获得的经验教训。这些病例突出了在管理青少年严重肥胖症时需要全面护理，其中可能包括：多次就诊于多个医学专家和精神与行为健康提供者；学校适应；与社区资源的联系；以及可能涉及儿童保护服务。通过对这些青少年的护理，我们的医疗团队在使用抗肥胖药物和代餐方面获得了更多经验。这些青少年的护理也使我们更加重视心理健康服务和社区资源在管理青少年严重肥胖症中的重要作用。
