Center for Pediatric Obesity Medicine, Department of Pediatrics, University of Minnesota, 2450 Riverside Avenue, 6th floor, East Bldg, Minneapolis, MN, 55454, USA.
Curr Obes Rep. 2019 Sep;8(3):201-209. doi: 10.1007/s13679-019-00347-z.
This review describes (1) the clinical assessment of pediatric patients with severe obesity, including a summary of salient biological, psychological, and social factors that may be contributing to the patient's obesity and (2) the current state of treatment strategies for pediatric severe obesity, including lifestyle modification therapy, pharmacotherapy, and metabolic and bariatric surgery.
Lifestyle modification therapy alone is insufficient for achieving clinically significant BMI reduction for most youth with severe obesity and metabolic and bariatric surgery, though effective and durable, is not a scalable treatment strategy. Pharmacological agents in the pipeline may 1 day fill this gap in treatment. Treatment of severe pediatric obesity requires a chronic care management approach utilizing multidisciplinary teams of health care providers and multi-pronged therapies.
本文描述了（1）严重肥胖儿科患者的临床评估，包括总结可能导致患者肥胖的显著生物学、心理和社会因素，以及（2）儿科严重肥胖的当前治疗策略，包括生活方式改变疗法、药物治疗以及代谢和减重手术。
对于大多数患有严重肥胖和代谢及减重手术的青少年而言，单纯的生活方式改变疗法不足以显著降低 BMI，尽管有效且持久，但它不是一种可扩展的治疗策略。在治疗方面，可能有一天会出现新的药物来填补这一空白。严重儿科肥胖的治疗需要采用多学科医疗团队的慢性疾病管理方法和多方面的治疗方法。
