Division of Gastroenterology, Hepatology, and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Curr Opin Pediatr. 2019 Oct;31(5):645-653. doi: 10.1097/MOP.0000000000000786.
We aim to describe current concepts on childhood and adolescent obesity with a strong focus on its sequela. Childhood obesity is a national epidemic with increasing prevalence over the past three decades placing children at increased risk for many serious comorbidities, previously felt to be only adult-specific diseases, making this topic both timely and relevant for general pediatricians as well as for subspecialists.
Childhood obesity develops through an interplay of genetics, environment, and behavior. Treatment includes lifestyle modification, and now metabolic and bariatric surgery is more commonly considered in carefully selected adolescents. The off-label use of adjunct medications for weight loss in childhood and adolescent obesity is still in its infancy, but will likely become the next logical step in those with lifestyle modification refractory obesity. Obesity can lead to several comorbidities, which can persist into adulthood potentially shortening the child's lifespan.
Efforts should be focused primarily on reducing childhood and adolescent obesity, and when indicated treating its sequela in effort to reduce future morbidity and mortality in this precious population. VIDEO ABSTRACT: http://links.lww.com/MOP/A36.
本综述旨在描述儿童和青少年肥胖的现有概念，并特别强调其后果。儿童肥胖是一种全国性的流行疾病，过去三十年来患病率不断上升，使儿童罹患许多严重合并症的风险增加，这些合并症以前被认为仅为成人特有的疾病，因此，这个话题不仅与普通儿科医生有关，也与亚专科医生有关，具有及时性和相关性。
儿童肥胖是通过遗传、环境和行为的相互作用发展起来的。治疗包括生活方式的改变，现在代谢和减肥手术在经过精心挑选的青少年中更常被考虑。在儿童和青少年肥胖症中，附加药物辅助减肥的标签外使用仍处于起步阶段，但对于生活方式改变难治性肥胖的患者，可能成为下一个合乎逻辑的步骤。肥胖可导致多种合并症，这些合并症可能持续到成年期，从而潜在缩短儿童的寿命。
应主要集中精力减少儿童和青少年肥胖，并在有指征时治疗其后果，以努力降低这一宝贵人群的未来发病率和死亡率。
