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青少年肥胖时代的药物体重管理。

Pharmacologic Weight Management in the Era of Adolescent Obesity.

机构信息

Department of Pediatrics, University of Utah, Salt Lake City, Utah 84113, USA.

Department of Pediatrics, Children's Hospital of Richmond at Virginia Commonwealth University, Richmond, Virginia 23219, USA.

出版信息

J Clin Endocrinol Metab. 2022 Sep 28;107(10):2716-2728. doi: 10.1210/clinem/dgac418.

Abstract

CONTEXT

Pediatric obesity is a serious health problem in the United States. While lifestyle modification therapy with dietary changes and increased physical activity are integral for the prevention and treatment of mild to moderate obesity in youth, only a modest effect on sustained weight reduction is observed in children and young adults with severe obesity. This underscores the need for additional evidence-based interventions for children and adolescents with severe obesity, including pharmacotherapy, before considering invasive procedures such as bariatric surgery.

EVIDENCE ACQUISITION

This publication focuses on recent advances in pharmacotherapy of obesity with an emphasis on medications approved for common and rarer monogenic forms of pediatric obesity.

EVIDENCE SYNTHESIS

We review medications currently available in the United States, both those approved for weight reduction in children and "off-label" medications that have a broad safety margin.

CONCLUSION

It is intended that this review will provide guidance for practicing clinicians and will encourage future exploration for successful pharmacotherapy and other interventions for obesity in youth.

摘要

背景

小儿肥胖在美国是一个严重的健康问题。虽然饮食改变和增加身体活动的生活方式改变疗法对于预防和治疗青少年的轻度至中度肥胖是必不可少的,但在严重肥胖的儿童和年轻成年人中,仅观察到对持续体重减轻的适度影响。这凸显了需要针对严重肥胖的儿童和青少年进行额外的基于证据的干预,包括药物治疗,然后再考虑侵入性手术,如减肥手术。

证据获取

本出版物重点介绍肥胖症药物治疗的最新进展,重点是批准用于常见和罕见儿科肥胖单基因形式的药物。

证据综合

我们回顾了目前在美国可用的药物,包括批准用于儿童减肥的药物和具有广泛安全范围的“超适应证”药物。

结论

本综述旨在为临床医生提供指导,并鼓励未来探索成功的药物治疗和其他干预肥胖的方法。

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