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儿童和青少年肥胖的减肥治疗。

Medical treatment of weight loss in children and adolescents with obesity.

机构信息

Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy; Department of Internal Medicine and Therapeutics, University of Pavia, 27100 Pavia, Italy.

Department of Pediatrics, Vittore Buzzi Children's Hospital, 20154 Milan, Italy.

出版信息

Pharmacol Res. 2022 Nov;185:106471. doi: 10.1016/j.phrs.2022.106471. Epub 2022 Sep 26.

Abstract

Obesity remains one of the biggest health problems both in adults and children. Lifestyle modification, including diet and exercise, continues to be the mainstay of obesity prevention and treatment. Unfortunately, lifestyle modifications are often unsuccessful. Pharmacological treatment of obesity in pediatric patients can be applied in selected cases, and not before evidence of failure of the multidisciplinary lifestyle intervention. In this narrative review, we revised the most up-to-date evidence on medical treatment of weight loss in children and adolescents with obesity, including FDA- or EMA-approved and -experimented, not approved, drugs for pediatric population. Multidisciplinary treatment of childhood obesity, regulation of appetite control, energy balance and body weight were also discussed, in order to clarify the indications and mechanism action of drugs. Despite a substantial number of medications used for the treatment of obesity in adults, a limited number of drugs are approved by the drug regulatory agencies for pediatric population. Further research is needed to evaluate the efficacy and safety of novel pharmacological approaches for treatment of pediatric obesity in order to optimize weight management for children and adolescents and limit the development obesity-related comorbidities.

摘要

肥胖仍然是成年人和儿童面临的最大健康问题之一。生活方式的改变,包括饮食和运动,仍然是预防和治疗肥胖的主要方法。不幸的是,生活方式的改变往往并不成功。在多学科生活方式干预失败的证据出现之前,可在特定情况下对儿科患者的肥胖进行药物治疗。在这篇叙述性综述中,我们回顾了最新的关于肥胖儿童和青少年体重减轻的医学治疗的证据,包括美国食品和药物管理局或欧洲药品管理局批准和试验的、不适用于儿科人群的药物。我们还讨论了儿童肥胖的多学科治疗、食欲控制、能量平衡和体重调节,以阐明药物的适应证和作用机制。尽管有大量的药物用于治疗成年人的肥胖,但只有少数药物被药物监管机构批准用于儿科人群。为了评估新型药物治疗儿童肥胖的疗效和安全性,以便为儿童和青少年进行体重管理并限制肥胖相关并发症的发展,还需要进一步的研究。

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