Shaban Mohamed Mossad Abdelhak, AbouKhatwa Merna Mahmoud, Saifullah Abdul Aziz, Hareez Syahmi Muhammad, Mosaad Mohamed, Elrggal Mahmoud E, Dehele Inderpal Singh, Elnaem Mohamed Hassan
Department of Pediatrics, Faculty of Medicine, International Islamic University Malaysia, Kuantan 25200, Malaysia.
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Alexandria University, Alexandria 5372066, Egypt.
Children (Basel). 2022 Dec 16;9(12):1975. doi: 10.3390/children9121975.
Obesity might adversely affect the health and well-being of children and their families. Childhood obesity has crucial implications for health, both during childhood and as they age. It is highly associated with many acute problems and is commonly present during childhood, making visits and hospital admissions polarized in this group of children. The problems that may affect these children can be medical, such as asthma, chronic inflammation, orthopedic abnormalities, liver disease, diabetes mellitus or dyslipidemia. Long-term consequences of cardiovascular risk factors, the persistence of obesity and premature mortality are common among adults who had obesity during their early lives. Additionally, they could also suffer from psychological issues, such as low self-esteem, which puts them at risk of a much more serious psychosocial problem that may lead to depression, as well as a disruption in educational achievements and social relationships. A healthy diet, physical activity, adequate sleep, and limited screen time are all preventive measures that should be implemented at the family and community levels, preferably through well-structured programs. Furthermore, pharmacological management of childhood obesity is limited and only used after non-pharmacological interventions have failed or in the late stages of obesity. However, recent guidelines advocate the early use of medical interventions. Approved pharmacotherapeutic options include orlistat, phentermine/topiramate combination and liraglutide. There are several other options approved primarily for other specific forms of obesity or for other indications, including setmelanotide, metformin, lisdexamfetamine, zonisamide and fluoxetine. Bariatric surgery is a safe and effective option in cases with extreme obesity and comorbidities considering the need for long-term monitoring and support for cases and their families post-surgery. This review aims to discuss and highlight the recent evidence regarding risk factors, clinical consequences, prevention, and treatment of childhood obesity.
肥胖可能会对儿童及其家庭的健康和幸福产生不利影响。儿童肥胖对健康有着至关重要的影响，无论是在儿童时期还是随着他们长大成人。它与许多急性问题高度相关，且在儿童期很常见，导致这组儿童的就诊和住院情况两极分化。可能影响这些儿童的问题包括医学方面的，如哮喘、慢性炎症、骨科异常、肝病、糖尿病或血脂异常。心血管危险因素的长期后果、肥胖的持续存在和过早死亡在早年肥胖的成年人中很常见。此外，他们还可能遭受心理问题，如自卑，这使他们面临更严重的心理社会问题的风险，可能导致抑郁，以及教育成就和社会关系的中断。健康饮食、体育活动、充足睡眠和限制屏幕时间都是应在家庭和社区层面实施的预防措施，最好通过精心组织的项目来进行。此外，儿童肥胖的药物治疗有限，仅在非药物干预失败或肥胖晚期使用。然而，最近的指南提倡早期使用医学干预措施。批准的药物治疗选择包括奥利司他、苯丁胺/托吡酯组合和利拉鲁肽。还有其他几种主要针对其他特定形式的肥胖或其他适应症批准的选择，包括setmelanotide、二甲双胍、赖氨酸安非他命、唑尼沙胺和氟西汀。考虑到术后需要对病例及其家庭进行长期监测和支持，对于极度肥胖和合并症的病例，减肥手术是一种安全有效的选择。本综述旨在讨论并强调有关儿童肥胖的危险因素、临床后果、预防和治疗的最新证据。
