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优化儿童肥胖管理:埃德蒙顿肥胖分期系统在个性化护理路径中的作用。

Optimizing Childhood Obesity Management: The Role of Edmonton Obesity Staging System in Personalized Care Pathways.

作者信息

De Wolf Astrid, Nauwynck Elise, Vanbesien Jesse, Staels Willem, De Schepper Jean, Gies Inge

机构信息

Department of Paediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.

Division of Paediatric Endocrinology, Department of Paediatrics, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), 1090 Brussels, Belgium.

出版信息

Life (Basel). 2024 Feb 28;14(3):319. doi: 10.3390/life14030319.

Abstract

Childhood obesity, affecting 29% of 7-9-year-olds across 33 European countries, is a significant public health challenge. Its persistence into adulthood poses grave health risks influenced by genetic, environmental, and socio-economic factors. Belgium introduced a new care pathway in December 2023, based on the Edmonton Obesity Staging System for Pediatrics (EOSS-P), addressing four health domains and staging obesity severity. This pathway operates across three levels: primary care physicians, Paediatric Multidisciplinary Obesity Management Centres (PMOCs), and Centers of Expertise for Paediatric Obesity Management (CEPOs). Each stage of EOSS-P demands tailored interventions. Early stages involve dietary interventions, physical activity promotion, and behavior modifications. As obesity severity progresses, treatments intensify, encompassing psychological support, anti-obesity medications, and, in some cases, bariatric surgery. Throughout these stages, the involvement of multidisciplinary teams is crucial, emphasizing family-based approaches and continuous monitoring. This article provides detailed guidelines for healthcare professionals, delineating interventions and recommendations tailored to each EOSS-P stage. It emphasizes a holistic approach that extends beyond BMI-based diagnosis, promoting personalized care and prompt escalations between care levels, thereby ensuring optimal management of childhood obesity. This comprehensive framework aims to address the complexities of childhood obesity, emphasizing the importance of timely and targeted interventions for better health outcomes.

摘要

儿童肥胖是一项重大的公共卫生挑战,在33个欧洲国家中,29%的7至9岁儿童受其影响。儿童肥胖持续至成年会带来严重的健康风险,这受到遗传、环境和社会经济因素的影响。比利时于2023年12月引入了一条新的护理途径,该途径基于儿科埃德蒙顿肥胖分期系统(EOSS-P),涉及四个健康领域并对肥胖严重程度进行分期。这条途径在三个层面开展工作:初级保健医生、儿科多学科肥胖管理中心(PMOC)和儿科肥胖管理专业中心(CEPO)。EOSS-P的每个阶段都需要量身定制的干预措施。早期阶段包括饮食干预、促进身体活动和行为改变。随着肥胖严重程度的进展,治疗会加强,包括心理支持、抗肥胖药物,在某些情况下还包括减肥手术。在这些阶段中,多学科团队的参与至关重要,强调以家庭为基础的方法和持续监测。本文为医疗保健专业人员提供了详细指南,阐述了针对EOSS-P每个阶段的干预措施和建议。它强调一种超越基于体重指数诊断的整体方法,促进个性化护理以及护理层面之间的及时升级,从而确保对儿童肥胖进行最佳管理。这一综合框架旨在应对儿童肥胖的复杂性,强调及时和有针对性的干预措施对改善健康结果的重要性。

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