Abstract
Over the last decades, pediatric obesity has become a global epidemic with worldwide estimates as high as 43 million children and adolescents affected, and this number is rising at an exponential rate. With pediatric obesity comes a host of co-morbidities including impaired glucose tolerance, dyslipidemia, hypertension, and impaired liver function. Treatment of this population has proven to be challenging for many reasons. For patients, a new baseline exists consisting of an increasingly sedentary lifestyle as well as a lack of availability of affordable healthy alternatives. In addition, there is an overwhelming presence of energy-dense foods. For physicians, there are many issues including lack of time, training, and reimbursement. The most efficacious and reliable way to treat this population and its co-morbidities is with a healthy, balanced lifestyle consisting of a realistic diet plan and exercise regimen. The is the cornerstone of therapy in the Center for Obesity And its Complications in Health (COACH) clinic which is Children’s Medical Center’s (Dallas, TX) strategy to combat and treat pediatric overweight and obesity. Lifestyle changes of diet and exercise plans are tailored to each individual’s interests and metabolic needs in COACH which is a multi-disciplinary clinic. Additionally, co-morbidities are screened for and treated aggressively to help prevent long-term complications of overweight and obesity. If others do similar interventions in their communities, this global epidemic has the possibility of more positive outcomes than those currently projected.
Similar content being viewed by others
References
Dietz WH. Overweight in childhood and adolescence. N Engl J Med. 2004;350:855–7.
Pulgarón ER. Childhood obesity: A review of increased risk for physical and psychological comorbidities. Clin Ther. 2013;35:A18–32.
Ogden CL, Carroll MD, Curtin LR, McDowell MA, Tabak CJ, Flegal KM. Prevalence of overweight and obesity in the United States, 1999–2004. JAMA. 2006;295:1549–55.
Arons A. Childhood Obesity in Texas: The Costs, the Policies, and a Framework for the Future. Texas: Children’s Hospital Association of Texas; 2011. pp. 1–56.
U.S. Centers for Disease Control and Prevention. Health Topics: Childhood Obesity. Last revised on January 5, 2011.
Bhardwaj S, Misra A, Khurana L, Gulati S, Shah P, Vikram NK. Childhood obesity in Asian Indians: A burgeoning cause of insulin resistance, diabetes and sub-clinical inflammation. Asia Pac J Clin Nutr. 2008;17:172–5.
Singh RB, Pella D, Mechirova V, Kartikey K, Demeester F, Tomar RS, et al. Prevalence of obesity, physical inactivity, and undernutrition, a triple burden of diseases during transition in a developing economy. The five city study group. Acta Cardiol. 2007;62:119–27.
Eaton D, Kann L, Kinchen S, Shanklin S, Ross J, Hawkins J, et al. Youth risk behavior surveillance – United States, 2007. MMWR Surveill Summ. 2008;54:1–131.
American Academy of Child & Adolescent Psychiatry. Obesity in children and teens: Facts for families (May 2008). Texas Department of State Health Services: Strategic plan for the prevention of obesity in Texas: 2005–2010 (Austin, Texas, March 10, 2006). Last revised January 5, 2011.
Wajchenberg BL, Gianella-Neto D, da Silva ME, Santos RF. Depot-specific hormonal characteristics of subcutaneous and visceral adipose tissue and their relation to the metabolic syndrome. Horm Metab Res. 2002;34:616–21.
Csábi G, Török K, Jeges S, Molnár D. Presence of metabolic cardiovascular syndrome in obese children. Eur J Pediatr. 2000;159:91–4.
Burniat W, Cole T, Lissau I, Poskitt E. Child and Adolescent Obesity: Causes and Consequences, Prevention, and Management. Cambridge: Cambridge University Press; 2002.
Sinha R, Fisch G, Teague B, Tamborlane WW, Banyas B, Allen K, et al. Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Eng J Med. 2002;346:802–10.
Elcarte López R, Villa Elizaga I, Sada Goñi J, Gasco Eguiluz M, Oyarzábal Irigoyen M, Sola Mateos A, et al. The Navarra study: Prevalence of arterial hypertension, hyperlipidemia and obesity in the infant-child population of Navarra. Association of risk factors. An Esp Pediatr. 1993;38:428–36.
Freedman DS, Dietz WH, Srinivasan SR, Berenson GS. The relation of overweight to cardiovascular risk factors among children and adolescents: The Bogalusa Heart Study. Pediatrics. 1999;103:1175–82.
Weitz D, Weintraub H, Fisher E, Schqartzbard AZ. Fish oil for the treatment of cardiovascular disease. Cardiol Rev. 2010;18:258–63.
Daniels SR, Greer FR; Committee on nutrition. Lipid screening and cardiovascular health in childhood. Pediatrics. 2008;122:198–208.
Sorof JM, Poffenbarger T, Franco K, Bernard L, Portman RJ. Isolated systolic hypertension, obesity, and hyperkinetic hemodynamic states in children. J Pediatr. 2002;140:660–6.
Vogt B, Bochud M, Burnier M. The association of aldosterone with obesity-related hypertension and the metabolic syndrome. Semin Nephrol. 2007;27:529–37.
Sorof J, Daniels S. Obesity hypertension in children: A problem of epidemic proportions. Hypertension. 2002;40:441–7.
Mathur P, Das MK, Arora NK. Non-alcoholic fatty liver disease and childhood obesity. Indian J Pediatr. 2007;74:401–7.
Bergomi AL, Iughetti N, Corciulo P, Predieri B. Italian multicenter study on liver damage in pediatric obesity. Int J Obes Relat Metab Disord. 2000;24:772–6.
Chan DF, Li AM, Chu WC, Chan MH, Wong EM, Liu EK, et al. Hepatic steatosis in obese Chinese children. Int J Obes Relat Metab Disord. 2004;28:1257–63.
Englemann G, Lenhartz H, Grulich-Henn J. Obesity and metabolic syndrome in children and adolescents. N Eng J Med. 2004;351:1146–8.
Arner P. Impact of exercise on adipose tissue metabolism in humans. Int J Obes Relat Metab Disord. 1995;19:S18–21.
Siergrist M, Rank M, Wolfarth B, Langho H, Haller B, Koenig W, et al. Leptin, adiponectin, and short-term and long-term weight loss after a lifestyle intervention in obese children. Nutrition. 2013;29:851–7.
Person ES, Irwin JD, Burke SM, Shapiro S. Parental perspectives of a 4-week family-based lifestyle intervention for children with obesity. Glob J Health Sci. 2012;5:111–22.
Epstein LH, Valoski A, Wing RR, McCurley J. Ten-year outcomes of behavioral family-based treatment for childhood obesity. Health Psychol. 1994;13:373–83.
Conflict of Interest
None.
Role of Funding Source
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Trivedi, S., Burton, A. & Oden, J. Management of Pediatric Obesity: A Lifestyle Modification Approach. Indian J Pediatr 81, 152–157 (2014). https://doi.org/10.1007/s12098-013-1138-0
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-013-1138-0