Overweight and Obesity in Childhood Flashcards
Describe the obesogenic environment
Modern environment that encourages both foods high in energy-density (but low in nutrients) and decreased physical activity levels
This results in a chronic +ve energy imbalance
Define obesity?
High body fat content associated with disease risk
Centiles that indicate obesity in children?
≥ 91st centile is overweight
≥ 98th centile is obese
≥ 99.6th centile is severe obesity
≥ +3.33 SD is morbid obesity
Endocrine causes of obesity?
- Hypothyroidism
- GH insufficiency
- Hypopituitarism
- Hypogonadotrophic hypogonadism
- Hypogonadism
- Excessive corticosteroid administration (iatrogenic)
- Pseudohypoparathyroidism
- Craniopharyngioma
Recommendations for physical activity and screen time?
Physical activity - at least 1 hour/day; if under 5 years of age and able to walk, 3 hours/day
Screen time - no more than 2 hours/day
Aims for treatment outcomes?
-0.2 to -0.3 BMI SDs per year
Why is BMI reduction approached differently in children?
If weight can be maintained, as the child grows, their BMI will reduce
Recommendations for anti-obesity drugs (e.g: orlistat) in adolescents?
For severely obese adolescents (BMI >99.6th centile) with co-morbidities and attending a specialist clinic
They require regular reviews throughout the period of use and monitoring for side effects
Recommendations for bariatric surgery in adolescents?
Can be considered for post-pubertal adolescents with very severe to extreme obesity (BMI ≥3.5 SD above mean) and severe co-morbidities
