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Endocrine Society releases pediatric obesity clinical practice guideline
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The Endocrine Society recently released a clinical practice guideline addressing the prevention and treatment of pediatric obesity, including how to evaluate for medical or psychological complications, when to evaluate for genetic causes and when to considered medications or surgery for adolescents.
According to the guideline authors, future research is needed to determine how environmental and economic factors influence worldwide cultural changes in diet and activity.
Specific recommendations in the guideline include the following:
- Evaluation for obesity-related conditions, such as diabetes and dyslipidemia, is advised for children and adolescents with BMI at least in the 85th percentile for age and sex.
- Fasting insulin levels should not be measured because there are no well-defined values for diagnosing insulin resistance.
- Routine laboratory evaluations for endocrine disorders are not needed in children and adolescents unless their height or growth rate is less than expected.
- Specific genetic testing is advised for children with early-onset obesity (before age 5 years), extreme hyperphagia, other clinical findings of genetic obesity syndromes or a family history of extreme obesity.
- Lifestyle modifications should be first-line options for promoting weight loss with pharmacotherapy reserved for children and adolescents with obesity in whom a formal intensive lifestyle modification program has not halted weight gain or improved comorbidities.
- Bariatric surgery is recommended only in certain patients with advanced pubertal development, extreme obesity and favorable family support.
“Intensive, family-centered lifestyle modifications to encourage healthy diet and activity remain the central approach to preventing and treating obesity in children and teenagers,” Dennis M. Styne, MD, of the University of California Davis Medical Center in Sacramento, said in a press release. “Since the Society last issued a pediatric obesity guideline in 2008, physicians have access to new information on genetic causes of obesity, psychological complications associated with obesity, surgical techniques and medications that are now available for the most severely affected older teenagers. The guideline offers information on incorporating these developments into patient care.” – by Amber Cox
Disclosure: Styne reports various financial ties with Bristol-Myers Squibb, Organovo and Teva. Please see the full study for a list of all other authors’ relevant financial disclosures.
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