Pediatric obesity has risen dramatically in the past several decades, becoming the most common chronic childhood disease (1–8). In the United States, obesity prevalence is 19.3%, with over 4.5 million children meeting the criteria for severe obesity (Class 2 or Class 3 Obesity) (1,3,5,9,10). Obese children are known to be at high risk for the development of multiple significant comorbidities. These can persist into adulthood and increase the risk of premature mortality (3–5,10–15). Under the guise of the previously championed “watchful waiting” strategy, BMIs increase and comorbidities are compounded (3,13,14). Referral to a multidisciplinary treatment team is imperative. Metabolic and Bariatric Surgery (MBS) has been shown to be a safe and effective intervention for the treatment of pediatric obesity, with sustained weight loss and resolution of comorbidities (1,3,4,11,12,16). Medications, including the GLP-1 agonists, have shown promise but are not a panacea. Lifestyle modification, diet, and exercise remain at the foundation of healthy change. Despite recent efforts by professional organizations to raise awareness and create new policy recommendations, the pediatric population struggling with obesity remains underserved. Pediatric obesity deserves our attention and our advocacy. Our patients deserve evidence-based treatment now.
References
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2. American Society for Metabolic and Bariatric Surgery [Internet]. [cited 2024 Jan 7]. Childhood and Adolescent Obesity. Available from: https://asmbs.org/patients/adolescent-obesity/
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8. World Health Organization. Fact Sheet: Obesity and overweight [Internet]. 2021 [cited 2024 Jan 5]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
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12. Armstrong SC, Bolling C, Michalsky MP, Reichard KW, Obesity SO, Kurt F. Heiss, et al. Pediatric Metabolic and Bariatric Surgery: Evidence, Barriers, and Best Practices. Pediatrics. 2019 Oct 1;144(6).
13. Freedman DS, Khan LK, Dietz WH, Srinivasan SR, Berenson GS. Relationship of Childhood Obesity to Coronary Heart Disease Risk Factors in Adulthood: The Bogalusa Heart Study. Pediatrics. 2001 Sep 1;108(3):712–8.
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15. Eisenberg D, Shikora SA, Aarts E, Aminian A, Angrisani L, Cohen RV, et al. 2022 American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO): Indications for Metabolic and Bariatric Surgery. Surg Obes Relat Dis. 2022 Dec 1;18(12):1345–56.
16. Inge TH, Courcoulas AP, Jenkins TM, Michalsky MP, Helmrath MA, Brandt ML, et al. Weight Loss and Health Status 3 Years after Bariatric Surgery in Adolescents. N Engl J Med. 2016 Jan 14;374(2):113–23.
September 2024