Treatment Of Adolescent Obesity Research Articles

Sleep Patterns and Quality Are Associated with Severity of Obesity and Weight-Related Behaviors in Adolescents with Overweight and Obesity.

Inadequate sleep duration, sleep patterns, and sleep quality have been associated with metabolic, circadian, and behavioral changes that promote obesity. Adolescence is a period during which sleep habits change to include less sleep, later bedtimes, and greater bedtime shift (e.g., difference between weekend and weekday bedtime). Thus, sleep may play a role in adolescent obesity and weight-related behaviors. This study assesses sleep duration, quality, and schedules and their relationships to relative weight and body fat percentage as well as diet, physical activity, and screen time in adolescents with overweight/obesity. Adolescents between 12 and 17 years old (n = 186) were weighed and measured, reported typical sleep and wake times on weekdays and weekends, and responded to questionnaires assessing diet, physical activity, and screen time habits. Controlling for sleep duration, later weekend bedtime and greater bedtime shift were associated with greater severity of overweight (β = 0.20; β = 0.16) and greater screen time use (β = 0.22; β = 0.2). Later bedtimes on the weekdays and weekends were associated with fewer healthy diet practices (β = -0.26; β = -0.27). In addition, poorer sleep quality was associated with fewer healthy diet habits (β = -0.21), greater unhealthy diet habits (β = 0.15), and less physical activity (β = -0.22). Sleep duration was not associated with any weight or weight-related behavior. Sleep patterns and quality are associated with severity of overweight/obesity and various weight-related behaviors. Promoting a consistent sleep schedule throughout the week may be a worthwhile treatment target to optimize behavioral and weight outcomes in adolescent obesity treatment.

Theoretical frameworks informing family-based child and adolescent obesity interventions: A qualitative meta-synthesis

Child and adolescent obesity trends are rising throughout the world, revealing treatment difficulties and a lack of consensus about treatment. The family system is broadly viewed as a potential setting for facilitation of behaviour change. Therefore, family-based interventions have come into focus. However, the use of theoretical frameworks to strengthen these interventions is rare and very uneven. To conduct a qualitative meta-synthesis of family-based interventions for child and adolescent obesity to identify the theoretical frameworks applied, thus understanding how theory is used in practice. A literature review was conducted between January and March 2016. A total of 35 family-based interventions were selected for analysis. Eleven interventions explicitly stated that theory guided the development and were classified as theory-inspired. The social cognitive, self-efficacy and Family Systems Theory appeared most frequently. The remaining 24 were classified as theory-related as theoretical elements of self-monitoring; stimulus control, reinforcement and modelling were used. The designs of family-based interventions reveal numerous inconsistencies and a significant void between research results and health care practice. Based on the analysis, this article proposes three themes to be used as focus points when designing future interventions and when selecting theories for the development of solid, theory-based frameworks for application. The themes are: (1) age of target group, (2) intervention objective, and (3) self-efficacy and readiness for change.

Evolution of 29 Anthropometric, Nutritional, and Cardiometabolic Parameters Among Morbidly Obese Adolescents 2 Years Post Sleeve Gastrectomy

BackgroundLaparoscopic sleeve gastrectomy (LSG) is a popular treatment for adolescent morbid obesity. Research on LSG outcomes among adolescents assessed a narrow range of anthropometric, nutritional, or cardiometabolic parameters, leading to an incomplete picture of these changes. We examined a wide variety of anthropometric, nutritional, and cardiometabolic parameters among adolescents before and after LSG.MethodsWe retrospectively reviewed medical charts of all obese adolescents who underwent LSG at Hamad Medical Corporation, Qatar, between January 2011 and June 2015 (N = 102). We assessed preoperative levels and postoperative changes in 4 anthropometric, 15 nutritional, and 10 cardiometabolic parameters.ResultsThe study sample comprised 79 patients with complete information (36 males, mean age 15.99 ± 1.1 years). At a mean of 24.2 months post-LSG, we observed (1) significantly reduced mean weight and body mass index by 51.82 ± 28.1 kg and 17 ± 6.24 kg/m2, respectively; (2) the highest prevalence of post-LSG deficiencies pertained to vitamin D, albumin, and ferritin (89.3, 38, and 33.3%, respectively); (3) low hemoglobin levels (29.3%) only in females; (4) trace elements were not deficient; (4) significant reductions in percentage of adolescents with elevated low-density lipoprotein (from 66.1 to 38.9%), alanine aminotransferase (from 45.3 to 10.9%), and aspartate aminotransferase (from 24.1 to 8.6%) levels; (5) 100% remission of prediabetes cases; and (6) 80% remission of type 2 diabetes cases.ConclusionsLSG achieved significant weight loss and improvement of cardiometabolic risk factors among adolescents. However, the slight worsening of preexisting nutritional deficiencies warrants careful preoperative surveillance and appropriate postoperative nutritional supplementation.

Cardiorespiratory fitness in adolescents with obesity: a 6-month follow-up study

The aim of this study was to investigate whether the effects of a multidisciplinary intervention on cardiorespiratory fitness are maintained after 6-month follow-up in adolescents with obesity. One-hundred and seven adolescents with obesity were intentionally allocated in two groups: experimental or control. Adolescents in experimental group underwent a multidisciplinary intervention (supervised aerobic exercise, psychological, nutritional, and clinical counseling). Cardiorespiratory fitness (direct gas analysis), body composition (dual-energy-DXA), anthropometry and blood lipids were measured before intervention (baseline), at the end of the 24-week intervention (post-intervention) and six months after the end of the intervention (follow-up). Cardiorespiratory fitness reduced in control group with no changes in experimental group, and these differences were maintained in the follow-up assessment (control group: 24.2±4.4 ml.kg-1.min-1 to 22.6±4.9 ml.kg-1.min-1; follow-up: 22.6±4.9 ml.kg-1.min-1 vs. experimental group: 28.0±4.0 ml.kg-1.min-1 to 29.7±4.0 ml.kg-1.min-1; follow-up: 28.9±5.7 ml.kg-1.min-1). Reductions in z-score body mass index (BMI) and increases HDL-C after multidisciplinary intervention were maintained after a 6-month follow-up. In conclusion, the benefits of a multidisciplinary intervention on cardiorespiratory fitness, BMI and blood lipids are maintained after a 6-month follow-up. These findings indicate that multidisciplinary interventions produce long-term health consequences. Reinforcing the importance of lifestyle changes as a therapeutic approach for the treatment of obesity in adolescents.

A multidisciplinary approach to laparoscopic sleeve gastrectomy among multiethnic adolescents in the United States

BackgroundChildhood obesity has become a serious public health problem in our country with a prevalence that is disproportionately higher among minority groups. Laparoscopic sleeve gastrectomy (LSG) is gaining attention as a safe bariatric alternative for severely obese adolescents. Study designA retrospective study on morbidly obese adolescents that underwent LSG at our institution from 2009 to 2017. Primary outcomes were weight loss as measured by change in BMI and percent excess weight loss (%EWL) at 1 year after surgery, resolution of comorbidities and occurrence of complications. ResultsThirty-eight patients, of whom 71% were female and 74% were ethnic minorities, underwent LSG between 2009 and 2016. Mean age was 16.8years, mean weight was 132.0kg and mean BMI was 46.7. There were no surgical complications. Mean %EWL was 19.4%, 27.9%, 37.4%, 44.9%, and 47.7% at 1.5, 3, 6, 9, and 12month follow up visits, respectively. Comorbidity resolution rates were 100% for hypertension and nonalcoholic fatty liver disease, 91% for diabetes, 44% for prediabetes, 82% for dyslipidemia and 89% for OSA. ConclusionsLSG is an effective and safe method of treatment of morbid obesity in adolescents as it can significantly decrease excess body weight and resolve comorbid conditions. Further studies are needed to investigate the long-term effects of LSG in adolescents. Clinical research studyDescriptive case series with prospective database. Level of evidenceIV.

Long-Term Outcome of Bariatric Surgery in Morbidly Obese Adolescents: a Systematic Review and Meta-Analysis of 950 Patients with a Minimum of 3years Follow-Up.

Obesity in pediatric and adolescent population has reached a universal pandemic. This study aimed to summarize the literature on the longest available outcome of bariatric surgery in morbidly obese adolescents. A systematic review was conducted to pool available data on the longest available (>3years) weight loss and comorbidity resolution outcome in adolescent bariatric surgery. A total of 14 studies reporting the result of bariatric surgery after 3years in 950 morbidly obese adolescents were included. Preoperative age and BMI ranged from 12 to 19years and from 26 to 91kg/m2, respectively. Females were the predominant gender (72.8%). Laparoscopic roux-en-Y gastric bypass (n=453) and adjustable gastric banding (n=265) were the most common bariatric procedure performed. The number of patients at the latest follow-up was 677 (range from 2 to 23years). On average, patients lost 13.3kg/m2 of their BMI. Among comorbidities, only diabetes mellitus resolved or improved dramatically. Of 108 readmissions, 91 led to reoperation. There was a weight regain <5kg/m2 between 5 and 6years of follow-up. Removal, exchange, or conversion of the previous band constituted the majority of the revisional procedures. Three deaths were reported. No long-term data was obtainable on nutritional deficiency or growth status of adolescents who underwent a bariatric procedure. Although bariatric surgery is a safe and effective procedure in the treatment of adolescent morbid obesity, long-term data is scarce regarding its nutritional and developmental complication in this growing population of patients.

Efficacy of Cognitive Behavior Therapy and Pharmacotherapy on Adolescent Obesity

Adolescent obesity is an urgent health issue in the U.S., and is a precursor to many physiological and psychological conditions. There are different treatment options for adolescent obesity, and it is important for the general public to understand the benefits and risks associated with the particular treatments. This paper focuses on two treatment options for adolescent obesity, cognitive behavioral therapy (CBT; type of psychological therapy) and Orlistat (medication for obesity), and discusses the effectiveness of each treatment for adolescent obesity. CBT focuses on the behaviors that are associated with the development and maintenance of obesity, while Orlistat targets the physiologic mechanisms of obesity. It appears that while both treatments may be effective for obesity, in general, CBT could help adolescents make lifestyle changes that are more beneficial in long-term mental and physical health. Additionally, when CBT is combined with Orlistat to initiate weight loss, which is then maintained by CBT alone, it could have the greater treatment effects.

Reductions in blood pressure during a community-based overweight and obesity treatment in children and adolescents with prehypertension and hypertension.

Due to the pandemic of childhood obesity and thus obesity-related hypertension, improvements in treatment availability are needed. Hence, we investigated whether reductions in blood pressure (BP) would occur in children with overweight and obesity exhibiting prehypertension/hypertension during a community-based overweight and obesity treatment program, and if changes in body mass index (BMI) are associated with changes in BP. The study included 663 children aged 3-18 years with a BMI ⩾85th percentile for sex and age that entered treatment from June 2012 to January 2015. Height, weight and BP were measured upon entry and every 3-6 months. BMI and BP s.d. scores (SDSs) were calculated according to sex and age, or sex, age and height. Prehypertension was defined as a BP SDS ⩾1.28 and <1.65. Hypertension was defined as a BP SDS ⩾1.65. Upon entry, 52% exhibited prehypertension (11.9%) or exhibited hypertension (40.1%). After 12 months (range: 3-29) of treatment, 29.3% of the children with prehypertension/hypertension were normotensive. Children with systolic prehypertension/hypertension upon entry reduced their systolic BP SDSs by 0.31 (95% confidence interval (CI): 0.70-0.83, P<0.0001). Children with diastolic prehypertension/hypertension upon entry reduced their diastolic BP SDSs by 0.78 (95% CI: 0.78-0.86, P<0.0001). BMI SDS changes were positively associated with BP SDS changes (P<0.0001). Nonetheless, some children reduced BP SDSs while increasing their BMI SDSs, and prehypertension/hypertension developed in 23.3% of the normotensive children despite reductions in BMI SDSs (P<0.0001). These results suggest that community-based overweight and obesity treatment can reduce BP, and thus may help improve treatment availability.

Effects Of A School-based Exercising And Nutrition Counseling Intervention On Sleep Parameters (Sleep Time, Sleep Latency And Number Of Awakenings) And Time In MVPA In School-aged Obese Adolescents From Monterrey méXico.

Obesity has positioned itself as a public health problem worldwide with multifactorial characteristics. Different studies define sleep time as obesogenic factor while others found a correlation with the levels of moderate to vigorous physical activity.(MVPA) PURPOSE: To assess the effect of a School-based Exercising and Nutrition Counseling Intervention On sleep parameters (sleep time, sleep latency and number of awakenings) and time in MVPA In School-aged Obese Adolescents from Monterrey México. METHODS: An experimental study with a sample of 51 adolescents (13±2 yrs) randomly distributed in two groups: Control (CG) and experimental (EG). CG had 4 weekly sessions of 60 minutes of PA and one weekly session of nutritional counseling. EG engaged in regular school activities. Sleep variables and levels of MVPA were monitored by triaxial accelerometer (ActiGraph wGT3X -BT) for at least 7 consecutive days. RESULTS: Pre-post test comparison showed into de EG significative changes on sleep latency when MPVA increased (P=.006), other diferences were observed on the decrease in awakenings on sleep (P<.001). No changes were observed on MPVA. CG increased only sleep latency (P<.001), on the other parameters no changes were found. CONCLUSIONS: The practice of physical shows a significant relationship with sleep parameters which seems to be a favorable factor in the treatment of obesity in adolescents. We suggest further studies to modify the duration of the intervention and use other indirect instruments for analyzing the quality of sleep

Efficacy of Intragastric Balloon Treatment for Adolescent Obesity.

Several studies conducted in adults suggest that intragastric balloon (IGB) is an effective and safe method for weight loss. Although the prevalence of obesity in adolescents has increased in recent years, the outcomes of IGB treatment in this age group are not known. The aim of this study was to evaluate the safety and efficacy of IGB treatment for weight loss in adolescents followed up for 6months. This is a retrospective longitudinal study including 27 adolescents (14-19years; 23 female). All participants were referred to IGB treatment by their attending physician, presented body mass index (BMI)≥29kg/m2 (>p97 BMI/age index) and failed to lose weight in clinical treatments. A liquid-filled nonadjustable IGB with a volume of 600 to 700ml was used for 6months. All patients were included in a multidisciplinary program, and adherence to this program was evaluated as the number of attended appointments. There were no serious complications or deaths. The BMI decreased from 37.04 to 31.18kg/m2 (p<0.0001), body weight decreased from 102.21 to 86.23kg (p<0.0001), and excess weight diminished from 35.18 to 19.12kg (p<0.0001). The % excess weight loss (%EWL) was 56.19 and % total weight loss (%TWL) 16.35. Adherence to the multidisciplinary program correlated directly with %EWL (r=0.55; p=0.0033) and %TWL (r=0.53; p=0.0052). Endoscopic treatment of obesity with an IGB is safe, effective, and may be an emerging therapeutic option for adolescents.

The association of self-regulation with weight loss maintenance after an intensive combined lifestyle intervention for children and adolescents with severe obesity

BackgroundKnowledge is limited on the role the ability to self-regulate plays in the long-term outcome of obesity treatment in children and adolescents with severe obesity. The purpose of this study was to determine whether the ability to self-regulate after an one year intensive, partly inpatient, combined lifestyle intervention is associated with weight loss maintenance in children and adolescents with severe obesity.MethodsOne hundred twenty participants (8–19 years) with an average SDS-BMI of 3.41 and their parents/caregivers were included in an intervention study. As primary determinant of weight loss maintenance, general self-regulation ability was evaluated using two behavioral computer tasks assessing inhibitory control and sensitivity to reward.ResultsThere was no association between inhibitory control at T12 and ∆SDS-BMI between T12 and T24 (β = 0.0002; CI 95% = −0.0010–0.0014; P = 0.761). There was also no relation between sensitivity to reward at T12 and ∆SDS-BMI between T12 and T24 (β = −0.0028; CI 95% = −0.0075–0.0019; P = 0.244). None of the psychosocial factors that were examined as moderators, showed a statistically significant interaction, except for parental feeding style (P = 0.023).ConclusionsThe ability to self-regulate after an intensive, partly inpatient, multidisciplinary one year intervention for severe obesity in children and adolescents was not associated with the ability to maintain the achieved weight loss during the following year. Factors that explain the large range of long term outcomes need to be elucidated.Trial registrationNetherlands Trial Register (NTR1678, registered 20-Feb-2009).

Rationale and design of theory‐based nutritional strategy to promote healthy dietary habits in severe obese adolescents: Study protocol for ICAAN (Intervention for childhood and adolescent obesity via activity and nutrition) project

BackgroundBehavioral modification on healthy eating and lifestyle is required to improve metabolically healthy status in severe obese child and adolescents. We aimed to develop tailored nutritional education programs to find barriers on dietary and lifestyle for severe obese adolescents and their caregivers.MethodsFocused on theoretical framework approaches are effective to change behavior and achieve goals. To develop four monthly contents, social cognitive theory and transtheoretical model were applied to this program. All sessions were designed to give nutritional knowledge and practical mission in a real life for individual goal setting and self‐control. In the 1st and 2nd sessions, my meal planning and portion control were emphasized based on five food groups for diet and health outcome expectations. The 3rd and 4th sessions were build up skills to choose healthy snacks and cook with fruit and vegetables. 103 participants aged 8 to 16 years will be participated in a 16 week intervention program. During the each sessions, the participants and their family will be interviewed by nutritional expert for further tailored nutritional education and counselling.ResultsEach 20‐min individual face to face nutritional education and counselling will be offered every month for the participants and their parents; monthly phone contact and txt message for social support and online food recipe to emphasize having breakfast and vegetable and fruit consumption. Following as the monthly contents, individual dietary goal setting will be attained by every participants with their family. Promoting healthy eating practices resources; an educational book, practice posters, food diaries and a water bottle will be provided to all intervention participants to motivate healthy lifestyle behaviors.DiscussionThis nutritional intervention program might be assist to implement further researches in severe obese adolescents' population.Support or Funding InformationPreparation of this article was supported by Grant 2015‐ER6401‐00 from the Division of Metabolic disease, Center for Biomedical science, Korea National Institute of Health.

Determining the Association between Child Dietary Behaviors and Weight Status

IntroductionIn 2011–2012, over a third of U.S. children were overweight or obese and 17% were obese. The Expert Committee on the Assessment, Prevention and Treatment of Child and Adolescent Overweight and Obesity created a list of behaviors with recommendations to prevent or treat overweight and obesity in children. A screening tool was developed at the Rush Pediatric Primary Care Center to start the conversation between physicians and registered dietitian nutritionists with families about these behaviors.ObjectiveTo determine the association between the child's weight status, dietary behaviors, and other demographic variables assessed on the Child Nutrition and Physical Activity (CNPA) screener.DesignA cross sectional design study was conducted using a retrospective chart review method.MethodsDietary behavior and parent perception responses were collected using the CNPA screener. Dietary behaviors included sugar sweetened beverage (SSB), fruit and vegetable intake, eating breakfast, eating out, eating dinner with family, number of meals and snacks consumed, and type and amount of milk consumed. A CNPA was given to parents of children who came to the clinic between 2012–2015. Chi square was used to determine the association between weight status, demographic characteristics and dietary behaviors, as well as the association between accurate parent perception and demographic characteristics. Forward logistic regression analysis was conducted with odds of being obese and severe obese compared to healthy weight.ResultsA total of 2,230 children, 2–18 years old were included in the analysis. A majority of the sample was non‐Hispanic black (59.6%) and healthy weight (61.1%). Based on univariate analysis, 17 variables were entered into the forward logistic regression analysis; age, sex, race, drinking SSBs, eating breakfast, fruit and vegetable, eating out, eating dinner with family, number of meals and snacks consumed, milk type consumed, and parent perception of the child's weight status. The forward wald model was statistically significant χ2 (7, N=1312) = 501.01, p &lt;.001, indicating that the model was able to distinguish between healthy weight children and those who were obese or severe obese. The model explained 31.7% to 46.3% of the variance in weight status and correctly classified 84.3% of cases. Increasing age (1.14 OR (95% CI 1.10–1.18) (p&lt;.001), being non‐Hispanic black (2.33 OR (95% CI 1.34–4.06) (p=.003), consuming 2% milk (2.97 OR (95% CI 1.91–4.62) (p&lt;.001), being Hispanic (3.14 OR (95% CI 1.77–5.57) (p&lt;.001), and consuming non‐fat/1% milk (8.83 OR (95% CI 5.01–15.55) (p&lt;.001) increased the odds of being obese or severe obese. Increasing number of meals (.75 OR (95% CI .59–.95) (p&lt;.001) and correctly perceiving the child's weight status (0.03 OR (95% CI 0.02–0.04) (p&lt;.001) decreased the odds of being obese or severe obese.ConclusionThe odds of being obese or severe obese were higher if the child consumed nonfat/1% milk or 2% milk, and lower as number of meals increased and if the parent correctly perceived their child's weight. The other dietary behaviors had no significant association with the odds of being obese or severe obese in this predominately non‐Hispanic black sample.Support or Funding InformationDepartmental Funding

A hospital-based child and adolescent overweight and obesity treatment protocol transferred into a community healthcare setting.

BackgroundDue to the pandemic of child and adolescent overweight and obesity, improvements in overweight and obesity treatment availability and accessibility are needed.MethodsIn this prospective study, we investigated if reductions in body mass index (BMI) standard deviation scores (SDS) and waist circumference (WC) would occur during 1.5 years of community-based overweight and obesity treatment based upon an effective hospital-based overweight and obesity treatment protocol, The Children’s Obesity Clinics’ Treatment protocol. Height, weight, and WC were measured at all consultations. Changes in BMI SDS and WC were analyzed using linear mixed models based upon the repeated measures in each child.ResultsFrom June 2012 to January 2015, 1,001 children (455 boys) were consecutively enrolled in the community-based treatment program. Upon entry, the median age was 11 years (range: 3−18), and the median BMI SDS was 2.85 (range: 1.26−8.96) in boys and 2.48 (range: 1.08−4.41) in girls. After 1.5 years of treatment BMI SDS was reduced in 74% of the children. BMI SDS was reduced by a mean of 0.38 (95% confidence interval (CI): 0.30−0.45, p<0.0001) in boys and 0.18 (95% CI: 0.12−0.25, p<0.0001) in girls after 1.5 years of treatment, independently of baseline age, BMI SDS, and Tanner stage (all p>0.08). WC was reduced by a mean of 3.8 cm (95% CI: 2.7−4.9, p>0.0001) in boys and 5.1 cm (95% CI: 4.0−6.2, p>0.0001) in girls. The dropout rate was 31% after 1.5 years. A median of 4.5 consultation hours was invested per child per year.ConclusionBMI SDS and WC were reduced after 1.5 years of treatment. Hence, this community-based overweight and obesity treatment program may help accommodate the need for improvements in treatment availability and accessibility.

Effects of a psychological intervention on the quality of life of obese adolescents under a multidisciplinary treatment

ObjectiveTo investigate the effects of multidisciplinary treatment with and without psychological counseling on obese adolescents’ self‐reported quality of life. MethodsSeventy‐six obese adolescents (15.87±1.53 y) were allocated into psychological counseling group (PCG; n=36) or control group (CG; n=40) for 12 weeks. All participants received the same supervised exercise training, nutritional and clinical counseling. Participants in PCG also received psychological counseling. QOL was measured before and after 12 weeks of intervention by Generic Questionnaire for the Evaluation of Quality of Life (SF‐36). ResultsThe dropout rate was higher in GC (22.5%) when compared with PCG (0.0%) (p<0.001). After 12 weeks, participants from PCG presents lower body weight, relative fat mass and higher free fat mass (p<0.001 for all) compared to GC. QOL improved among adolescents from both groups (p<0.05), however, a better QOL was reported from those adolescents enrolled in PCG. ConclusionThe inclusion of a psychological counseling component in multidisciplinary treatment for adolescent obesity appears to provide benefits observed for improved QOL as compared with treatment without psychological counseling.

Prevalence of adolescent obesity at a high school in the City of Tshwane.

BackgroundObesity has been reported to be on the rise in the world and South Africa is no exception. In recent years obesity has been reported to contribute to the increasing number of people with hypertension and diabetes mellitus. Africa has the fastest growing number of overweight and obese adolescents, with indications that in 2010, it had more than doubled since 1990. Some people might perceive being overweight as being round and healthy which might contribute to the increased rate of obesity in South Africa. Physical and psychological changes that occur during adolescence can also be observed earlier during the preteen years (ages 9–12 years). During this time, peer groups and external appearance are of importance. Physical changes, such as obesity, might be perceived negatively by adolescents, affecting their self-esteem.ObjectivesThe purpose of the study was to determine the prevalence of adolescent obesity at a high school in the City of Tshwane.MethodA cross-sectional survey was conducted. Stratified random sampling was used and data were collected from 30% of the total population as recommended by the statistician. Data analysis was performed using descriptive analysis. Validity and reliability were ensured through calibrating the weight-monitoring scale and the measuring tape, which are collection tools.ResultsThe results identified the prevalence of adolescent obesity at 8.57%. There is evidence of abdominal obesity and waist–hip ratio ≥ 1. The results show that there is a steady increase in obesity levels among adolescents. The poor response of parents was observed and could demonstrate the need to form stronger partnerships for weight reduction interventions.ConclusionEvidence-based prevalence allowed for conceptualisation of the scope of the obesity epidemic and how children and young people are also affected. To enable proper planning for adolescent obesity interventions, the depth of consequences of obesity for the adolescent cohort should be well defined and clarified.

Should bariatric surgery be performed in adolescents?

Adolescent obesity has markedly increased worldwide in both its extent and prevalence in recent decades and obesity prevention strategies are failing. As a result, effective treatment strategies are urgently needed. As behavioral and pharmacological treatment approaches have only moderate effects in severe obesity, bariatric surgery has begun to emerge as a treatment option. In this debate article, we offer arguments opposing and supporting bariatric surgery in the treatment of severe obesity in adolescents. Bariatric surgery has superior therapeutic outcomes with respect to weight loss and resolution of comorbid diseases over other existing treatments. However, long-term outcomes after bariatric surgery in adolescents are only just beginning to emerge. Furthermore, the procedures are generally considered irreversible, apart from gastric banding. Most importantly, not all adolescents seem to benefit greatly from bariatric surgery and we are not yet able to reliably identify those who stand to gain the greatest benefit. The authors agree that adolescent bariatric surgery should be offered exclusively within formal adolescent obesity programs, delivered by specialist multidisciplinary child/adolescent obesity teams, and within specialist centers, in order to optimize outcomes and minimize potential detrimental effects. Patients and their family/carers must be educated regarding the benefits and risks, potential side effects, expected changes in eating behavior and the lifelong requirement for regular medical follow-up after surgery. Before embarking upon a surgical treatment pathway in adolescents with severe obesity, it may also be beneficial to ensure compliance to treatment is demonstrated, in order to minimize the risk of nutritional deficiencies and associated potential complications.

Parent-adolescent influences on everyday dietary practices: Perceptions of adolescent females with obesity and their mothers.

Parents demonstrate an important influence on adolescent obesity and dietary behavior; yet, family-based obesity interventions continue to exhibit limited success among adolescents. To further inform family-based approaches for adolescent obesity treatment, we examined the perceptions of adolescent females with obesity and their mothers of the influences experienced within the parent-adolescent relationship that affect everyday dietary practices. We conducted six focus group interviews (three adolescent female and three mother) among 15 adolescent (12-17years old) females with obesity and 12 of their mothers. Content analysis techniques were used to analyze the transcribed interviews. Adolescent females with obesity discussed a diverse set of parental influences (controlling, supporting and cultivating, overlooking and tempting, acquiescing, providing, attending, and not providing and avoiding) on their daily dietary practices. Among mother focus groups, mothers discussed specific intentional and unintentional types of influences from children that affected the food and drink they consumed, prepared, and acquired. Findings provide a fuller view of the varied social influences on everyday dietary practices within the parent-adolescent relationship. They indicate the importance of examining both parent-to-child and child-to-parent influences and begin to illuminate the value of attending to the social circumstances surrounding dietary behaviors to strengthen family-based obesity treatment approaches.

Behavioral intervention in the treatment of obesity in children and adolescents: implications for Mexico.

Pediatric obesity is a worldwide health epidemic affecting both developed and developing countries. Mexico ranks second to the United States in rates of pediatric obesity. Obesity among youth has immediate and long-term consequences on physical and psychosocial development, including cardiovascular, respiratory, and health-related quality of life. Eventual amelioration of this epidemic will require change at the level of the family and community, along with policy initiatives to support healthier eating and activity habits. Evidence-based interventions for overweight/obese youth include family-based lifestyle programs that incorporate attention to diet quantity and quality, physical activity, sedentary behavior, and behavioral strategies to support change. While much of this research has been conducted in the United States, several recent studies suggest the efficacy of similar approaches for youth in Mexico.

Prader Willys syndrome diagnosed in extremely obese female adolescent

Introduction: Nutritional obesity is the most common cause of obesity (95%) in childhood and adolescence. Morbid obesity (5%), which usually begins at an early age, can be caused by monogenic disorders, various genetic syndromes, endocrine diseases-disorders, central nervous system lesions or iatrogenic causes. Presentation of the patient: A female adolescent aged 13 is presented who was due to obesity referred to the Center for the Prevention and Treatment of Obesity in children and adolescents at the Special Hospital “Cigota” at Mt. Zlatibor. Low height/stature and dysmorphic features: a face with a narrow bifrontal diameter, almond-shaped eyes, strabismus, small hands and feet, delay in puberty development and lagging in psychomotor development have indicated the morbid obesity. Anamnestic data on hypotonia and difficulty in feeding, psychomotor lagging behind, obesity since the third year of age, triggered a suspicion of Prader Willy’s syndrome. The suspicion of this syndrome was confirmed by a molecular DNA analysis which indicated a deletion on the long arm 15q11.2. Conclusion: Obesity, endocrinolopathies, retardation in psychomotor development and behavioral disorders in people with Prader Willy’s syndrome require a complex multidisciplinary treatment. Early diagnosis and adequate treatment prevent the occurrence of complications and improve the quality and length of life of the patients.