Diabetes and Obesity in the Child and Adolescent: Guidelines and Challenges

Progress in pediatric obesity: new and advanced therapies

“…However, the availability of large multidisciplinary weight management programs with comprehensive multidisciplinary intervention and tertiary care intervention is limited with large sections of the United States lacking obesity medicine specialists, in particular those with experience with pediatric obesity management. Positive weight loss results have been observed in numerous studies with younger children having a greater reduction in BMI z-score in comparison to adolescents when analyzing the effects of multidisciplinary interventions on weight loss and health outcomes in children and adolescents with severe obesity [10,13]. In other studies, adolescents with the most severe obesity had the greatest reductions in BMI [14].…”

“…We have detailed the guidelines and challenges to management of obesity in childhood through the Pediatric Obesity Algorithm, an evidence-based roadmap for the diagnosis and management of children with obesity [9,10]. In the Algorithm, we discuss agespecific recommendations that were developed for use by practicing clinicians with topics ranging from assessment to the diagnosis and treatment of obesity comorbidities [9,11].…”

“…with a BMI percentile at the >95th percentile have a greater chance of maintaining obesity into adulthood [10,18].…”

“…Metformin is commonly utilized in the population of children and adolescents, although FDA approved only in children 10 years with T2DM. However, metformin has been prescribed by obesity medicine specialists for polycystic ovary syndrome or severe insulin resistance with or without impaired glucose tolerance, with multiple trials [19,20] showing a small amount of weight loss associated with metformin use, particularly in the first few months of medication initiation [10]. By age 17 or 18, when more pharmaceutical treatment options are FDA approved, comorbidities have developed.…”

Special considerations for the adolescent with obesity: An obesity medicine association (OMA) clinical practice statement (CPS) 2024

“…Prevalence of obesity significantly increased in children aged 2–5 years, adolescents 12–19 years, and all children aged 2–19 years in all races and ethnicities [ 2 ]. Early intervention is crucial and adolescents with body mass index (BMI) > 95th%ile have a higher risk of obesity persisting into adulthood than younger children [ 3 , 4 ].…”