Metformin in Obese Children and Adolescents: The MOCA Trial

Kendall, Deborah; Vail, Andy; Amin, Rakesh; Barrett, Timothy; Dimitri, Paul; Ivison, Fiona; Kibirige, M S; Mathew, Verghese; Matyka, Krystyna; McGovern, Andrew; Stirling, Heather; Tetlow, Lesley; Wales, Jerry; Wright, Neil; Clayton, Peter E.; Hall, Catherine

doi:10.1210/jc.2012-2710

Cited by 106 publications

(100 citation statements)

References 139 publications

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“…The third study, conducted in children and adolescents (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) years old) with the shorter-acting (1000 mg in the morning and 500 mg in the evening) formulation, reported a placebosubtracted reduction in BMI of 1.1 kg/m 2 (BMI reduction of ≈3%) over a treatment period of 6 months. 202 None of the other cardiometabolic risk factors measured in the study improved at 6 months. A meta-analysis of 5 studies (with treatment periods ≥6 months) that used metformin in children and adolescents reported a placebo-subtracted reduction in BMI of 1.42 kg/m 2 .…”

Section: Metforminmentioning

confidence: 82%

“…Only 3 randomized controlled trials specified change in BMI as a primary efficacy end point. 189,201,202 The first study, conducted in adolescents (13-18 years old) with the extended-release formulation (2000 mg once per day), reported a placebo-subtracted reduction in BMI of 1.1 kg/m 2 (BMI reduction of ≈3%) over a treatment period of 1 year. 189 No improvements in lipid profile, blood pressure, or markers of insulin resistance were observed.…”

Section: Metforminmentioning

confidence: 99%

See 1 more Smart Citation

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Kelly¹,

Barlow

Rao³

et al. 2013

Circulation

887

804

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espite recent data suggesting that the rate of increase of obesity among children and adolescents has slowed and overall prevalence has possibly begun to plateau, 1,2 a worrisome trend has emerged in the form of severe pediatric obesity. As the fastest-growing subcategory of obesity in children and adolescents, 1,3,4 severe obesity afflicts between 4% and 6% of all youth in the United States 3-7 and has both immediate and long-term health consequences. Recent data further Abstract-Severe obesity afflicts between 4% and 6% of all youth in the United States, and the prevalence is increasing.Despite the serious immediate and long-term cardiovascular, metabolic, and other health consequences of severe pediatric obesity, current treatments are limited in effectiveness and lack widespread availability. Lifestyle modification/behaviorbased treatment interventions in youth with severe obesity have demonstrated modest improvement in body mass index status, but participants have generally remained severely obese and often regained weight after the conclusion of the treatment programs. The role of medical management is minimal, because only 1 medication is currently approved for the treatment of obesity in adolescents. Bariatric surgery has generally been effective in reducing body mass index and improving cardiovascular and metabolic risk factors; however, reports of long-term outcomes are few, many youth with severe obesity do not qualify for surgery, and access is limited by lack of insurance coverage. To begin to address these challenges, the purposes of this scientific statement are to (1) provide justification for and recommend a standardized definition of severe obesity in children and adolescents; (2) raise awareness of this serious and growing problem by summarizing the current literature in this area in terms of the epidemiology and trends, associated health risks (immediate and long-term), and challenges and shortcomings of currently available treatment options; and (3) highlight areas in need of future research. Innovative behavior-based treatment, minimally invasive procedures, and medications currently under development all need to be evaluated for their efficacy and safety in this group of patients with high medical and psychosocial risks. (Circulation. 2013;128:1689-1712.)

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Section: Metforminmentioning

confidence: 82%

Section: Metforminmentioning

confidence: 99%

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

Kelly¹,

Barlow

Rao³

et al. 2013

Circulation

887

804

View full text Add to dashboard Cite

show abstract

“…We prescribe Bofu-tsusho-san to mild obesity children and have observed consistent effects. A previous study also demonstrated that Metformin hydrochloride, an insulin sensitizer indicated for the treatment of insulin resistance in type 2 diabetes that may reduce appetite by increasing glucagon-like-peptide levels, was effective in reducing body weight (34).…”

Section: Pharmacotherapymentioning

confidence: 94%

Common approach to childhood obesity in Japan

Kubo

2014

Journal of Pediatric Endocrinology and Metabolism

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Although the prevalence of childhood obesity is plateauing, it remains a social concern. The Japan Society for the Study of Obesity devised criteria for obesity disease as a morbid state that requires medical treatment in 2002. Moreover, the Japanese Ministry of Health, Labour and Welfare announced diagnostic criteria for childhood metabolic syndrome in 2010 because of the increasing number of children with lifestyle-related diseases. The treatment of obesity needs to be prioritized, and three principles, other than behavioral therapy, have been introduced in this study for the general medical treatment of obesity without underlying diseases: (1) diet therapy, (2) exercise, and (3) no pharmacotherapy. However, preventing obesity is more important than its treatment. A previous study reported the tracking of an overweight status from infancy; therefore, it is important to prevent infants from becoming overweight. The concept of the developmental origins of health and disease has been attracting more attention in recent years; however, preventative measures prior to birth should also be considered to reduce the incidence of obesity. Although the methods used to approach the treatment of childhood obesity change with differences in race or lifestyle, those who are engaged in the medical treatment of childhood obesity worldwide can contribute to its treatment and prevention by a mutual exchange of information.

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“…Three randomized, placebo-controlled trials conducted in obese youth without diabetes mellitus reported a BMI reduction of ≈3% over a treatment period of 6 to 12 months. [226][227][228] Neither glucagon-like peptide-1 receptor agonists nor dipeptidyl peptidase-4 inhibitors are currently approved by the US Food and Drug Administration for the treatment of T2DM in children and adolescents. However, if the safety and efficacy of these drug classes are established and US Food and Drug Administration approval is obtained, these medications may be an attractive option because glucagon-like peptide-1 receptor agonists are associated with weight loss and dipeptidyl peptidase-4 inhibitors appear to be weight neutral, although safety concerns about long-term treatment exist that are based on recent autopsy studies.…”

Section: Type 2 Diabetes Mellitusmentioning

confidence: 99%