Clinical Considerations Regarding the Use of Obesity Pharmacotherapy in Adolescents with Obesity

Gitanjali Srivastava, Claudia K Fox, Aaron S Kelly, Ania M. Jastreboff, Allen F. Browne, Nancy T. Browne, Janey S.A. Pratt, Christopher Bolling, Marc P. Michalsky, Stephen Cook, Carine M. Lenders, Caroline M. Apovian

Research output: Contribution to journalReview article

2 Citations (Scopus)

Abstract

A growing number of youth suffer from obesity and in particular severe obesity for which intensive lifestyle intervention does not adequately reduce excess adiposity. A treatment gap exists wherein effective treatment options for an adolescent with severe obesity include intensive lifestyle modification or metabolic and bariatric surgery while the application of obesity pharmacotherapy remains largely underutilized. These youth often present with numerous obesity-related comorbid diseases, including hypertension, dyslipidemia, prediabetes/type 2 diabetes, obstructive sleep apnea, nonalcoholic fatty liver disease, musculoskeletal problems, and psychosocial issues such as depression, anxiety, and social stigmatization. Current pediatric obesity treatment algorithms for pediatric primary care providers focus primarily on intensive lifestyle intervention with escalation of treatment intensity through four stages of intervention. Although a recent surge in the number of Food and Drug Administration-approved medications for obesity treatment has emerged in adults, pharmacotherapy options for youth remain limited. Recognizing treatment and knowledge gaps related to pharmacological agents and the urgent need for more effective treatment strategies in this population, discussed here are the efficacy, safety, and clinical application of obesity pharmacotherapy in youth with obesity based on current literature. Legal ramifications, informed consent regulations, and appropriate off-label use of these medications in pediatrics are included, focusing on prescribing practices and prescriber limits.

Original languageEnglish (US)
Pages (from-to)190-204
Number of pages15
JournalObesity
Volume27
Issue number2
DOIs
StatePublished - Feb 1 2019

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Pediatric Obesity
Obesity
Drug Therapy
Life Style
Bariatric Surgery
Morbid Obesity
Therapeutics
Pediatrics
Off-Label Use
Prediabetic State
Stereotyping
Adiposity
Obstructive Sleep Apnea
United States Food and Drug Administration
Dyslipidemias
Informed Consent
Type 2 Diabetes Mellitus
Primary Health Care
Anxiety
Pharmacology

PubMed: MeSH publication types

  • Journal Article
  • Review

Cite this

Srivastava, G., Fox, C. K., Kelly, A. S., Jastreboff, A. M., Browne, A. F., Browne, N. T., ... Apovian, C. M. (2019). Clinical Considerations Regarding the Use of Obesity Pharmacotherapy in Adolescents with Obesity. Obesity, 27(2), 190-204. https://doi.org/10.1002/oby.22385

Clinical Considerations Regarding the Use of Obesity Pharmacotherapy in Adolescents with Obesity. / Srivastava, Gitanjali; Fox, Claudia K; Kelly, Aaron S; Jastreboff, Ania M.; Browne, Allen F.; Browne, Nancy T.; Pratt, Janey S.A.; Bolling, Christopher; Michalsky, Marc P.; Cook, Stephen; Lenders, Carine M.; Apovian, Caroline M.

In: Obesity, Vol. 27, No. 2, 01.02.2019, p. 190-204.

Research output: Contribution to journalReview article

Srivastava, G, Fox, CK, Kelly, AS, Jastreboff, AM, Browne, AF, Browne, NT, Pratt, JSA, Bolling, C, Michalsky, MP, Cook, S, Lenders, CM & Apovian, CM 2019, 'Clinical Considerations Regarding the Use of Obesity Pharmacotherapy in Adolescents with Obesity', Obesity, vol. 27, no. 2, pp. 190-204. https://doi.org/10.1002/oby.22385
Srivastava, Gitanjali ; Fox, Claudia K ; Kelly, Aaron S ; Jastreboff, Ania M. ; Browne, Allen F. ; Browne, Nancy T. ; Pratt, Janey S.A. ; Bolling, Christopher ; Michalsky, Marc P. ; Cook, Stephen ; Lenders, Carine M. ; Apovian, Caroline M. / Clinical Considerations Regarding the Use of Obesity Pharmacotherapy in Adolescents with Obesity. In: Obesity. 2019 ; Vol. 27, No. 2. pp. 190-204.
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