Severe obesity in children and adolescents: Identification, associated health risks, and treatment approaches: A scientific statement from the American Heart Association

Aaron S. Kelly, Sarah E. Barlow, Goutham Rao, Thomas H. Inge, Laura L. Hayman, Julia Steinberger, Elaine M. Urbina, Linda J. Ewing, Stephen R. Daniels

Research output: Contribution to journalArticle

369 Citations (Scopus)

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/behavior-based 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.

Original languageEnglish (US)
Pages (from-to)1689-1712
Number of pages24
JournalCirculation
Volume128
Issue number15
DOIs
StatePublished - Oct 8 2013

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Morbid Obesity
Health
Pediatric Obesity
Body Mass Index
Therapeutics
Insurance Coverage
Bariatric Surgery
Behavior Therapy
Life Style
Epidemiology
Safety
Weights and Measures

Keywords

  • AHA Scientific Statements
  • Adolescents
  • Children
  • Obesity
  • Risk factors

Cite this

Severe obesity in children and adolescents : Identification, associated health risks, and treatment approaches: A scientific statement from the American Heart Association. / Kelly, Aaron S.; Barlow, Sarah E.; Rao, Goutham; Inge, Thomas H.; Hayman, Laura L.; Steinberger, Julia; Urbina, Elaine M.; Ewing, Linda J.; Daniels, Stephen R.

In: Circulation, Vol. 128, No. 15, 08.10.2013, p. 1689-1712.

Research output: Contribution to journalArticle

Kelly, Aaron S. ; Barlow, Sarah E. ; Rao, Goutham ; Inge, Thomas H. ; Hayman, Laura L. ; Steinberger, Julia ; Urbina, Elaine M. ; Ewing, Linda J. ; Daniels, Stephen R. / Severe obesity in children and adolescents : Identification, associated health risks, and treatment approaches: A scientific statement from the American Heart Association. In: Circulation. 2013 ; Vol. 128, No. 15. pp. 1689-1712.
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