How to treat childhood and adolescent obesity?

It is a problem of great importance, that every day more and more families suffer in their homes… The frequency of overweight and obesity in children under 18 has almost tripled in the last 30 years:

Infantile-juvenile overweight, over 45%
Infantile-juvenile obesity, over 15-16%.

In addition, the growing number of obese people that we see in our society today, in reality come from a rate of obesity child – youth lower than the current.

We need a radical change in our dietary model and lifestyle and a real overall performance.

And how should we measure obesity in our children? When should we worry?

• In the infantile period, the habitual percentiles are handled (>80 overweight, >95 obesity )
• In the adolescent period (>14 years), the BMI of adults (BMI > 30 obesity) is used.

What diseases are most frequently seen associated with secondary obesity?

• Genetic problems: Sdr. de Down.
• Endocrine problems: malfunction of the thyroid, ovaries or testicles, or adrenal glands, which manifest themselves in many different ways.
• Neurological problems: Spina Bifida.
• Psychiatric problems: Bulimia nervosa.

What problems can obesity cause, at a time apparently as delicate as the child’s growth?

• Advance puberty.
• Advance sexual maturation.
• Eating Disorders.
• Cardiovascular problems…

How should such a problem be addressed?

Through multidisciplinary work that addresses all areas of the child: family (different family nuclei), school and social.

Should we really think about an obesity operation on obese teenagers? From what degree of obesity should it be used?

Yes, when the child has psychological problems that are difficult to manage or a poor response to psychotherapy, and with a BMI greater than 45-50.

• In the infantile period, the habitual percentiles are handled (>80 overweight, >95 obesity )
• In the adolescent period (>14 years), the BMI of adults (BMI > 30 obesity) is used.
• Endocrine problems: malfunction of the thyroid, ovaries or testicles, or adrenal glands, which manifest themselves in many different ways.
• Genetic problems: Sdr. de Down.
• Neurological problems: Spina Bifida.
• Psychiatric problems: Bulimia nervosa.
• Advance puberty.
• Advance sexual maturation.
• Eating Disorders.
• Cardiovascular problems…
• Intervention on the child:
• Balanced diet.
• Physical exercise and active living.
• Behavioural Psychological Tto.
• Primary Obesity Pharmacological Tto (orlistat, metformin)
• Intragastric Balloon?
• Integral family therapy.
• School support and other environments.

Are special conditions necessary in the child and / or his family, in order to indicate an operation of obesity in an adolescent?

The stability and support of the child’s family and school environment is very important. Family psychological treatment may be necessary with some frequency.

The nutritional control of the adolescent after the operation is fundamental, and blood controls may be necessary more frequently than in the adult.

What would be the most appropriate type of operation in your experience to control obesity in an adolescent?

The operation of the Gastric Tube is the most accepted at present, although the Gastric Band could also be used.

And can these operations on teenagers affect their definitive growth or maturation?

In general, malabsorptive procedures should be avoided because they may affect the growth and maturation of the adolescent.

Does the risk of the operation outweigh the profit achieved?

There is no doubt that the benefit outweighs the risk, although the control, training and post-operative support of the patient and the family is very important.