Treatment of obesity in children and adolescents

Institute for Clinical Systems Improvement
Record ID 32005001136
Authors' objectives:

This review investigates a variety of possible treatments for the serious and growing public health problem of obesity in children and adolescents.

Authors' recommendations: With regard to treatment of obesity in children and adolescents, the ICSI Technology Assessment Committee concludes: 1. Safe treatments for pediatric obesity include exercise and behavioral interventions. 2. Any caloric restriction in prepubertal children and very low calorie diets (such as protein sparing modified fasts) for children and adolescents require medical supervision. 3. Integration of dietary, exercise, and behavioral treatments for obesity into a multidisciplinary program with appropriately trained personnel appears to be more effective than any of the treatments alone, noting a long-term decrease in excess weight by 10% to 15% in controlled trials. However, small sample sizes and the intensity of the intervention in the studies make generalizing the results to populations in the clinical (non-investigational) setting difficult (Conclusion Grade II). 4. There are no long-term results to demonstrate that pharmacological agents for weight loss are safe and efficacious in children and adolescents. 5. In contrast to adults, there are no controlled or long-term studies in children or adolescents to show lasting efficacy of bariatric surgery. In the short-term, bariatric surgery appears to lead to significant weight loss with resolution of comorbidities. Based on small case series, bariatric surgical complications in adolescents (age 11 years or greater) are no higher than in adults, although the impact of bariatric surgery on growth, development, metabolic homeostasis, and nutritional balance is unknown. There are no data on bariatric surgery in prepubertal children (age less than 11 years) to permit conclusions regarding safety and efficacy in this population.
Authors' methods: Review
Project Status: Completed
Year Published: 2005
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: United States
MeSH Terms
  • Adolescent
  • Child
  • Diet
  • Exercise
  • Obesity
Organisation Name: Institute for Clinical Systems Improvement
Contact Address: 8009 34th Avenue South, Suite 1200, Bloomington, MN, USA. Tel: +1 952 814 7060; Fax: +1 952 858 9675
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Copyright: Institute for Clinical Systems Improvement (ICSI)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.