Overweight Children and Adolescents

A seven-year-old girl is 130 cm tall (the 90th percentile for girls of the same age) and weighs 34.6 kg (above the 95th percentile), with a body-mass index of 20.5 (above the 95th percentile). Physical examination reveals no abnormalities aside from her excess weight. She eats fast food and drinks soft drinks regularly, has limited exercise, and watches television or uses the computer for hours each day. What should you advise?

[1]  T. Robinson Behavioural treatment of childhood and adolescent obesity , 1999, International Journal of Obesity.

[2]  Guijing Wang,et al.  Economic burden of obesity in youths aged 6 to 17 years: 1979-1999. , 2002, Pediatrics.

[3]  M. Jacobson,et al.  Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. , 2003, The Journal of pediatrics.

[4]  H. Pollack,et al.  Epidemic increase in childhood overweight, 1986-1998. , 2001, JAMA.

[5]  J. Schwimmer,et al.  Nonalcoholic fatty liver disease in the pediatric population. , 2004, Clinics in liver disease.

[6]  J. Flier,et al.  A Transgenic Model of Visceral Obesity and the Metabolic Syndrome , 2001, Science.

[7]  James O. Hill,et al.  Obesity and the Environment: Where Do We Go from Here? , 2003, Science.

[8]  C. Cowell Food Guide Pyramid for Young Children , 1999 .

[9]  H. Hauner,et al.  Glucocorticoids and insulin promote the differentiation of human adipocyte precursor cells into fat cells. , 1987, The Journal of clinical endocrinology and metabolism.

[10]  S. Kihara,et al.  Obesity, adiponectin and vascular inflammatory disease , 2003, Current opinion in lipidology.

[11]  Lester R Curtin,et al.  Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. , 2002, Pediatrics.

[12]  M. Weissman,et al.  The association between childhood depression and adulthood body mass index. , 2001, Pediatrics.

[13]  W. Pryse-Phillips,et al.  The cardinal manifestations of Bardet-Biedl syndrome, a form of Laurence-Moon-Biedl syndrome. , 1989, The New England journal of medicine.

[14]  A. Magarey,et al.  Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions , 2001, The Medical journal of Australia.

[15]  W. Dietz,et al.  Guidelines for overweight in adolescent preventive services: recommendations from an expert committee. The Expert Committee on Clinical Guidelines for Overweight in Adolescent Preventive Services. , 1994, The American journal of clinical nutrition.

[16]  R. Tracy,et al.  Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. , 1998, The New England journal of medicine.

[17]  M A Waclawiw,et al.  Overweight, fat patterning, and cardiovascular disease risk factors in black and white girls: The National Heart, Lung, and Blood Institute Growth and Health Study. , 1999, The Journal of pediatrics.

[18]  T. Robinson,et al.  Children's food consumption during television viewing. , 2004, The American journal of clinical nutrition.

[19]  E. Waters,et al.  Interventions for preventing obesity in children. , 2001, The Cochrane database of systematic reviews.

[20]  N. Butte,et al.  Comment on "Obesity and the Environment: Where Do We Go from Here?" , 2003, Science.

[21]  D. Galuska,et al.  Are health care professionals advising obese patients to lose weight? , 1999, JAMA.

[22]  B. Swinburn,et al.  Dissecting obesogenic environments: the development and application of a framework for identifying and prioritizing environmental interventions for obesity. , 1999, Preventive medicine.

[23]  K. Dewey Is Breastfeeding Protective Against Child Obesity? , 2003, Journal of human lactation : official journal of International Lactation Consultant Association.

[24]  G. Mallory,et al.  Sleep-associated breathing disorders in morbidly obese children and adolescents. , 1989, The Journal of pediatrics.

[25]  M. Jacobson,et al.  Effects of a low-carbohydrate diet on weight loss and cardiovascular risk factor in overweight adolescents. , 2003, The Journal of pediatrics.

[26]  T. Robinson,et al.  Phase 1 of the Girls health Enrichment Multi-site Studies (GEMS): conclusion. , 2003, Ethnicity & disease.

[27]  R. Lauer,et al.  Factors affecting the relationship between childhood and adult cholesterol levels: the Muscatine Study. , 1988, Pediatrics.

[28]  W. Dietz,et al.  Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988-1994. , 2003, Archives of pediatrics & adolescent medicine.

[29]  V. Hubbard,et al.  Three-month tolerability of orlistat in adolescents with obesity-related comorbid conditions. , 2002, Obesity research.

[30]  K. Fujioka,et al.  Recombinant leptin for weight loss in obese and lean adults: a randomized, controlled, dose-escalation trial. , 1999, JAMA.

[31]  V. Garcia,et al.  A multidisciplinary approach to the adolescent bariatric surgical patient. , 2004, Journal of pediatric surgery.

[32]  H. Pollack,et al.  Social marginalization of overweight children. , 2003, Archives of pediatrics & adolescent medicine.

[33]  W H Dietz,et al.  Role of the prenatal environment in the development of obesity. , 1998, The Journal of pediatrics.

[34]  E. Waters,et al.  Interventions for preventing obesity in childhood. A systematic review , 2001, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[35]  T. Robinson Television viewing and childhood obesity. , 2001, Pediatric clinics of North America.

[36]  C. Summerbell,et al.  Childhood predictors of adult obesity: a systematic review. , 1999, International journal of obesity and related metabolic disorders : journal of the International Association for the Study of Obesity.

[37]  L. Epstein,et al.  Treatment of pediatric obesity. , 1998, Pediatrics.

[38]  M. Overpeck,et al.  Association between infant breastfeeding and overweight in young children. , 2001, JAMA.

[39]  T. Mckenna,et al.  Pathogenesis and treatment of polycystic ovary syndrome. , 1988, The New England journal of medicine.

[40]  D. Neumark-Sztainer,et al.  Associations of weight-based teasing and emotional well-being among adolescents. , 2003, Archives of pediatrics & adolescent medicine.

[41]  L. Epstein,et al.  Decreasing sedentary behaviors in treating pediatric obesity. , 2000, Archives of pediatrics & adolescent medicine.

[42]  S. Daniels,et al.  Overweight, fat patterning, and cardiovascular disease risk factors in black and white boys. , 1999, The Journal of pediatrics.

[43]  Clive Osmond,et al.  Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood. , 2004, The New England journal of medicine.

[44]  T. Wadden,et al.  Behavior therapy and sibutramine for the treatment of adolescent obesity: a randomized controlled trial. , 2003, JAMA.

[45]  M. Schwartz,et al.  Neuroendocrine mechanisms regulating food intake and body weight , 2000, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[46]  S. Gortmaker,et al.  Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. , 1999, Archives of pediatrics & adolescent medicine.

[47]  B. Popkin,et al.  The relationship of ethnicity, socioeconomic factors, and overweight in US adolescents. , 2003, Obesity research.

[48]  T. Cole,et al.  Ethnic group differences in overweight and obese children and young people in England: cross sectional survey. , 2004, Archives of disease in childhood.

[49]  T N Robinson,et al.  Reducing children's television viewing to prevent obesity: a randomized controlled trial. , 1999, JAMA.

[50]  P A Raffle,et al.  Coronary heart-disease and physical activity of work. , 1953, Lancet.

[51]  G. Colditz,et al.  Risk of overweight among adolescents who were breastfed as infants. , 2001, JAMA.

[52]  W. Mueller,et al.  The changes with age of the anatomical distribution of fat. , 1982, Social Science & Medicine (1967).

[53]  Ronald M. Krauss,et al.  American Heart Association Call to Action: Obesity as a Major Risk Factor for Coronary Heart Disease , 1998 .

[54]  Kiang Liu,et al.  Cardiorespiratory fitness in young adulthood and the development of cardiovascular disease risk factors. , 2003, JAMA.

[55]  B. Rodgers Bariatric surgery for adolescents: a view from the American Pediatric Surgical Association. , 2004, Pediatrics.

[56]  L. K. Khan,et al.  Relationship of childhood obesity to coronary heart disease risk factors in adulthood: the Bogalusa Heart Study. , 2001, Pediatrics.

[57]  W. Dietz,et al.  The Relation of Overweight to Cardiovascular Risk Factors Among Children and Adolescents: The Bogalusa Heart Study , 1999, Pediatrics.

[58]  D. Jacobs,et al.  Adiposity in childhood predicts obesity and insulin resistance in young adulthood. , 2001, The Journal of pediatrics.

[59]  B. Thompson,et al.  Coronary risk factors measured in childhood and young adult life are associated with coronary artery calcification in young adults: the Muscatine Study. , 1996, Journal of the American College of Cardiology.

[60]  Katherine M Flegal,et al.  Prevalence and trends in overweight among US children and adolescents, 1999-2000. , 2002, JAMA.

[61]  W. Dietz,et al.  Overweight in childhood and adolescence. , 2004, The New England journal of medicine.

[62]  J. Yanovski Intensive therapies for pediatric obesity. , 2001, Pediatric clinics of North America.

[63]  S. Booth,et al.  Effects of Orlistat on Fat‐Soluble Vitamins in Obese Adolescents , 2002, Pharmacotherapy.

[64]  A. Prentice,et al.  Effects of recombinant leptin therapy in a child with congenital leptin deficiency. , 1999, The New England journal of medicine.

[65]  Thomas N Robinson,et al.  Cardiovascular Health in Childhood: A Statement for Health Professionals From the Committee on Atherosclerosis, Hypertension, and Obesity in the Young (AHOY) of the Council on Cardiovascular Disease in the Young, American Heart Association , 2002, Circulation.

[66]  M. Pepe,et al.  Predicting obesity in young adulthood from childhood and parental obesity. , 1997, The New England journal of medicine.

[67]  F. Lifshitz,et al.  Growth failure. A complication of dietary treatment of hypercholesterolemia. , 1989, American journal of diseases of children.

[68]  N M Laird,et al.  Tutorial in Biostatistics: Evaluating the impact of 'critical periods' in longitudinal studies of growth using piecewise mixed effects models. , 2001, International journal of epidemiology.

[69]  W. Dietz,et al.  Obesity Evaluation and Treatment: Expert Committee Recommendations , 1998 .

[70]  Henry J. Kaiser,et al.  The Role of Media in Childhood Obesity , 2004 .

[71]  J. Everhart Contributions of Obesity and Weight Loss to Gallstone Disease , 1993, Annals of Internal Medicine.

[72]  J. Wang,et al.  Relation of BMI to fat and fat-free mass among children and adolescents , 2005, International Journal of Obesity.

[73]  K. Flegal,et al.  Prevalence of overweight and obesity among US children, adolescents, and adults, 1999-2002. , 2004, JAMA.

[74]  S. Daniels,et al.  Bariatric surgery for severely overweight adolescents: concerns and recommendations. , 2004, Pediatrics.

[75]  B. Hetzel,et al.  An investigation of the effects of daily physical activity on the health of primary school students in South Australia. , 1983, International journal of epidemiology.

[76]  J. Strong,et al.  Relation of glycohemoglobin and adiposity to atherosclerosis in youth. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. , 1995, Arteriosclerosis, thrombosis, and vascular biology.

[77]  W. Rakowski,et al.  The potential variances of tailoring in health behavior interventions , 1999, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[78]  C Osmond,et al.  Birth weight and body fat distribution in adolescent girls , 1997, Archives of disease in childhood.

[79]  T. Robinson,et al.  School-based cardiovascular disease prevention studies: Review and synthesis , 1997 .

[80]  B. Zemel,et al.  Infant weight gain and childhood overweight status in a multicenter, cohort study. , 2002, Pediatrics.

[81]  R. Leibel,et al.  Understanding obesity in youth. A statement for healthcare professionals from the Committee on Atherosclerosis and Hypertension in the Young of the Council on Cardiovascular Disease in the Young and the Nutrition Committee, American Heart Association. Writing Group. , 1996, Circulation.

[82]  S. Daniels,et al.  Effect of lean body mass, fat mass, blood pressure, and sexual maturation on left ventricular mass in children and adolescents. Statistical, biological, and clinical significance. , 1995, Circulation.

[83]  S. Daniels,et al.  Increased incidence of non-insulin-dependent diabetes mellitus among adolescents. , 1996, The Journal of pediatrics.

[84]  S. Daniels,et al.  The utility of body mass index as a measure of body fatness in children and adolescents: differences by race and gender. , 1997, Pediatrics.

[85]  J. Morris,et al.  Physique of London busmen; epidemiology of uniforms. , 1956, Lancet.

[86]  R. DeFronzo,et al.  Insulin Resistance: A Multifaceted Syndrome Responsible for NIDDM, Obesity, Hypertension, Dyslipidemia, and Atherosclerotic Cardiovascular Disease , 1991, Diabetes Care.

[87]  L. Birch,et al.  Development of eating behaviors among children and adolescents. , 1998, Pediatrics.

[88]  Albert J. Stunkard,et al.  Behavioral weight control. , 2002 .

[89]  W R Clarke,et al.  Childhood risk factors for high adult blood pressure: the Muscatine Study. , 1989, Pediatrics.

[90]  S. Daniels,et al.  Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertension. , 1998, Circulation.

[91]  R. Uauy,et al.  Obesity in children and young people: a crisis in public health. , 2004, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[92]  E. Dellinger,et al.  Plasma ghrelin levels after diet-induced weight loss or gastric bypass surgery. , 2002, The New England journal of medicine.

[93]  B. Mantur,et al.  Childhood brucellosis--a microbiological, epidemiological and clinical study. , 2004, Journal of tropical pediatrics.

[94]  Steven L Gortmaker,et al.  Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational analysis , 2001, The Lancet.

[95]  J. Kelsey,et al.  The body build of patients with slipped capital femoral epiphysis. , 1972, American journal of diseases of children.

[96]  T. Cole,et al.  Establishing a standard definition for child overweight and obesity worldwide: international survey , 2000, BMJ : British Medical Journal.

[97]  Relationship between obesity and sleep-disordered breathing in children: is it a closed loop? , 2002, The Journal of pediatrics.

[98]  T N Robinson,et al.  Pursuit of thinness and onset of eating disorder symptoms in a community sample of adolescent girls: a three-year prospective analysis. , 1994, The International journal of eating disorders.

[99]  G A Colditz,et al.  Television viewing as a cause of increasing obesity among children in the United States, 1986-1990. , 1996, Archives of pediatrics & adolescent medicine.

[100]  C. Williams,et al.  Cardiovascular Risk Reduction in Preschool Children: The “Healthy Start” Project , 2004, Journal of the American College of Nutrition.

[101]  L. Grummer-Strawn,et al.  Shifts in percentiles of growth during early childhood: analysis of longitudinal data from the California Child Health and Development Study. , 2004, Pediatrics.

[102]  Scott Owens,et al.  Effects of exercise intensity on cardiovascular fitness, total body composition, and visceral adiposity of obese adolescents. , 2002, The American journal of clinical nutrition.

[103]  S. Rössner,et al.  Effects of weight reduction on the regulation of lipolysis in adipocytes of women with upper-body obesity. , 1995, Clinical science.

[104]  A. Must Does overweight in childhood have an impact on adult health? , 2003, Nutrition reviews.

[105]  S. Woods Gastrointestinal satiety signals I. An overview of gastrointestinal signals that influence food intake. , 2004, American journal of physiology. Gastrointestinal and liver physiology.

[106]  K. Brownell,et al.  Psychological correlates of obesity: moving to the next research generation. , 1995, Psychological bulletin.

[107]  B. Zuckerman,et al.  Association between clinically meaningful behavior problems and overweight in children. , 2003, Pediatrics.

[108]  Thomas Bodenheimer,et al.  Improving primary care for patients with chronic illness. , 2002, JAMA.

[109]  E. Paditz,et al.  Obstructive Sleep Apnea Syndrome in Children , 2004, Treatments in respiratory medicine.

[110]  W. Dietz,et al.  Blount disease (tibia vara): another skeletal disorder associated with childhood obesity. , 1982, The Journal of pediatrics.

[111]  R. Krauss,et al.  American Heart Association call to action: obesity as a major risk factor for coronary heart disease. AHA Nutrition Committee. , 1998, Circulation.

[112]  Mohammad A Ghatei,et al.  Inhibition of food intake in obese subjects by peptide YY3-36. , 2003, The New England journal of medicine.

[113]  R R Wing,et al.  Ten-year outcomes of behavioral family-based treatment for childhood obesity. , 1994, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[114]  P. Hinds,et al.  Octreotide therapy of pediatric hypothalamic obesity: a double-blind, placebo-controlled trial. , 2003, The Journal of clinical endocrinology and metabolism.

[115]  E. Goodman,et al.  A prospective study of the role of depression in the development and persistence of adolescent obesity. , 2002, Pediatrics.

[116]  Jeffrey B. Schwimmer,et al.  Preventing Childhood Obesity: Health in the Balance , 2005, Environmental Health Perspectives.

[117]  Michael M. Engelgau,et al.  Type 2 diabetes among North adolescents: An epidemiologic health perspective , 2000 .

[118]  M. Freemark,et al.  The Effects of Metformin on Body Mass Index and Glucose Tolerance in Obese Adolescents With Fasting Hyperinsulinemia and a Family History of Type 2 Diabetes , 2001, Pediatrics.

[119]  W. Dietz,et al.  Prevalence of abnormal serum aminotransferase values in overweight and obese adolescents. , 2000, The Journal of pediatrics.

[120]  L. Weisberg,et al.  Pseudotumor cerebri of childhood. , 1977, American journal of diseases of children.

[121]  A. Barnett,et al.  The effects of androgens and estrogens on preadipocyte proliferation in human adipose tissue: influence of gender and site. , 2001, The Journal of clinical endocrinology and metabolism.

[122]  T. Ivković-Lazar [Development and differentiation of adipose tissue]. , 2003, Medicinski pregled.

[123]  W. Dietz,et al.  Introduction: the use of body mass index to assess obesity in children. , 1999, The American journal of clinical nutrition.

[124]  R. Briefel,et al.  Feeding infants and toddlers study: Improvements needed in meeting infant feeding recommendations. , 2004, Journal of the American Dietetic Association.

[125]  R. Eckel,et al.  Suction lipectomy: outcome relates to region-specific lipoprotein lipase activity and interval weight change. , 1993, Plastic and reconstructive surgery.

[126]  S. Daniels,et al.  Left ventricular hypertrophy and abnormal ventricular geometry in children and adolescents with obstructive sleep apnea. , 2002, American journal of respiratory and critical care medicine.

[127]  R. Troiano,et al.  Changes in the distribution of body mass index of adults and children in the US population , 2000, International Journal of Obesity.

[128]  S. Kumanyika Cultural Differences as Influences on Approaches to Obesity Treatment , 2003 .

[129]  J. Pankow,et al.  Insulin resistance and cardiovascular disease risk factors in children of parents with the insulin resistance (metabolic) syndrome. , 2004, Diabetes care.

[130]  S. Franks,et al.  Polycystic ovary syndrome. , 1995, Archives of disease in childhood.

[131]  D. Schoeller,et al.  Optimal dietary therapy for obese adolescents: comparison of protein plus glucose and protein plus fat. , 1982, The Journal of pediatrics.

[132]  Y. Ben-Shlomo,et al.  A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and interdisciplinary perspectives. , 2002, International journal of epidemiology.

[133]  R. Flores,et al.  Dance for health: improving fitness in African American and Hispanic adolescents. , 1995, Public health reports.

[134]  E. Obarzanek,et al.  Pathways to obesity prevention: report of a National Institutes of Health workshop. , 2003, Obesity research.

[135]  L. Epstein,et al.  Increasing fruit and vegetable intake and decreasing fat and sugar intake in families at risk for childhood obesity. , 2001, Obesity research.

[136]  L S Geiss,et al.  Type 2 diabetes among North American children and adolescents: an epidemiologic review and a public health perspective. , 2000, The Journal of pediatrics.

[137]  M. Schwartz,et al.  Elevated plasma ghrelin levels in Prader–Willi syndrome , 2002, Nature Medicine.

[138]  W H Dietz,et al.  Critical periods in childhood for the development of obesity. , 1994, The American journal of clinical nutrition.

[139]  T. Wadden,et al.  Behavioral treatment of obesity. New approaches to an old disorder. , 1999 .