This presentation will cover difficulties in managing obesity in childhood which is not caused by hypothalamic, hormonal, monogenic or syndromic disorders.
Challenges in the management of childhood and adolescent obesity are common as in any other chronic medical condition. They include recognition and acceptance of the problem by child or adolescent, parents and health professionals; inconsistent and/or conflicting role models in households; limited appropriate health services and resources to deal with the multiple facets of this condition; and the lack of evidence for long term effective interventions.
Both parents are instrumental and both are required in establishing and promoting the maintenance of life-long behavioural lifestyle changes during growth and as the child matures mentally. Parenting also needs to adapt.
Adolescents are challenging patients as they experience substantial physical, physiological and behavioural changes that impact on weight management and their adherence to interventions. Additionally, newer medications that have been used in adults have not been evaluated in adolescents with severe obesity; and other invasive interventions such as bariatric surgical procedures have only been evaluated for short to medium term studies during adolescence. Whilst these studies report reasonable beneficial effects on weight loss there are also nutritional deficiencies of unknown long-term effects on general health and bone status.
The lack of effective transition programs for transfer to adult care also impacts on weight management success.