Childhood obesity.
OBJECTIVE
As childhood obesity is associated with premature death in adults, a research is critical. This review focuses on the recent proceedings concerning genesis, prevention, and treatment.


RESULTS
Identifying genetic variants in well phenotyped small cohorts of extremely obese children (e.g., the search for copy number variants in obesity-associated large chromosomal deletions) confirmed afterwards in large population-based studies is a new promising genetic approach to understand the disposition to obesity. A further important finding is that obesity of mothers predisposes their offsprings to obesity by epigenetic, prenatal effects. Therefore, prevention programs targeting parents even before pregnancy should be developed. Prevention programs in kindergarten and schools without involving the parents failed to fight against the obesity epidemic. A new promising prevention approach is to change the environment (e.g., ban on sugar drinks in schools). Therapy of choice in already obese children is lifestyle intervention. Again, including their parents is crucial for success. However, this kind of intervention is only suitable for families motivated to change their lifestyle habits. Especially in extremely obese adolescents, additional therapeutic approaches such as drugs and bariatric surgery have to be considered.


CONCLUSIONS
Even if of knowledge of childhood obesity improves every year, many questions concerning prevention and treatment remain still open. Future longitudinal research has to focus on which children will benefit from which kind of intervention to develop specific therapies.
Reinehr
Thomas
T
Department of Pediatric Endocrinology, Diabetes and Nutrition Medicine, Vestische Hospital for Children and Adolescents, University of Witten/Herdecke, Datteln, Germany.
Wabitsch
Martin
M
D000293:Adolescent; D002648:Child; D006801:Humans; D009765:Obesity / Q000453:epidemiology* / Q000517:prevention & control / Q000628:therapy