Pharmacological treatment of obesity in children and adolescents: current status and perspectives.
BACKGROUND
The prevalence of overweight and obesity in children and adolescents is increasing rapidly, while the short- and long-term morbid outcomes make these entities a major public health concern. Initial steps in therapy are based on dietary and lifestyle intervention. In the presence of an insufficient progress, medication or - eventually - surgery may be recommended. Three drugs are currently used: orlistat, metformin, and sibutramine; other candidates are in development. However, trials assessing the efficacy and safety of the current medications are frequently affected by methodological limitations, in particular insufficient power and period of follow-up.


METHODS
The efficacy and safety of antiobesity drugs currently used for children and adolescents are reviewed. Additional information on upcoming agents is presented.


RESULTS
This is an exhaustive review of current state on controversial issues regarding drugs used in children and adolescent obesity, specifically related with their efficacy and safety.


CONCLUSIONS
The efficacy of these drugs is modest. Our knowledge of their efficacy and safety comes from clinical trials affected by insufficient follow-up (1 year or less); very often, these trials are of limited power. Further data from larger and longer well-designed clinical trials would be advisable.
Hospital Enrique Tornú, Department of Pharmacology, Universidad de Buenos Aires, Argentina.
Natalia
N
Catoira
Mara
M
Nagel
Guillermo
G
Di Girolamo
Claudio D
CD
Gonzalez
D000293:Adolescent; D000818:Animals; D019440:Anti-Obesity Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001067:Appetite Depressants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002986:Clinical Trials as Topic / Q000379:methods; D015195:Drug Design; D006801:Humans; D008019:Life Style; D009765:Obesity / Q000188:drug therapy* / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D016896:Treatment Outcome
D019440:Anti-Obesity Agents; D001067:Appetite Depressants