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[Specific features of obesity in children and its management]
T Ohzeki1, Y Nakagawa, T Nakanishi
1Department of Pediatrics, Hamamatsu University School of Medicine.
Insights
Childhood obesity stems from genetic and lifestyle factors, with family history playing a role. Precise diagnosis involves assessing body mass index percentiles and fat distribution, not just adult BMI standards.
Area of Science:
- Pediatrics
- Genetics
- Public Health
Context:
- Childhood obesity is a growing concern with complex origins.
- Both genetic predispositions and environmental factors contribute to its prevalence.
- Family history, particularly maternal, is often associated with obese children.
Purpose:
- To explore the multifaceted causes of childhood obesity.
- To highlight the limitations of standard Body Mass Index (BMI) in pediatric populations.
- To emphasize the importance of accurate diagnostic methods for pediatric obesity.
Summary:
- Childhood obesity arises from congenital and acquired factors, including genetic defects (e.g., leptin, POMC, MC4 receptor) and lifestyle influences like altered calorie intake and energy expenditure.
- While family history is a common indicator, identical twins' similar weights suggest a strong genetic component.
- Accurate diagnosis in children and adolescents requires age-specific methods like BMI percentiles and evaluation of fat volume and distribution, as adult BMI standards are insufficient.
Impact:
- Provides a comprehensive overview of pediatric obesity etiology.
- Clarifies diagnostic challenges and recommended approaches for children and adolescents.
- Informs public health strategies and clinical practice for managing childhood obesity.
Abstract:
Obesity during childhood is caused by both congenital and acquired causes. Obese children usually have family history, especially of their mothers. Identical twins have similar weight even if they are reared apart. In very rare cases of heritable obesity, genetic defects in leptin synthesis and its receptor, POMC, MC4 receptor, and prohormone converting enzyme have been reported. In addition, body weight of children and adolescents is related with their life styles, and the prevalence of obesity in recent years is higher than before probably due to changes in calorie intake and energy expenditure. Diagnosis of obesity is based on the assessment of overweight using BMI in most cases of adults. During childhood and adolescence, BMI can not be applied as in adults and its percentile values are useful for children. Percentage of overweight for the standard weight for height has been used as well to demonstrate over- or underweight in children and adolescents. Evaluation of fat volume and its distribution is essential for the precise diagnosis of obesity in children as well as adults.