[Obesity in infancy: new precision treatment]

Area of Science:

• Pediatrics
• Endocrinology
• Genetics

Context:

• Childhood obesity is a chronic disease with significant short- and long-term health consequences.
• Approximately 4% of children and adolescents in Switzerland are affected by obesity.
• Early diagnosis and intervention are crucial to prevent the persistence of obesity into adulthood.

Purpose:

• To highlight the importance of prompt diagnosis and multicomponent lifestyle interventions for childhood obesity.
• To emphasize the role of growth and BMI charts in diagnosing obesity and its etiology.
• To discuss the suspicion and molecular diagnosis of monogenic obesity and its targeted therapies.

Summary:

• Growth and BMI charts are essential for diagnosing obesity and identifying its cause in children.
• Severe, early-onset obesity with hyperphagia suggests monogenic obesity, requiring molecular diagnosis.
• Specific genetic defects (LEP, LEPR, POMC, PCSK1) allow for targeted treatments such as leptin or setmelanotide.

Impact:

• Early identification and intervention can mitigate the long-term health impacts of childhood obesity.
• Molecular diagnosis of monogenic obesity opens avenues for personalized and effective therapeutic strategies.
• Understanding the genetic basis of obesity can lead to improved patient outcomes and management protocols.