[Therapy of obesity in childhood and adolescence]

Major therapeutic goal of the treatment of childhood obesity is to prevent immediate and long-term adverse health consequences. In obese adults weight loss is always necessary to achieve normal or tolerable weight. During infancy and childhood keeping body weight constant while body height increases can be acceptable. If substantial body weight loss in children and adolescents is mandatory, it is necessary to consider the special physiological peculiarities of the growing organism during weight reduction. The main cornerstones of therapeutic regimens for long-term weight reduction in childhood obesity are: eating behaviour modification resulting in changes in food selection, dietary fat intake and caloric restriction, instruction to increase physical activity in everyday life and guidance to an active life style. Integrated therapeutic programs including these components based on behaviour modification have been shown to be the most successful in long-term effect on body weight. Treatment of obesity is most successful if realistic goals are set, if parental support is strong and if behaviour therapy is provided during the course of treatment to help both child and parent achieve these goals.