Sideways in treatment of obese child: a personal experience
The prevalence of overweight children and adolescents is one of the most important public health challenges today. The impact of this early obesity extends into adulthood: increased mortality and morbidity from a variety of conditions and adverse socio-economic consequences. No single approach to the treatment of childhood overweight has been demonstrated to be more effective than another. Challenges faced in managing obese child is selecting the approach that will be adhered to on a long-term basis, involving whole family in the health lifestyle regarding the childs age, sex, cultural and entire environmental background.
Aim: Finding the best therapeutic approach for obese child.
Methods: A 2 years follow up effects of lifestyle modification (dietary, physical activity, psychotherapy) and/or drug (sibutramine) for treating obesity in 40 children (mean age 13 years) with the support of family members. Children with eating disorders, diabetes mellitus, secondary or syndromic obesity were excluded. Lifestyle interventions focused on physical activity and changing eating habits, with behaviorally orientated treatment were implemented in all. Sibutramine used in children with BMI ≥95th percentile (20 children). Reduction in overweight at 6, 12, 18 and 24 months follow up was observed in all children; addition of sibutramine showed more significant weight lost in longer time period (15 vs 8% after 2 years) with less psychological disturbances and better self-oriented outcomes.
Conclusions: Combined behavioral lifestyle interventions have a significant and meaningful reduction in overweight in children and adolescents. Pharmacotherapy is an effective adjunct to lifestyle interventions in morbid obese child.