Management of Obesity in Children: A Narrative Review

Background: Over the past three decades, the prevalence of overweight and obesity in children and adolescents has increased up to ۳ times. Obesity is a multi-systemic medical problem affecting all socioeconomic statuses and increases the risk of other severe comorbidities even in childhood. In ۵۰% of cases, there is a persistence of obesity from childhood into adulthood. This narrative review aimed to define the etiology, risk factors, prevention, and management of obesity in children.  Methods: This narrative review was conducted through a literature search on articles in English with the keywords of pediatric obesity, child, overweight, and bariatric surgery in PubMed, Scopus, ISI Web of Sciences, Cochrane, and EMBASE databases from ۲۰۰۱ to ۲۰۲۱ for ۴ categories of etiology, risk factors, prevention, and management of obesity in children. Scientific articles, systematic reviews, meta-analyses, consensus, recommendations, and international and national guidelines published on pediatric obesity were considered. Results: In this narrative review, we first assessed relevant articles to define childhood obesity and mention its etiologies. We then discussed the probability of persistent obesity from childhood into adulthood and intergenerational and perinatal transmission risks. We also noticed syndromic obesity, evaluation of childhood obesity, and its complications along with medical/surgical interventions. Conclusion: Metabolic programming in particular periods of life, such as before and during pregnancy, infancy, and at the age of rebound adiposity (۵.۵ years old), is necessary to prevent childhood obesity. Lifestyle changes, diet modifications, promoting exclusive breastfeeding, and increased activity are the main principles of preventing and managing obesity. It is prudent to rule out syndromic and endocrinologic causes of obesity in suspicious patients along with their management.

Keywords:

Pediatric obesity , Child , Overweight , Bariatric surgery