Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches

AHA: September 9, 2013

Abstract—Severe obesity afflicts between 4% and 6% of all youth in the United States, and the prevalence is increasing.

Despite the serious immediate and long-term cardiovascular, metabolic, and other health consequences of severe pediatric

obesity, current treatments are limited in effectiveness and lack widespread availability. Lifestyle modification/behaviorbased

treatment interventions in youth with severe obesity have demonstrated modest improvement in body mass index

status, but participants have generally remained severely obese and often regained weight after the conclusion of the

treatment programs. The role of medical management is minimal, because only 1 medication is currently approved for

the treatment of obesity in adolescents. Bariatric surgery has generally been effective in reducing body mass index and

improving cardiovascular and metabolic risk factors; however, reports of long-term outcomes are few, many youth with

severe obesity do not qualify for surgery, and access is limited by lack of insurance coverage. Read more