Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

Abstract

[...]the prevention by promoting healthful diet, physical activity, sleep pattern, and environment is strongly recommended since the intrauterine phase. Beyond the high prevalence and persistence of pediatric obesity [1], robust evidence demonstrates that physical and psychosocial complications are already present in obese children [2] and worsen in adulthood. [...]prevention and treatment of pediatric obesity and complications are key strategic goals, in order to reduce morbidity, mortality, and expected costs for the care of obese adults. The very fruitful scientific research on pediatric obesity of the last decade justified to update the guidelines, in order to provide the best evidence-based reccomendations. [...]the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics, with other Pediatric Societies joined in the common objective of contrasting pediatric obesity, made this Consensus on “Diagnosis, therapy and prevention of obesity in children and adolescents”, updating the document published in 2006 [3]. LOE III-A Obesity may be ascribed to a specific cause (endocrine, hypothalamic, genetic, iatrogenic). [...]clinical history, peculiar signs and symptoms must be accurately assessed such as: 1) onset of obesity before 5 years and/or rapid progression, especially in association with clues suggesting secondary causes (i.e. genetic forms); 2) continuous and/or rapid weight gain associated with reduced height velocity or short stature; 3) delayed cognitive development; 4) dismorphic features; and 5) use of drugs inducing hyperphagia (i.e. corticosteroids, sodium valproate, risperidone, phenothiazines, ciproeptadine) [13].