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John Puntis

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date: 31 May 2020

Obesity is the most common nutritional disorder affecting children in the developed world. The marked increase in prevalence is linked to environmental and behavioural changes; children’s energy expenditure has undoubtedly decreased. Obese children often become obese adults; children from lower socioeconomic groups are more likely to be obese. Obesity is a risk factor for ischaemic heart disease, hypertension, stroke, type 2 diabetes, depression, and certain cancers. There is no proven preventive strategy but limiting time in front of computer and TV screens appears important. Obese children are relatively tall; the combination of obesity with short stature suggests underlying disease (e.g. hypothyroidism; Cushing’s syndrome should be considered). Treatment should be considered if body mass index is greater than the 98th centile and the family are willing to make the necessary lifestyle changes. Drug and surgical treatments have a role in a small number of children, but should always be used on a background of a behavioural weight management programme.

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