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A Journal on Pediatrics, Neonatology, Adolescent Medicine,
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Minerva Pediatrica 2012 August;64(4):413-31

language: Italian

Management of children and adolescents with severe obesity

Valerio G. 1, Licenziati M. R. 2, Tanas R. 3, Morino G. 4, Ambruzzi A. M. 4, Balsamo A. 5, Brambilla P. 6, Bruzzi P. 7, Calcaterra V. 8, Crinò A. 9, De Falco R. 2, Franzese A. 10, Giordano U. 11, Grugni G. 12, Iaccarino Idelson P. 10, Iughetti L. 7, Maffeis C. 13, Manco M. 14, Miraglia Del Giudice E. 15, Mozzillo E. 1, 10, Zito E. 10, Bernasconi S. 16

1 Dipartimento di Studi delle Istituzionie dei Sistemi Territoriali,Università Parthenope, Napoli, Italia;
2 Dipartimento di Pediatria, Specialistica e Sistematica, AORN Santobono Pausilipon, Napoli, Italia;
3 Centro Obesità Villa Igea, Forlì, Italia;
4 U.O. di Dietologia Clinica, Ospedale Pediatrico Bambino Gesù IRCCS, Roma, Italia;
5 Dipartimento di Scienze Ginecologiche, Ostetriche e Pediatriche, Policlinico S. Orsola-Malpighi, Bologna, Italia;
6 ASL Milano 2, Milano, Italia;
7 Dipartimento Materno-Infantile, Università di Modena e Reggio Emilia, Modena, Italia;
8 Dipartimento di Medicina Interna, Università degli Studi di Pavia, Dipartimento di Pediatria, Fondazione IRCCS Policlinico San Matteo, Pavia, Italia;
9 O.S. di Patologia Endocrina Autoimmune, Ospedale Pediatrico Bambino Gesù, IRCCS Palidoro, Roma, Italia;
10 Dipartimento di Pediatria, Università Federico II, Napoli, Italia;
11 U.O.C di Medicina Cardiorespiratoria e dello Sport, Dipartimento Medico-Chirurgico di Cardiologia Pediatrica, Ospedale Pediatrico Bambino Gesù IRCCS, Roma, Italia;
12 Divisione di Auxologia, Istituto Auxologico Italiano, IRCCS, Piancavallo (Verbania), Italia;
13 U.O.C. Diabetologia, Nutrizione Clinica e Obesità in Età Pediatrica, Università di Verona, Verona;
14 Area di Ricerca per le Malattie Multifattoriali Direzione Scientifica, Ospedale Pediatrico Bambino Gesù IRCCS, Roma;
15 Dipartimento di Pediatria, Seconda Università, Napoli;
16 Dipartimento Materno-infantile, Università degli Studi-Azienda Ospedaliera Parma, Italia


Obesity is a complex public health issue. Recent data indicate the increasing prevalence and severity of obesity in children. Severe obesity is a real chronic condition for the difficulties of long-term clinical treatment, the high drop-out rate, the large burden of health and psychological problems and the high probability of persistence in adulthood. A staged approach for weight management is recommended. The establishment of permanent healthy lifestyle habits aimed at healthy eating, increasing physical activity and reducing sedentary behavior is the first outcome, because of the long-term health benefits of these behaviors. Improvement in medical conditions is also an important sign of long-term health benefits. Rapid weight loss is not pursued, for the implications on growth ad pubertal development and the risk of inducing eating disorders. Children and adolescents with severe obesity should be referred to a pediatric weight management center that has access to a multidisciplinary team with expertise in childhood obesity. This article provides pediatricians a comprehensive and evidence based update on treatment recommendations of severe obesity in children and adolescents.

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