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Heart association calls attention to 'severe obesity' in kids

Tuesday September 10, 2013
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Between 4% and 6% of U.S. children and teens are “severely obese,” a newly defined class of risk, according to an American Heart Association scientific statement.

“Severe obesity in young people has grave health consequences,” Aaron Kelly, PhD, the statement’s lead author and a researcher at the University of Minnesota Medical School in Minneapolis, said in a news release. “It’s a much more serious childhood disease than obesity.”

While childhood obesity rates are starting to level off, severe obesity has increased, Kelly said. Severely obese children have higher rates of type 2 diabetes and cardiovascular issues — including hypertension, high blood cholesterol and early signs of atherosclerosis — at younger ages.

Treatment options for children with this level of obesity are limited because most standard approaches to weight loss are insufficient for them, according to the statement, which was published Sept. 9 on the website of the journal Circulation.

The statement defines children over age 2 as severely obese if they either have a body mass index at least 20% higher than the 95th percentile for their gender and age or a BMI score of 35 or higher.

Age- and gender-specific growth charts are used to calculate BMI for children. Children at the 95th BMI percentile or higher are considered obese, and those between the 85th and 95th percentiles are overweight. A 7-year-old girl of average height weighing 75 pounds, or a 13-year-old boy of average height weighing 160 pounds, would be defined as severely obese.

Most experts recommend a step-wise approach for treating severely obese children, with treatment getting gradually more intensive from lifestyle changes to medication and potentially surgery.

However, only one medication has been approved to treat obesity in adolescents, and “the step from lifestyle change and medication to surgery is unacceptably large because weight-loss surgery isn’t appropriate for or available to all severely obese children,” Kelly said.

The statement calls for “innovative approaches to fill the gap between lifestyle/medication and surgery,” including:

• Conduct more research on bariatric surgery’s effects and safety;

• Evaluate the effectiveness of lifestyle modification interventions, including adherence to dietary and physical activity plans;

• Fund research to find other useful interventions, including better drugs and medical devices;

• Recognize severe obesity as a chronic disease requiring ongoing care and management.

Statement: http://circ.ahajournals.org/content/early/2013/09/09/CIR.0b013e3182a5cfb3.abstract.


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