How is childhood obesity managed?

Updated: Jun 09, 2021
  • Author: Osama Hamdy, MD, PhD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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In cases of childhood obesity, [123, 124, 125] the goal is not to cause weight loss, but to reduce the rate of weight gain to fit normal growth curves. The basic principles of management include the following:

  • Modifying diet

  • Increasing appropriate physical activity and exercise

  • Reducing time spent in sedentary activities - Eg, watching television

  • Modifying behavior

Medication therapy may also be used in the management of pediatric obesity, but close monitoring and a combination of all the aforementioned modalities is required to achieve substantial and sustained weight loss. At the present, orlistat is the only medication approved by the US Food and Drug Administration (FDA) for use as an adjunct for weight loss in adolescents.

Setmelanotide, a melanocortin-4 agonist, was approved by the FDA in November 2020 for patients aged 6 years or older for weight control in obesity caused by rare genetic conditions (eg, proopiomelanocortin [POMC], proprotein convertase subtilisin/kexin type 1 [PCSK1], leptin receptor [LEPR] deficiencies). [126, 127]

For a full discussion of childhood obesity management, see the Medscape Drugs & Diseases article Obesity in Children.

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