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Beyond Obesity and Overweight: the Clinical Assessment and Treatment of Excess Body Fat In Children

Part 2 — the Prescription of Low-Carbohydrate Eating as the First Approach

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Abstract

Purpose of Review

Pediatric obesity and comorbidities related to insulin resistance continue to be a growing public health crisis. If lifestyle measures are unsuccessful, pharmacological and surgical interventions are offered. In this paper, we describe the driving force of the obesity crisis: hyperinsulinemia and the development of insulin resistance. We give historical background of key policy issues which have contributed to this pandemic as well as the physiologic mechanisms of insulin resistance. The prevalence of obesity will continue to rise unless the root cause of hyperinsulinemia is addressed.

Recent Findings

Current research on insulin resistance demonstrates that a decreased consumption of carbohydrates is an effective first-line dietary intervention for the treatment of obesity and related metabolic diseases. Evidence shows it is safe and beneficial.

Summary

A low-carbohydrate eating pattern can be helpful to address pediatric obesity. However, there must be policy guardrails in place to ensure that this is a sustainable and viable option for children and their families. There must be a change in the nutritional environment to help individuals battle the chronic disease of obesity.

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Data Availability

No datasets were generated or analysed during the current study.

References

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Acknowledgements

We thank the Claude Worthington Benedum Foundation for their contributions to projects involving health in Appalachia and rural West Virginia.

Author information

Authors and Affiliations

  1. West Virginia University School of Medicine, Morgantown, WV, USA

    Mark Cucuzzella

  2. Marshall University, Huntington, WV, USA

    James Bailes

  3. Duke Pediatrics Healthy Lifestyles Program, Durham, NC, USA

    Jenny Favret

  4. Vanderbilt University Medical Center, Nashville, TN, USA

    Nina Paddu

  5. Vanderbilt University School of Medicine, Nashville, TN, USA

    Anna Beth Bradley

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  1. Mark Cucuzzella
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Contributions

M. C. wrote the main manuscript. J. B., J. F., and N. P. provided significant contributions, formatting, and editing. A. B. reviewed the manuscript. All authors had final approval of the submitted and published versions.

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Correspondence to Mark Cucuzzella.

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Cucuzzella, M., Bailes, J., Favret, J. et al. Beyond Obesity and Overweight: the Clinical Assessment and Treatment of Excess Body Fat In Children. Curr Obes Rep 13, 286–294 (2024). https://doi.org/10.1007/s13679-024-00564-1

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