Skip to main content
SpringerLink
Log in

Obesity in Children and Adolescents

  • Reference work entry
  • First Online:
Book cover Obesity

Part of the book series: Endocrinology ((ENDOCR))

Abstract

This chapter reviews the definitions, prevalence, etiology, comorbidities, prevention, and treatment of childhood obesity. Obesity in childhood and adolescents is highly prevalent with the rates of severe obesity, in particular, increasing considerably. Biological contributors, principally in the form of genetic risk which is susceptible to expression in the context of an obesogenic environment, account for the primary etiology of childhood obesity. Critical periods in child development, including gestation and early infancy, early childhood, and adolescence, are especially vulnerable to various factors that may increase the likelihood of later obesity. Comorbidities associated with childhood obesity are similar to those seen in adults: hypertension, dyslipidemia, insulin resistance, nonalcoholic fatty liver disease, obstructive sleep apnea, and psychosocial distress. Treatment to date relies mostly on lifestyle modification therapy despite the fact that outcomes in the real-world clinical setting remain dismal, particularly for adolescents with severe obesity. As the field of pediatric obesity management continues to mature, pharmacotherapy may prove to be a helpful adjunctive treatment and access to bariatric surgery for eligible adolescents may increase as evidence of its safety and effectiveness continues to accumulate.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 349.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Agostoni C, Braegger C, Decsi T, Kolacek S, Koletzko B, Mihatsch W, Moreno LA, Puntis J, Shamir R, Szajewska H, Turck D, Van Goudoever J. Role of dietary factors and food habits in the development of childhood obesity: a commentary by the ESPGHAN Committee On Nutrition. J Pediatr Gastroenterol Nutr. 2011;52:662–9.

    Article  CAS  PubMed  Google Scholar 

  • Anzman-Frasca S, Stifter CA, Birch LL. Temperament and childhood obesity risk: a review of the literature. J Dev Behav Pediatr. 2012;33:732–45.

    Article  PubMed  Google Scholar 

  • Arnold M, Jiang L, Stefanick ML, Johnson KC, Lane DS, Leblanc ES, Prentice R, Rohan TE, Snively BM, Vitolins M, Zaslavsky O, Soerjomataram I, Anton-Culver H. Duration of adulthood overweight, obesity, and cancer risk in the women’s health initiative: a longitudinal study from the United States. PLoS Med. 2016;13:e1002081.

    Article  PubMed  PubMed Central  Google Scholar 

  • Barlow SE. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report. Pediatrics. 2007;120(Suppl 4):S164–92.

    Article  PubMed  Google Scholar 

  • Bleich SN, Ku R, Wang YC. Relative contribution of energy intake and energy expenditure to childhood obesity: a review of the literature and directions for future research. Int J Obes. 2011;35:1–15.

    Article  CAS  Google Scholar 

  • Borys JM, Le Bodo Y, Jebb SA, Seidell JC, Summerbell C, Richard D, De Henauw S, Moreno LA, Romon M, Visscher TL, Raffin S, Swinburn B. EPODE approach for childhood obesity prevention: methods, progress and international development. Obes Rev. 2012;13:299–315.

    Article  PubMed  PubMed Central  Google Scholar 

  • Bretault M, Boillot A, Muzard L, Poitou C, Oppert JM, Barsamian C, Gatta B, Muller H, Weismann D, Rottembourg D, Inge T, Veyrie N, Carette C, Czernichow S. Clinical review: bariatric surgery following treatment for craniopharyngioma: a systematic review and individual-level data meta-analysis. J Clin Endocrinol Metab. 2013;98:2239–46.

    Article  CAS  PubMed  Google Scholar 

  • Campbell MK. Biological, environmental, and social influences on childhood obesity. Pediatr Res. 2016;79:205–11.

    Article  PubMed  Google Scholar 

  • Cassidy SB, Schwartz S, Miller JL, Driscoll DJ. Prader-Willi syndrome. Genet Med. 2012;14:10–26.

    Article  CAS  PubMed  Google Scholar 

  • Cole TJ, Bellizzi MC, Flegal KM, Dietz WH. Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ. 2000;320:1240–1243.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Cortese S, Angriman M, Maffeis C, Isnard P, Konofal E, Lecendreux M, Purper-Ouakil D, Vincenzi B, Bernardina BD, Mouren MC. Attention-deficit/hyperactivity disorder (ADHD) and obesity: a systematic review of the literature. Crit Rev Food Sci Nutr. 2008;48:524–37.

    Article  PubMed  Google Scholar 

  • Dohil R, Meyer L, Schmeltzer S, Cabrera BL, Lavine JE, Phillips SA. The effect of cysteamine bitartrate on adiponectin multimerization in non-alcoholic fatty liver disease and healthy subjects. J Pediatr. 2012;161:639–45.e1.

    Article  Google Scholar 

  • Doyle J, Colville S, Brown P, Christie D. ‘For the cases we’ve had…I don’t think anybody has had enormous confidence’ – exploring ‘uncertainty’ in adolescent bariatric teams: an interpretative phenomenological analysis. Clin Obes. 2014;4:45–52.

    Article  CAS  PubMed  Google Scholar 

  • Farooqi S, O’Rahilly S. Genetics of obesity in humans. Endocr Rev. 2006;27:710–8.

    Article  CAS  PubMed  Google Scholar 

  • Farooqi IS, O’Rahilly S. Mutations in ligands and receptors of the leptin-melanocortin pathway that lead to obesity. Nat Clin Pract Endocrinol Metab. 2008;4:569–77.

    Article  CAS  PubMed  Google Scholar 

  • Feldstein AE, Charatcharoenwitthaya P, Treeprasertsuk S, Benson JT, Enders FB, Angulo P. The natural history of non-alcoholic fatty liver disease in children: a follow-up study for up to 20 years. Gut. 2009;58:1538–44.

    Article  CAS  PubMed  Google Scholar 

  • Franks PW, Hanson RL, Knowler WC, Sievers ML, Bennett PH, Looker HC. Childhood obesity, other cardiovascular risk factors, and premature death. N Engl J Med. 2010;362:485–93.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Germano G, Allavena P, Mantovani A. Cytokines as a key component of cancer-related inflammation. Cytokine. 2008;43:374–9.

    Article  CAS  PubMed  Google Scholar 

  • Gulati AK, Kaplan DW, Daniels SR. Clinical tracking of severely obese children: a new growth chart. Pediatrics. 2012;130:1136–40.

    Article  PubMed  PubMed Central  Google Scholar 

  • Guo DF, Rahmouni K. Molecular basis of the obesity associated with Bardet-Biedl syndrome. Trends Endocrinol Metab. 2011;22:286–93.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Jansen E, Mulkens S, Jansen A. Tackling childhood overweight: treating parents exclusively is effective. Int J Obes. 2011;35:501–9.

    Article  CAS  Google Scholar 

  • Katzmarzyk PT, Barlow S, Bouchard C, Catalano PM, Hsia DS, Inge TH, Lovelady C, Raynor H, Redman LM, Staiano AE, Spruijt-Metz D, Symonds ME, Vickers M, Wilfley D, Yanovski JA. An evolving scientific basis for the prevention and treatment of pediatric obesity. Int J Obes. 2014;38:887–905.

    Article  CAS  Google Scholar 

  • Kelly KP, Kirschenbaum DS. Immersion treatment of childhood and adolescent obesity: the first review of a promising intervention. Obes Rev. 2011;12:37–49.

    Article  CAS  PubMed  Google Scholar 

  • Khan MJ, Gerasimidis K, Edwards CA, Shaikh MG. Mechanisms of obesity in Prader-Willi syndrome. Pediatr Obes. 2016.Nov 10. https://doi.org/10.1111/ijpo.12177. [Epub ahead of print]

    Article  PubMed  Google Scholar 

  • Kim JH, Choi JH. Pathophysiology and clinical characteristics of hypothalamic obesity in children and adolescents. Ann Pediatr Endocrinol Metab. 2013;18:161–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kit BK, Kuklina E, Carroll MD, Ostchega Y, Freedman DS, Ogden CL. Prevalence of and trends in dyslipidemia and blood pressure among US children and adolescents, 1999–2012. JAMA Pediatr. 2015;169:272–9.

    Article  PubMed  PubMed Central  Google Scholar 

  • Koot BG, Van Der Baan-Slootweg OH, Vinke S, Bohte AE, Tamminga-Smeulders CL, Jansen PL, Stoker J, Benninga MA. Intensive lifestyle treatment for non-alcoholic fatty liver disease in children with severe obesity: inpatient versus ambulatory treatment. Int J Obes. 2016;40:51–7.

    Article  CAS  Google Scholar 

  • Ladikou EE, Kassi E. The emerging role of estrogen in B cell malignancies. Leuk Lymphoma. 2017;58(3):528–539.

    Article  Google Scholar 

  • Latzer Y, Stein D. A review of the psychological and familial perspectives of childhood obesity. J Eat Disord. 2013;1:7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lauby-Secretan B, Scoccianti C, Loomis D, Grosse Y, Bianchini F, Straif K. Body fatness and cancer – viewpoint of the IARC Working Group. N Engl J Med. 2016;375:794–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lavine JE, Schwimmer JB, Van Natta ML, Molleston JP, Murray KF, Rosenthal P, Abrams SH, Scheimann AO, Sanyal AJ, Chalasani N, Tonascia J, Unalp A, Clark JM, Brunt EM, Kleiner DE, Hoofnagle JH, Robuck PR. Effect of vitamin E or metformin for treatment of nonalcoholic fatty liver disease in children and adolescents: the TONIC randomized controlled trial. JAMA. 2011;305:1659–68.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lee JM, Pilli S, Gebremariam A, Keirns CC, Davis MM, Vijan S, Freed GL, Herman WH, Gurney JG. Getting heavier, younger: trajectories of obesity over the life course. Int J Obes. 2010;34:614–23.

    Article  CAS  Google Scholar 

  • Lobstein T, Jackson-Leach R. Planning for the worst: estimates of obesity and comorbidities in school-age children in 2025. Pediatr Obes. 2016;11:321–5.

    Article  CAS  PubMed  Google Scholar 

  • Lohmann AE, Goodwin PJ, Chlebowski RT, Pan K, Stambolic V, Dowling RJ. Association of obesity-related metabolic disruptions with cancer risk and outcome. J Clin Oncol. 2016;34:4249–55.

    Article  PubMed  Google Scholar 

  • Maes HH, Neale MC, Eaves LJ. Genetic and environmental factors in relative body weight and human adiposity. Behav Genet. 1997;27:325–51.

    Article  CAS  PubMed  Google Scholar 

  • Manco M, Dallapiccola B. Genetics of pediatric obesity. Pediatrics. 2012;130:123–33.

    Article  PubMed  Google Scholar 

  • Manco M, Mosca A, De Peppo F, Caccamo R, Cutrera R, Giordano U, De Stefanis C, Alisi A, Baumann U, Silecchia G, Nobili V. The benefit of sleeve gastrectomy in obese adolescents on nonalcoholic steatohepatitis and hepatic fibrosis. J Pediatr. 2017;180:31–37.e2.

    Article  PubMed  Google Scholar 

  • Mead E, Atkinson G, Richter B, Metzendorf MI, Baur L, Finer N, Corpeleijn E, O’Malley C, Ells LJ. Drug interventions for the treatment of obesity in children and adolescents. Cochrane Database Syst Rev. 2016;11:Cd012436.

    PubMed  Google Scholar 

  • Miller AL, Lumeng JC, Lebourgeois MK. Sleep patterns and obesity in childhood. Curr Opin Endocrinol Diabetes Obes. 2015;22:41–7.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mummadi RR, Kasturi KS, Chennareddygari S, Sood GK. Effect of bariatric surgery on nonalcoholic fatty liver disease: systematic review and meta-analysis. Clin Gastroenterol Hepatol. 2008;6:1396–402.

    Article  PubMed  Google Scholar 

  • Nobili V, Manco M, Ciampalini P, Alisi A, Devito R, Bugianesi E, Marcellini M, Marchesini G. Metformin use in children with nonalcoholic fatty liver disease: an open-label, 24-month, observational pilot study. Clin Ther. 2008;30:1168–76.

    Article  CAS  PubMed  Google Scholar 

  • Nobili V, Alkhouri N, Alisi A, Della Corte C, Fitzpatrick E, Raponi M, Dhawan A. Nonalcoholic fatty liver disease: a challenge for pediatricians. JAMA Pediatr. 2015;169:170–6.

    Article  PubMed  Google Scholar 

  • Ogden CL, Kuczmarski RJ, Flegal KM, Mei Z, Guo S, Wei R, Grummer-Strawn LM, Curtin LR, Roche AF, Johnson CL. Centers for Disease Control and Prevention 2000 growth charts for the United States: improvements to the 1977 National Center for Health Statistics version. Pediatrics. 2002;109:45–60.

    Article  PubMed  Google Scholar 

  • Orgel E, Tucci J, Alhushki W, Malvar J, Sposto R, Fu CH, Freyer DR, Abdel-Azim H, Mittelman SD. Obesity is associated with residual leukemia following induction therapy for childhood B-precursor acute lymphoblastic leukemia. Blood. 2014;124:3932–8.

    Article  CAS  PubMed  Google Scholar 

  • Park MH, Kinra S, Ward KJ, White B, Viner RM. Metformin for obesity in children and adolescents: a systematic review. Diabetes Care. 2009;32:1743–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Puhl RM, King KM. Weight discrimination and bullying. Best Pract Res Clin Endocrinol Metab. 2013;27:117–27.

    Article  PubMed  Google Scholar 

  • Rankin J, Matthews L, Cobley S, Han A, Sanders R, Wiltshire HD, Baker JS. Psychological consequences of childhood obesity: psychiatric comorbidity and prevention. Adolesc Health Med Ther. 2016;7:125–46.

    Article  PubMed  PubMed Central  Google Scholar 

  • Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371:569–78.

    Article  PubMed  Google Scholar 

  • Ryder JR, Kaizer AM, Rudser KD, Daniels SR, Kelly AS. Utility of body mass index in identifying excess adiposity in youth across the obesity Spectrum. J Pediatr. 2016;177:255–61.e2.

    Article  PubMed  PubMed Central  Google Scholar 

  • Santoro N, Zhang CK, Zhao H, Pakstis AJ, Kim G, Kursawe R, Dykas DJ, Bale AE, Giannini C, Pierpont B, Shaw MM, Groop L, Caprio S. Variant in the glucokinase regulatory protein (GCKR) gene is associated with fatty liver in obese children and adolescents. Hepatology. 2012;55:781–9.

    Article  CAS  PubMed  Google Scholar 

  • Sato A, Jelalian E, Hart C, Lloyd-Richardson E, Mehlenbeck R, Neill M, Wing R. Associations between parent behavior and adolescent weight control. J Pediatr Psychol. 2011;36:451–60.

    Article  PubMed  Google Scholar 

  • Schmidt ME, Haines J, O’Brien A, Mcdonald J, Price S, Sherry B, Taveras EM. Systematic review of effective strategies for reducing screen time among young children. Obesity (Silver Spring). 2012;20:1338–54.

    Article  Google Scholar 

  • Schwimmer JB. Cysteamine bitartrate delayed-release (DR) for the treatment of nonalcoholic fatty liver disease (NAFLD) in children (CyNCh) trial. Hepatology. 2015;62:1398A–9A.

    Article  Google Scholar 

  • Schwimmer JB. Clinical advances in pediatric nonalcoholic fatty liver disease. Hepatology. 2016;63:1718–25.

    Article  PubMed  Google Scholar 

  • Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA. 2003;289:1813–9.

    Article  PubMed  Google Scholar 

  • Schwimmer JB, Deutsch R, Kahen T, Lavine JE, Stanley C, Behling C. Prevalence of fatty liver in children and adolescents. Pediatrics. 2006;118:1388–93.

    Article  PubMed  Google Scholar 

  • Schwimmer JB, Middleton MS, Behling C, Newton KP, Awai HI, Paiz MN, Lam J, Hooker JC, Hamilton G, Fontanesi J, Sirlin CB. Magnetic resonance imaging and liver histology as biomarkers of hepatic steatosis in children with nonalcoholic fatty liver disease. Hepatology. 2015;61:1887–1895.

    Article  CAS  PubMed  Google Scholar 

  • Sica A, Allavena P, Mantovani A. Cancer related inflammation: the macrophage connection. Cancer Lett. 2008;267:204–15.

    Article  CAS  PubMed  Google Scholar 

  • Silva ACF, Bortolini GA, Jaime PC. Brazil’s national programs targeting childhood obesity prevention. Int J Obes Supp. 2013;3:S9–S11.

    Article  CAS  Google Scholar 

  • Singh RK, Kumar P, Mahalingam K. Molecular genetics of human obesity: a comprehensive review. C R Biol. 2017;340(2):87–108.

    Article  PubMed  Google Scholar 

  • Skinner AC, Perrin EM, Skelton JA. Prevalence of obesity and severe obesity in US children, 1999–2014. Obesity. 2016;24:1116–23.

    Article  PubMed  Google Scholar 

  • Small L, Aplasca A. Child obesity and mental health: a complex interaction. Child Adolesc Psychiatr Clin N Am. 2016;25:269–82.

    Article  PubMed  Google Scholar 

  • Swinburn BA, Sacks G, Hall KD, Mcpherson K, Finegood DT, Moodie ML, Gortmaker SL. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378:804–14.

    Article  PubMed  Google Scholar 

  • Tevie J, Shaya FT. Association between mental health and comorbid obesity and hypertension among children and adolescents in the US. Eur Child Adolesc Psychiatry. 2015;24:497–502.

    Article  PubMed  Google Scholar 

  • Twig G, Tirosh A, Leiba A, Levine H, Ben-Ami Shor D, Derazne E, Haklai Z, Goldberger N, Kasher-Meron M, Yifrach D, Gerstein HC, Kark JD. BMI at age 17 years and diabetes mortality in midlife: a Nationwide cohort of 2.3 million adolescents. Diabetes Care. 2016a;39:1996–2003.

    Article  PubMed  Google Scholar 

  • Twig G, Yaniv G, Levine H, Leiba A, Goldberger N, Derazne E, Ben-Ami Shor D, Tzur D, Afek A, Shamiss A, Haklai Z, Kark JD. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med. 2016b;374:2430–40.

    Article  PubMed  Google Scholar 

  • Wang Y, Cai L, Wu Y, Wilson RF, Weston C, Fawole O, Bleich SN, Cheskin LJ, Showell NN, Lau BD, Chiu DT, Zhang A, Segal J. What childhood obesity prevention programmes work? A systematic review and meta-analysis. Obes Rev. 2015;16:547–65.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Waterhouse EG, Xu B. The skinny on brain-derived neurotrophic factor: evidence from animal models to GWAS. J Mol Med (Berl). 2013;91:1241–7.

    Article  CAS  Google Scholar 

  • Weismann D, Pelka T, Bender G, Jurowich C, Fassnacht M, Thalheimer A, Allolio B. Bariatric surgery for morbid obesity in craniopharyngioma. Clin Endocrinol. 2013;78:385–90.

    Article  Google Scholar 

  • Xanthakos SA, Schwimmer JB. On a knife-edge – weight-loss surgery for NAFLD in adolescents. Nat Rev Gastroenterol Hepatol. 2015;12:316–8.

    Article  PubMed  PubMed Central  Google Scholar 

  • Xanthakos S, Miles L, Bucuvalas J, Daniels S, Garcia V, Inge T. Histologic spectrum of nonalcoholic fatty liver disease in morbidly obese adolescents. Clin Gastroenterol Hepatol. 2006;4:226–32.

    Article  PubMed  Google Scholar 

  • Xanthakos SA, Jenkins TM, Kleiner DE, Boyce TW, Mourya R, Karns R, Brandt ML, Harmon CM, Helmrath MA, Michalsky MP, Courcoulas AP, Zeller MH, Inge TH. High prevalence of nonalcoholic fatty liver disease in adolescents undergoing bariatric surgery. Gastroenterology. 2015;149:623–34.e8.

    Article  Google Scholar 

  • Xi B, Zhang T, Zhang M, Liu F, Zong X, Zhao M, Wang Y. Trends in elevated blood pressure among US children and adolescents: 1999–2012. Am J Hypertens. 2016;29:217–25.

    Article  PubMed  Google Scholar 

  • Yang Q, Zhong Y, Merritt R, Cogswell ME. Trends in high blood pressure among United States adolescents across body weight category between 1988 and 2012. J Pediatr. 2016;169:166–73.e3.

    Google Scholar 

  • Zegers D, Beckers S, Hendrickx R, Van Camp JK, De Craemer V, Verrijken A, Van Hoorenbeeck K, Verhulst SL, Rooman RP, Desager KN, Massa G, Van Gaal LF, Van Hul W. Mutation screen of the SIM1 gene in pediatric patients with early-onset obesity. Int J Obes. 2014;38:1000–4.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA

    Claudia K. Fox, Justin R. Ryder, Amy C. Gross & Aaron S. Kelly

Authors
  1. Claudia K. Fox
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Justin R. Ryder
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Amy C. Gross
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aaron S. Kelly
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Claudia K. Fox .

Editor information

Editors and Affiliations

  1. Department of Systems Medicine, Internal Medicine Unit and Obesity Center, University of Rome Tor Vergata, University Hospital Policlinico Tor Vergata, Rome, Italy

    Paolo Sbraccia

  2. National Centre for Cardiovascular Prevention, University College London, London, UK

    Nicholas Finer

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Fox, C.K., Ryder, J.R., Gross, A.C., Kelly, A.S. (2019). Obesity in Children and Adolescents. In: Sbraccia, P., Finer, N. (eds) Obesity. Endocrinology. Springer, Cham. https://doi.org/10.1007/978-3-319-46933-1_27

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-46933-1_27

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-46932-4

  • Online ISBN: 978-3-319-46933-1

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation