Authors write that bariatric surgery should be last resort; lifestyle interventions should be used
THURSDAY, May 6 (HealthDay News) -- Although the rapid increase in childhood obesity prevalence in developed countries may be stabilizing, rates have risen substantially since the 1970s, and efforts to prevent obesity should continue at all levels, though bariatric surgery should be used only as a last-resort treatment in extreme cases, according to a seminar published online May 6 in The Lancet.
Childhood obesity, which can adversely affect almost every organ system, increased two-fold or three-fold between the early 1970s and late 1990s in countries around the world, the authors write. They add that, by 2010, more than 40 percent of children in the North American and Mediterranean World Health Organization regions were predicted to be overweight or obese, as were 38 percent in Europe, 27 percent in the western Pacific, and 22 percent in southeast Asia.
The authors estimate an excess of calories, too little exercise, or a combination of both is responsible for about 90 percent of the cases of childhood obesity, with certain health conditions and the use of appetite-affecting drugs responsible for the other 10 percent. They suggest that, given the sedentary lifestyles of children today, caloric intake and activity recommendations at a population level may need reassessment. They add that lifestyle interventions -- such as those involving diet and exercise -- should be first-line therapy, drug treatment should be used rarely, and bariatric surgery should be considered only as a last resort in the most severe cases of obesity.
"Despite remaining challenges, glimmers of hope can be seen. Recent statistics suggest that prevalence of childhood obesity might be stabilizing in developed countries. All past efforts made towards prevention and treatment of obesity, though not of notable individual effect in trials, might still have contributed collectively to this trend," the authors write. "Efforts to prevent obesity should continue at all levels, with the goal of an outcome that is greater than the sum of its parts. These efforts should be made in tandem with an increased commitment to more robust research."
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