Guía de Práctica Clínica para la Evaluación y Tratamiento de Niños y Adolescentes con Obesidad

Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity

Sarah E. Hampl, Sandra G. Hassink, Asheley C. Skinner, Sarah C. Armstrong, Sarah E. Barlow, Christopher F. Bolling, Kimberly C. Avila Edwards, Ihuoma Eneli, Robin Hamre, Madeline M. Joseph, Doug Lunsford, Eneida Mendonca, Marc P. Michalsky, Nazrat Mirza, Eduardo R. Ochoa, Jr, Mona Sharifi, Amanda E. Staiano, Ashley E. Weedn, Susan K. Flinn, Jeanne Lindros, Kymika Okechukwu.

INTRODUCTION

The current and long-term health of 14.4 million children and adolescents is affected by obesity,^1,2 making it one of the most common pediatric chronic diseases.^3–5 Long stigmatized as a reversible consequence of personal choices, obesity has complex genetic, physiologic, socioeconomic, and environmental contributors. As the environment has become increasingly obesogenic, access to evidence-based treatment has become even more crucial.

A significant milestone in the fight to counter misperceptions about obesity and its causes occurred in 1998, when the National Institutes of Health (NIH) designated obesity as a chronic disease. The NIH made a further commitment to necessary research in the “Strategic Plan for NIH Obesity Research,” released by the NIH Obesity Task Force in 2011.⁶ In 2013, on the basis of accumulating evidence, the American Medical Association recognized obesity as a complex, chronic disease that requires medical attention.⁷

The scientific and medical community’s understanding of obesity is constantly evolving. Increased understanding of the impact of social determinants of health (SDoHs, see Definition of Terms section) on the chronic disease of obesity—along with heightened appreciation of the impact of the chronicity and severity of obesity comorbidities—has enabled broader and deeper understanding of the complexity of both obesity risk and treatment.^8,9 Multiple randomized controlled trials and comparative effectiveness studies have yielded effective treatment strategies, demonstrating that, despite the complex nature of this disease, obesity treatment can be successful.^10,11