Present trends in childhood and adolescent obesity treatment

Obesity is the most frequent nutritional disorder in infancy and adolescence. The rise in its prevalence and severity have highlighted its numerous and significant associated comorbidities. Despite the knowledge acquired in recent years on weight control and the advent of new hormones, the treatment of obesity remains one of the most difficult problems in clnical practice, and therefore preventive measures are paramount. Changes in eating habits, encouragement of physical exercise and moral support are fundamental to achieve effective weight loss in children and adolescents. With these aims in mind, our group developed a programme of integral obesity treatment with a group format ("Niñ@s en movimiento") which has proved successful in the short and medium term. The indication of drug treatment of childhood obesity should not be used as an isolated therapy, but as a complement to basic therapies of nutritional education and always when obesity-associated metabolic complications are present. Only two drugs are currently authorised for the treatment of childhood obesity: orlistat in children over 12, and sibutramine in adolescents over 16. Bariatric surgery in very obese adolescents, with BMI over 40, can be considered when other alternative therapies have failed.