Overview

Treatment of pediatric obesity, to date, has largely focused on lifestyle therapy. While lifestyle therapy is essential for obesity management, it is often insufficient, particularly for youth who have severe forms of the disease. Underlying the limitations of lifestyle therapy is the recognition that obesity is a biological disorder of the energy regulatory system and accordingly, to effectively manage obesity, the underpinning pathophysiology needs to be addressed. This pathophysiology can be targeted with more advanced therapies including anti-obesity medications and metabolic and bariatric surgery, two treatment strategies supported by the American Academy of Pediatrics. Written by leading experts in the field, A Practical Guide to Managing Pediatric Obesity is comprised of thirteen chapters, each including suggested protocols and case examples. The first chapter details the complex pathophysiology of obesity and sets the stage for why advanced therapies are critical for effective obesity management. Chapter two provides guidance on best practices for communicating with patients and families about obesity. The next three chapters provide direction on how to do a comprehensive patient assessment, and employ dietary and physical activity interventions. The heart of this guidebook is the chapter on pharmacological treatments, which details the mechanisms of action, research results, and recommendations for anti-obesity medication selection and monitoring outlined in a step-by-step fashion. Pre- and post-operative care for the pediatric bariatric surgery patient is detailed in the next chapter. Assessment and management of behavioral and psychological complications, type 2 diabetes, non-alcoholic fatty liver disease, polycystic ovary syndrome, hypertension, and dyslipidemia are covered in the subsequent five chapters. Syndromic and monogenic obesity are discussed in the final chapter.

Full Product Details

Author:   Claudia K. Fox
Publisher:   Springer International Publishing AG
Imprint:   Springer International Publishing AG
Edition:   1st ed. 2023
Weight:   0.800kg
ISBN:  

9783031373794

ISBN 10:   3031373790
Pages:   419
Publication Date:   26 October 2023
Audience:   Professional and scholarly ,  Professional & Vocational
Format:   Paperback
Publisher's Status:   Active
Availability:   Manufactured on demand  
We will order this item for you from a manufactured on demand supplier.

Table of Contents

Foreword, by Aaron Kelly, PhD Description of the epidemiology of obesity in children and adolescents; ie the most common chronic disease of childhood Importance of this book – need for practical guidance on how to treat children afflicted with obesity; state of the art recommendations from experts in the trenches; comprehensive approach including lifestyle therapy, pharmacotherapy, and bariatric surgery   Biology of Obesity, by Claudia Fox, MD Critically important to understand the biology of obesity in order to provide effective, patient-centered treatment that addresses bias and stigma Description of the pathophysiology of obesity, a chronic disease (Figure) Patient education (Boxed)   Communication, Bias, and Stigma, by TBD Language preferred by patients (Boxed) Bias in healthcare and how to check your own bias                                                                i.      Parents’ bringing their own experiences with bias to the clinic visit                                                               ii.      Challenges of parenting a child with obesity Clinic setting and equipment (Boxed)   Assessment of the Pediatric Patient with Obesity, by TBD History                                                                i.      Weight history                                                               ii.      Diet history                                                             iii.      Eating behaviours and questionnaires (Boxed)                                                             iv.      Physical activity                                                               v.      Sleep history                                                             vi.      Menstrual history                                                            vii.      Mental health history                                                          viii.      PMH                                                             ix.      Surgical history (T&A, Blounts)                                                               x.      Medications (Table)                                                             xi.      Family history                                                            xii.      Social history                                                          xiii.      Review of systems including screens for mental illness Physical exam                                                                i.      BMI, definitions, and growth chart (Figure)                                                               ii.      Linear growth (Figure)                                                             iii.      Table of PE findings and diagnosis (Table)                                                             iv.      Body composition (bioelectrical impedance, skin-fold thickness)                                                               v.      Waist circumference Labs                                                                i.      Standard                                                               ii.      Genetic evaluation Metabolism                                                                i.      Indirect calorimetry                                                               ii.      MedGem Case examples demonstrating heterogeneity of obesity (Boxed)   Dietary Interventions, by Jessica Graumann, RD and Rachel Fog, RD Primary dietary recommendations Meal replacements Low-glycemic load diet Ketogenic diet Others   Physical Activity Interventions, by Carolyn Bramante, MD and Amanda Schaffran, DPT   Pharmacological Strategies, by Claudia Fox, MD Indications FDA-approved (Table) (for each medication include mechanism of action, data on outcomes, side effects, cost, protocol for use, patient selection, clinical pearls)                                                                i.      Orlistat                                                               ii.      Liraglutide                                                             iii.      Phentermine                                                             iv.      Setmelanotide Non FDA-approved                                                                i.      Metformin                                                               ii.      Topiramate                                                             iii.      Bupropion+naltrexone                                                             iv.      Lisdexamfetamine (other stimulants) Soon to be FDA-approved                                                                i.      Semaglutide                                                               ii.      Phentermine+topiramate ER Goal of treatment Case examples (Boxed)   Metabolic and Bariatric Surgery, by Sarah Raatz, MD Pre-surgical evaluation                                                                i.      Eligibility (Table)                                                               ii.      Diet                                                             iii.      Psychology                                                             iv.      Physical therapy b.       Procedures (include outcomes and side effects)                                                                i.      Vertical sleeve gastrectomy                                                               ii.      Roux en Y gastric bypass c.        Post-operative care                                                                i.      Diet                                                               ii.      Supplements                                                             iii.      Labs                                                             iv.      Weight regain d.       Case examples (Boxed)     Psychological complications, by TBD a.       Depression b.       Anxiety c.        ADHD    Behavioral Challenges, by Amy Gross, PhD a.       Common scenarios/issues   Type 2 Diabetes Mellitus, by Megan Oberle, MD Diagnosis (rule out T1DM) Management   Non-alcoholic Fatty Liver Disease, by TBD Diagnosis Management   Polycystic Ovary Syndrome, by Eric Bomberg, MD Diagnosis Management   Hypertension, by TBD (?Scott McEwan) Diagnosis Management   Precocious Puberty, by Eric Bomberg, MD Diagnosis Management   Dyslipidemia, by Julia Steinberger, MD Diagnosis Management

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Author Information

  Claudia K. Fox, M.D., M.P.H., FAAP, DABOM Associate Professor, Department of Pediatrics Co-Director, Center for Pediatric Obesity Medicine University of Minnesota, Medical School Minneapolis, MN, USA Claudia Fox, MD is an Associate Professor of Pediatrics and Co-Director of the Center for Pediatric Obesity Medicine at the University of Minnesota Medical School, where she earned her Medical Degree and Masters of Public Health degree. Dr. Fox is one of the first pediatricians to become board certified by the American Board of Obesity Medicine and is nationally and internationally recognized as an expert in the treatment of pediatric obesity. She is the medical director of the University of Minnesota Children’s Hospital Pediatric Weight Management Program and is an accomplished researcher and educator in the field of pediatric obesity, particularly in the area of pharmacotherapy for pediatric obesity. Dr. Fox is the principle investigator and co-investigator of multiple NIH-funded clinical trials and co-directs the Pediatric Obesity Medicine Fellowship at the University of Minnesota.

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