Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches: A Scientific Statement From the American Heart Association

Kelly, Aaron S.; Barlow, Sarah E.; Rao, Goutham; Inge, Thomas H.; Hayman, Laura L.; Steinberger, Julia; Urbina, Elaine M.; Ewing, Linda J.; Daniels, Stephen R.

doi:10.1161/cir.0b013e3182a5cfb3

Cited by 980Obesity, Physical Activity, DietBariatric Surgery and OutcomesObesity and Health Practices

Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches: A Scientific Statement From the American Heart Association

Kelly, Aaron S., Barlow, Sarah E., Rao, Goutham, Inge, Thomas H., Hayman, Laura L., Steinberger, Julia, Urbina, Elaine M., Ewing, Linda J. +1 more·2013·Circulation

DOI 10.1161/cir.0b013e3182a5cfb3

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Abstract

Severe obesity afflicts between 4% and 6% of all youth in the United States, and the prevalence is increasing. Despite the serious immediate and long-term cardiovascular, metabolic, and other health consequences of severe pediatric obesity, current treatments are limited in effectiveness and lack widespread availability. Lifestyle modification/behavior-based treatment interventions in youth with severe obesity have demonstrated modest improvement in body mass index status, but participants have generally remained severely obese and often regained weight after the conclusion of the treatment programs. The role of medical management is minimal, because only 1 medication is currently approved for the treatment of obesity in adolescents. Bariatric surgery has generally been effective in reducing body mass index and improving cardiovascular and metabolic risk factors; however, reports of long-term outcomes are few, many youth with severe obesity do not qualify for surgery, and access is limited by lack of insurance coverage. To begin to address these challenges, the purposes of this scientific statement are to (1) provide justification for and recommend a standardized definition of severe obesity in children and adolescents; (2) raise awareness of this serious and growing problem by summarizing the current literature in this area in terms of the epidemiology and trends, associated health risks (immediate and long-term), and challenges and shortcomings of currently available treatment options; and (3) highlight areas in need of future research. Innovative behavior-based treatment, minimally invasive procedures, and medications currently under development all need to be evaluated for their efficacy and safety in this group of patients with high medical and psychosocial risks.

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“A nationally representative survey of the civilian, noninstitutionalized population, the National Health and Nutrition Examination Survey (NHANES) contains both interviews and examinations.14”
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School-aged children and adolescents who have high BMIs and excessive body weights are known to be at high risk of developing cardiovascular, metabolic and musculoskeletal diseases.
“school-aged children and adolescents who have high BMIs and excessive body weights are known to be at high risk of developing other health problems, including cardiovascular, metabolic and musculoskeletal diseases,25”
From Physical activity and health in Chinese children and adolescents: expert consensus statement (2020) (2020) · cites this paper as [25]

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Impact of Obesity on Orthopaedics
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Authors: Kelly, A. S., Barlow, S. E., Rao, G., Inge, T. H., Hayman, L. L., Steinberger, J., Urbina, E. M., Ewing, L. J., & Daniels, S. R.
ORCID: Kelly, Aaron S.
Barlow, Sarah E.
Rao, Goutham
Inge, Thomas H.
Hayman, Laura L.
Steinberger, Julia
Urbina, Elaine M.
Ewing, Linda J.
Daniels, Stephen R.
Venue: Circulation
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2013-10-08
Volume: 128
Issue: 15
Pages: 1689-1712
ISSN: 0009-7322 (ISSN-L)
1524-4539
DOI: 10.1161/cir.0b013e3182a5cfb3
OpenAlex: W2111740150
Cited by: 980
References: 273
Citations by year: 2026: 32 · 2025: 38 · 2024: 55 · 2023: 72 · 2022: 83 · 2021: 92 · 2020: 105 · 2019: 93 · 2018: 98 · 2017: 100 · 2016: 86 · 2015: 71 · 2014: 49 · 2013: 4 · 2012: 1
FWCI: 71.40
Type: journal article
Language: en
Open access: closed
Locations: Circulation (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (UL1TR000077)
National Center for Advancing Translational Sciences
Topics: Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
Health Sciences › Medicine › Surgery › Bariatric Surgery and Outcomes
Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
Keywords: childhood obesity, adolescent obesity, obesity prevalence trends, cardiovascular risk, metabolic risk, obesity treatment, bariatric surgery, anti-obesity drugs, lifestyle modification, weight regain, minimally invasive procedures, psychosocial risks
MeSH terms: Adolescent, American Heart Association, Child, Humans, Obesity, Morbid, Risk Factors, United States

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Severe Obesity in Children and Adolescents: Identification, Associated Health Risks, and Treatment Approaches: A Scientific Statement From the American Heart Association

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