The treatment of obesity in children and adolescents: consensus position statement of the Italian society of pediatric endocrinology and diabetology, Italian Society of Pediatrics and Italian Society of Pediatric Surgery

Claudio Maffeis¹, Francesca Olivieri², Giuliana Valerio³, Elvira Verduci⁴, Maria Rosaria Licenziati⁵, Valeria Calcaterra^{6

7}, Gloria Pelizzo⁸, Mariacarolina Salerno⁹, Annamaria Staiano⁹, Sergio Bernasconi¹⁰, Raffaele Buganza¹¹, Antonino Crinò¹², Nicola Corciulo¹³, Domenico Corica¹⁴, Francesca Destro⁸, Procolo Di Bonito¹⁵, Mario Di Pietro¹⁶, Anna Di Sessa¹⁷, Luisa deSanctis¹⁸, Maria Felicia Faienza¹⁹, Grazia Filannino²⁰, Danilo Fintini²¹, Elena Fornari¹, Roberto Franceschi²², Francesca Franco²³, Adriana Franzese⁹, Lia Franca Giusti²⁴, Graziano Grugni²⁵, Dario Iafusco¹⁷, Lorenzo Iughetti²⁶, Riccardo Lera²⁷, Raffaele Limauro²⁸, Alice Maguolo¹, Valentina Mancioppi¹, Melania Manco²⁹, Emanuele Miraglia Del Giudice¹⁷, Anita Morandi¹, Beatrice Moro³⁰, Enza Mozzillo⁹, Ivana Rabbone³¹, Paola Peverelli³², Barbara Predieri²⁶, Salvo Purromuto³³, Stefano Stagi³⁴, Maria Elisabeth Street³⁵, Rita Tanas³⁶, Gianluca Tornese³⁷, Giuseppina Rosaria Umano¹⁷, Malgorzata Wasniewska¹⁴

Affiliations

¹ Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy.
² Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy. francesca.olivieri@aovr.veneto.it.
³ Department of Movement Sciences and Wellbeing, Parthenope University of Naples, Naples, Italy.
⁴ Deparment of Pediatrics, Department of Health Science, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy.
⁵ Department of Neurosciences, Neuro-Endocrine Diseases and Obesity Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.
⁶ Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy.
⁷ Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
⁸ Department of Pediatric Surgery, Vittore Buzzi Children's Hospital, Milan, Italy.
⁹ Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy.
¹⁰ Microbiome Reaserch Hub, University of Parma, Parma, Italy.
¹¹ Pediatric Endocrinology Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy.
¹² Autoimmune Endocrine Diseases Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
¹³ Pediatric Unit, Hospital of Gallipoli, Lecce, Italy.
¹⁴ Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.
¹⁵ Department of Internal Medicine, S. Maria Delle Grazie Hospital, Naples, Pozzuoli, Italy.
¹⁶ Pediatric and Neonatal Unit, Hospital of Teramo and Atri, Teramo, Italy.
¹⁷ Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy.
¹⁸ Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy.
¹⁹ Department of Precision and Regenerative Medicine and Ionan Area, University of Bari, Bari, Italy.
²⁰ Pediatric Unit Ostuni Hospital, Brindisi, Italy.
²¹ Refernce Center for Prader Willi Syndrome, Endocrinology and Diabetology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
²² Pediatric Unit, S. Chiara Hospital, APSS Trento, Trento, Italy.
²³ Pediatric Department, Azienda Sanitaria Universitaria del Friuli Centrale, Hospital of Udine, Udine, Italy.
²⁴ Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Lucca, Italy.
²⁵ Division of Auxology, Istituto Auxologico Italiano, IRCCS, Verbania, Italy.
²⁶ Department of Medical and Surgical Sciences of Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy.
²⁷ Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Alessandria, Italy.
²⁸ Local Health Unit Napoli, 3 Sud, Naples, Italy.
²⁹ Research Area for Multifactorial Diseases, Children's Hospital Bambino Gesù, Rome, Italy.
³⁰ UOSD Diabetology, Complesso Ai Colli, AULSS 6 Euganea, Padua, Italy.
³¹ Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.
³² Department of Pediatrics and Gynecology, Hospital of Belluno, Belluno, Italy.
³³ Pediatric Obesity Unit, ASP of Ragusa, Ragusa, Italy.
³⁴ Department of Health Sciences, University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy.
³⁵ Department of Medicine and Surgery, Unit of Paediatrics, University of Parma, University Hospital of Parma, Parma, Italy.
³⁶ Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Ferrara, Italy.
³⁷ Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy.

PMID: 37291604
PMCID: PMC10249209
DOI: 10.1186/s13052-023-01458-z

Review

The treatment of obesity in children and adolescents: consensus position statement of the Italian society of pediatric endocrinology and diabetology, Italian Society of Pediatrics and Italian Society of Pediatric Surgery

Claudio Maffeis et al. Ital J Pediatr. 2023.

. 2023 Jun 8;49(1):69.

doi: 10.1186/s13052-023-01458-z.

Authors

Affiliations

¹ Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy.
² Department of Surgery, Dentistry, Pediatrics and Gynecology, Section of Pediatric Diabetes and Metabolism, University of Verona, Verona, Italy. francesca.olivieri@aovr.veneto.it.
³ Department of Movement Sciences and Wellbeing, Parthenope University of Naples, Naples, Italy.
⁴ Deparment of Pediatrics, Department of Health Science, Vittore Buzzi Children's Hospital, University of Milan, Milan, Italy.
⁵ Department of Neurosciences, Neuro-Endocrine Diseases and Obesity Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy.
⁶ Department of Pediatrics, Vittore Buzzi Children's Hospital, Milan, Italy.
⁷ Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy.
⁸ Department of Pediatric Surgery, Vittore Buzzi Children's Hospital, Milan, Italy.
⁹ Department of Traslational Medical Sciences, Section of Pediatrics, University of Naples Federico II, Naples, Italy.
¹⁰ Microbiome Reaserch Hub, University of Parma, Parma, Italy.
¹¹ Pediatric Endocrinology Unit, Department of Public Health and Pediatric Sciences, University of Turin, Turin, Italy.
¹² Autoimmune Endocrine Diseases Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
¹³ Pediatric Unit, Hospital of Gallipoli, Lecce, Italy.
¹⁴ Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.
¹⁵ Department of Internal Medicine, S. Maria Delle Grazie Hospital, Naples, Pozzuoli, Italy.
¹⁶ Pediatric and Neonatal Unit, Hospital of Teramo and Atri, Teramo, Italy.
¹⁷ Department of Woman, Child and General and Specialized Surgery, University of Campania L. Vanvitelli, Naples, Italy.
¹⁸ Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy.
¹⁹ Department of Precision and Regenerative Medicine and Ionan Area, University of Bari, Bari, Italy.
²⁰ Pediatric Unit Ostuni Hospital, Brindisi, Italy.
²¹ Refernce Center for Prader Willi Syndrome, Endocrinology and Diabetology Unit, Bambino Gesù Children Hospital, IRCCS, Rome, Italy.
²² Pediatric Unit, S. Chiara Hospital, APSS Trento, Trento, Italy.
²³ Pediatric Department, Azienda Sanitaria Universitaria del Friuli Centrale, Hospital of Udine, Udine, Italy.
²⁴ Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Lucca, Italy.
²⁵ Division of Auxology, Istituto Auxologico Italiano, IRCCS, Verbania, Italy.
²⁶ Department of Medical and Surgical Sciences of Mother, Children and Adults, Pediatric Unit, University of Modena and Reggio Emilia, Modena, Italy.
²⁷ Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Alessandria, Italy.
²⁸ Local Health Unit Napoli, 3 Sud, Naples, Italy.
²⁹ Research Area for Multifactorial Diseases, Children's Hospital Bambino Gesù, Rome, Italy.
³⁰ UOSD Diabetology, Complesso Ai Colli, AULSS 6 Euganea, Padua, Italy.
³¹ Division of Pediatrics, Department of Health Sciences, University of Piemonte Orientale, Novara, Italy.
³² Department of Pediatrics and Gynecology, Hospital of Belluno, Belluno, Italy.
³³ Pediatric Obesity Unit, ASP of Ragusa, Ragusa, Italy.
³⁴ Department of Health Sciences, University of Florence, Meyer Children's Hospital IRCCS, Florence, Italy.
³⁵ Department of Medicine and Surgery, Unit of Paediatrics, University of Parma, University Hospital of Parma, Parma, Italy.
³⁶ Italian Society for Pediatric Endocrinology and Diabetology (SIEDP), Ferrara, Italy.
³⁷ Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste, Italy.

PMID: 37291604
PMCID: PMC10249209
DOI: 10.1186/s13052-023-01458-z

Abstract

This Position Statement updates the different components of the therapy of obesity (lifestyle intervention, drugs, and surgery) in children and adolescents, previously reported in the consensus position statement on pediatric obesity of the Italian Society of Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics. Lifestyle intervention is the first step of treatment. In children older than 12 years, pharmacotherapy is the second step, and bariatric surgery is the third one, in selected cases. Novelties are available in the field of the medical treatment of obesity. In particular, new drugs demonstrated their efficacy and safety and have been approved in adolescents. Moreover, several randomized control trials with other drugs are in process and it is likely that some of them will become available in the future. The increase of the portfolio of treatment options for obesity in children and adolescents is promising for a more effective treatment of this disorder.

Keywords: Adolescents; Bariatric surgery; Children; Cognitive and family-based behavior therapy; Drug; Nutrition; Obesity; Physical activity; Treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

References

1. Wang Y. Epidemiology of childhood obesity—methodological aspects and guidelines: what is new? Int J Obes Relat Metab Disord. 2004;28(3):S21–8. doi: 10.1038/sj.ijo.0802801. - DOI - PubMed
1. Kostovski M, Tasic V, Laban N, Polenakovic M, Danilovski D, Gucev Z. Obesity in childhood and adolescence. Genetic Factors Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2017;38(3):121–133. doi: 10.2478/prilozi-2018-0013. - DOI - PubMed
1. Nittari G, Scuri S, Petrelli F, Pirillo I, di Luca NM, Grappasonni I. Fighting obesity in children from European World Health Organization member states. epidemiological data, medical-social aspects, and prevention programs. Clin Ter. 2019;170(3):e223–30. - PubMed
1. Singh AS, Mulder C, Twisk JWR, Van Mechelen W, Chinapaw MJM. Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev. 2008;9(5):474–488. doi: 10.1111/j.1467-789X.2008.00475.x. - DOI - PubMed
1. Grugni G, Licenziati MR, Valerio G, Crinò A, Maffeis C, Tanas R, Morino GS. Childhood obesity study group of the Italian Society for Pediatric Endocrinology and Diabetology (ISPED). The rehabilitation of children and adolescents with severe or medically complicated obesity: an ISPED expert opinion document. Eat Weight Disord. 2017;22(1):3–12. doi: 10.1007/s40519-016-0305-5. - DOI - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

The treatment of obesity in children and adolescents: consensus position statement of the Italian society of pediatric endocrinology and diabetology, Italian Society of Pediatrics and Italian Society of Pediatric Surgery

Affiliations

The treatment of obesity in children and adolescents: consensus position statement of the Italian society of pediatric endocrinology and diabetology, Italian Society of Pediatrics and Italian Society of Pediatric Surgery

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical