Mogućnosti liječenja pretilosti u djece

Childhood obesity is a global public health problem of the 21st century. Today, childhood obesity is considered a complex chronic, relapsing disease that negatively affects the quality of life, not only by causing unnecessary accumulation of adipose tissue, excessive body weight, but also by triggering severe health complications that have traditionally been described in adults. These complications include type 2 diabetes, hyperlipidemia, and cardiovascular disease, as well as many other negative health consequences. The etiology of obesity is multifactorial and includes genetic predisposition, environmental factors, socio-economic and behavioral factors. Obesity that begins in early childhood often continues into adolescence. It has been observed that obese adolescents have a higher risk of remaining obese in adulthood. Treatment of obesity in children requires a comprehensive approach, including changes in health behavior and lifestyle, pharmacological, psychological, motivational, metabolic and surgical interventions. The first step in treating childhood obesity is considered to be changing unhealthy behavior and lifestyle. This intervention is considered safe in almost all age groups of children and includes nutritional interventions aimed at changing unhealthy eating habits and establishing long-term healthy eating habits and can be combined with motivational and psychological support. If necessary, this intervention may be combined with other treatment modalities including pharmacotherapy and surgery. It is also considered that this intervention should be individually tailored personalized. Such an approach also requires a comprehensive understanding of the polygenic factors that contribute to obesity and their interactions with genetic factors, pathogenic environmental factors, and the impact on the outcomes of different treatment strategies. Also, a personalized approach to the treatment of obesity in children aims to increase the effectiveness of interventions and reduce side effects. Interventions that include changes in health behavior and lifestyle, however, require further research. The addition of anti-obesity medication to an intervention that changes health behavior and lifestyle is considered a step that should be taken immediately after the diagnosis of obesity in children. This combination shows promise for the effective management of obesity in children (1-4). The use of anti-obesity medications in children must be rational because it is still unknown whether and what the negative effects of these medications on the child's growth and development may be. Data on the efficacy and safety of anti-obesity medications in children mainly come from not so many clinical trials, and long-term effects on weight loss, adherence to treatment, and side effects require long-term evaluation. Poor reimbursement for anti-obesity medications, a lack of prevention programs, and a widespread belief that obesity is not a chronic disease are also issues that limit the practice of initiating treatment for obesity in childhood. Effective treatment of childhood obesity requires a comprehensive, multidisciplinary approach that addresses not only the physical aspects of obesity, but also social, socioeconomic, and other factors. Overcoming the barriers to treating childhood obesity will require firm efforts by health care providers, researchers, policymakers, and families.