Drug Therapy of Childhood Obesity

G. Farello, F. Patrizi, R. Tambucci, A. Verrotti
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Abstract

Over the last decades obesity prevalence among children and adolescents has increased dramatically and coincidentally the well-established comorbidities associated with the excess body weight have become a major health challenge worldwide. Despite intensive lifestyle modifications, patients severely obese might warrant adjunctive interventions. Although, antiobesity pharmacotherapy is emerging as a promising adjunctive strategy for adults who fail to respond to behavioral strategies, most of agents are not licensed for the treatment of obesity in children and adolescents. The aim of this narrative review is to discuss possible mechanisms by which drugs lead to weight loss and to summarize data concerning FDA-approved anti-obesity focusing on relatively small body of evidence concerning pharmacological options for managing pediatric obesity. Lifestyle and behavioral interventions remain the mainstream of the obesity treatment in children, but adjunctive pharmacotherapy may be beneficial in some patients. Although well-designed clinical trials are needed to properly evaluate safety and efficacy of anti-obesity drugs in children and adolescents, pediatricians dealing with obesity should know what drugs are available. Early identification, during childhood, of individuals who most likely respond favorably to a specific anti-obesity agent will be possibly more efficacious in addressing the global obesity epidemic, than pharmacotherapies started in older ages.
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儿童肥胖的药物治疗
在过去的几十年里,儿童和青少年的肥胖患病率急剧增加,与体重过重相关的公认的合并症已成为世界范围内的主要健康挑战。尽管密集的生活方式的改变,严重肥胖患者可能需要辅助干预。虽然,抗肥胖药物治疗正在成为一种有希望的辅助策略,用于对行为策略没有反应的成年人,但大多数药物没有被许可用于治疗儿童和青少年的肥胖。这篇叙述性综述的目的是讨论药物导致体重减轻的可能机制,并总结有关fda批准的抗肥胖的数据,重点是关于治疗儿童肥胖的药物选择的相对较少的证据。生活方式和行为干预仍然是儿童肥胖治疗的主流,但辅助药物治疗可能对一些患者有益。虽然需要精心设计的临床试验来正确评估儿童和青少年抗肥胖药物的安全性和有效性,但处理肥胖的儿科医生应该知道哪些药物是可用的。早期识别,在儿童时期,最可能对特定的抗肥胖药物反应良好的个体,可能比在老年开始的药物治疗更有效地解决全球肥胖流行病。
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