Treatment of childhood obesity: a multidisciplinary approach

Childhood obesity is a serious global health problem associated with increased risk of disease in the short- and long-term. Excess weight gain begins early, during the preschool years, and many children remain overweight throughout childhood and adult life. Once established, obesity is difficult to reverse and costly to manage. In the UK, direct treatment costs the NHS £4.2 billion a year and without fast action, this could rise to £10 billion by 2050. Treatment options in childhood are limited. Lifestyle intervention is the first line treatment recommended by the National Institute for Care excellence (NICE) in the UK. In younger children (<6 years) this is the only management option. In older children, pharmacological intervention is possible under specialist medical supervision. Evidence for the safety and success of bariatric surgery in children is limited. However, there is enough evidence to consider making the treatment available for a small number of highly selected children, with severe and complex obesity. Prevention is the best strategy. Lifestyle interventions are feasible and effective in both the prevention and treatment of childhood obesity. These require evaluation in rigorous trials and if successful should be integrated into healthcare and widely available.