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Childhood Obesity

University Hospital, Malmö, Sweden, carl-erik.flodmark{at}pediatrik.mas.lu.se

Prevention of obesity should have the highest priority and be started as early in life as possible in high-risk families. This article covers the most promising areas of today's research aimed at finding better ways of treating obesity in the future and an overview of the treatment choices available today. The cause of obesity is genetic in approximately 40-50 percent of adults and probably to a higher degree in children. This means that it is possible to remain overweight without a calorie intake that exceeds that of those individuals of normal weight who lack the genetic susceptibility of obesity. Treatment is recommended from 10 years of age with a hypocaloric diet (1500 kcal) and a reduced fat content (30 energy-percent). Exercise is often obtained naturally by the child before this age. It is helpful to try to replace a sedentary lifestyle including television-viewing with moderate physical activities such as walking. In introducing these changes in lifestyle family therapy has been effective. Other strategies such as behavioural therapy has also been tried individually or in groups or at school with short-term benefits only. Cognitive therapy in childhood obesity gives no advantages over behavioural therapy. No reports on psychodynamic therapy have been published. Surgery is used only in rare inborn metabolic diseases. Although the treatment of children seems to give better results than does treating adults, further development of therapy for obesity is needed.

Key Words: childhood obesity • family therapy • review • treatment

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