The increased prevalence of adolescent obesity and associated short-term and long-term complications emphasize the need for effective treatment. In this Review, we aim to describe the evidence for, and elements of, behaviour management and adjunctive therapies and highlight the opportunities and challenges presented by obesity management in adolescence. The broad principles of treatment include management of obesity-associated complications; a developmentally appropriate approach; long-term behaviour modification (dietary change, increased physical activity, decreased sedentary behaviours and improved sleep patterns); long-term weight maintenance strategies; and consideration of the use of pharmacotherapy, more intensive dietary therapies and bariatric surgery. Bariatric surgery should be considered in those with severe obesity and be undertaken by skilled bariatric surgeons affiliated with teams experienced in the medical and psychosocial management of adolescents. Adolescent obesity management strategies are more reliant on active participation than those for childhood obesity and should recognize the emerging autonomy of the patient. The challenges in adolescent obesity relate primarily to the often competing demands of developing autonomy and not yet having attained neurocognitive maturity.
The preferred treatment approach for adolescent patients with obesity includes management of obesity-associated complications, a developmentally appropriate approach, support for long-term behavioural change, long-term weight maintenance strategies and consideration of other therapies.
Long-term weight maintenance therapy, through face-to-face or electronic support, phone coaching or group programmes, is likely to be required.
Bariatric surgery should be considered in adolescents with severe obesity (BMI >40 kg/m2, or >35 kg/m2 in the presence of complications), and patients should be treated in centres experienced in bariatric surgery.
Pharmacotherapy should be used as adjunctive therapy, particularly in the maintenance of weight loss, and for the treatment of obesity-associated complications.
Clinicians should understand where the adolescent is in puberty development — age does not equal stage — and not support beliefs that young people will grow out of obesity with the onset of puberty.
Clinicians must work within the contexts of both the normal rapid changes in adolescent brain development and the psychosocial tasks of adolescence that are necessary for mature adulthood.
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World Health Organization. Health for the world’s adolescents: a second chance in the second decade. WHO http://www.who.int/maternal_child_adolescent/documents/second-decade/en/ (2014).
Ng, M. et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the global burden of disease study 2013. Lancet 384, 766–781 (2014).
NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. Lancet 390, 2627–2642 (2017).
Chung, A. et al. Trends in child and adolescent obesity prevalence in economically advanced countries according to socioeconomic position: a systematic review. Obes. Rev. 17, 276–295 (2016).
Skinner, A. C. & Skelton, J. A. Prevalence and trends in obesity and severe obesity among children in the United States, 1999–2012. JAMA Pediatr. 168, 561–566 (2014).
Garnett, S. P., Baur, L. A., Jones, A. M. & Hardy, L. L. Trends in the prevalence of morbid and severe obesity in Australian children aged 7–15 years, 1985–2012. PLoS ONE 11, e0154879 (2016).
Skinner, A. C., Perrin, E. M. & Skelton, J. A. Prevalence of obesity and severe obesity in US children, 1999–2014. Obesity 24, 1116–1123 (2016).
Gordon-Larsen, P., Adair, L. S., Nelson, M. C. & Popkin, B. M. Five-year obesity incidence in the transition period between adolescence and adulthood: the national longitudinal study of adolescent health. Am. J. Clin. Nutr. 80, 569–575 (2004).
Patton, G. C. et al. Overweight and obesity between adolescence and young adulthood: a 10-year prospective cohort study. J. Adolesc. Health 48, 275–280 (2011).
Baur, L. A., Hazelton, B. & Shrewsbury, V. A. Assessment and management of obesity in childhood and adolescence. Nat. Rev. Gastroenterol. Hepatol. 8, 635–645 (2011).
National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. NHMRC www.nhmrc.gov.au/guidelines/publications/n57 (2013).
National Clinical Guideline Centre (UK). Obesity: identification, assessment and management. NICE www.nice.org.uk/guidance/cg189 (2014).
Parkin, P. et al. Recommendations for growth monitoring, and prevention and management of overweight and obesity in children and youth in primary care. CMAJ 187, 411–421 (2015).
Styne, D. M. et al. Pediatric obesity — assessment, treatment, and prevention: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 102, 709–757 (2017).
Blakemore, S.-J. Imaging brain development: the adolescent brain. Neuroimage 61, 397–406 (2012).
Shulman, E. P. et al. The dual systems model: review, reappraisal, and reaffirmation. Dev. Cogn. Neurosci. 17, 103–117 (2016).
Al-Khudairy, L. et al. Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years. Cochrane Database Syst. Rev. 6, CD012691 (2017).
Ho, M. et al. Effectiveness of lifestyle interventions in child obesity: systematic review with meta-analysis. Pediatrics 130, e1647–e1671 (2012).
Patton, G. C. & Viner, R. Pubertal transitions in health. Lancet 369, 1130–1139 (2007).
Moran, A. et al. Insulin resistance during puberty: results from clamp studies in 357 children. Diabetes 48, 2039–2044 (1999).
Kelsey, M. M. & Zeitler, P. S. Insulin resistance of puberty. Curr. Diab. Rep. 16, 64 (2016).
Pont, S. J., Puhl, R., Cook, S. R. & Slusser, W. Stigma experienced by children and adolescents with obesity. Pediatrics 140, e20173034 (2017).
Puhl, R. M. & Latner, J. D. Stigma, obesity, and the health of the nation’s children. Psychol. Bull. 133, 557 (2007).
Tang-Péronard, J. & Heitmann, B. Stigmatization of obese children and adolescents, the importance of gender. Obes. Rev. 9, 522–534 (2008).
Dietz, W. H. et al. Management of obesity: improvement of health-care training and systems for prevention and care. Lancet 385, 2521–2533 (2015).
Berger, S. E., Huggins, G. S., McCaffery, J. M. & Lichtenstein, A. H. Comparison among criteria to define successful weight-loss maintainers and regainers in the action for health in diabetes (Look AHEAD) and diabetes prevention program trials. Am. J. Clin. Nutr. 106, 1337–1346 (2017).
MacLean, P. S. et al. NIH working group report: innovative research to improve maintenance of weight loss. Obesity 23, 7–15 (2015).
Rajjo, T. et al. The association of weight loss and cardiometabolic outcomes in obese children: systematic review and meta-regression. J. Clin. Endocrinol. Metab. 102, 758–762 (2016).
Ho, M. et al. Impact of dietary and exercise interventions on weight change and metabolic outcomes in obese children and adolescents: a systematic review and meta-analysis of randomized trials. JAMA Pediatr. 167, 759–768 (2013).
Ruotsalainen, H., Kyngäs, H., Tammelin, T. & Kääriäinen, M. Systematic review of physical activity and exercise interventions on body mass indices, subsequent physical activity and psychological symptoms in overweight and obese adolescents. J. Adv. Nurs. 71, 2461–2477 (2015).
Altman, M. & Wilfley, D. E. Evidence update on the treatment of overweight and obesity in children and adolescents. J. Clin. Child Adolesc. Psychol. 44, 521–537 (2015).
Webb, V. L. & Wadden, T. A. Intensive lifestyle intervention for obesity: principles, practices, and results. Gastroenterology 152, 1752–1764 (2017).
Oude Luttikhuis, H. et al. Interventions for treating obesity in children. Cochrane Database Syst. Rev. 21, CD001872 (2009).
Samdal, G. B., Eide, G. E., Barth, T., Williams, G. & Meland, E. Effective behaviour change techniques for physical activity and healthy eating in overweight and obese adults; systematic review and meta-regression analyses. Int. J. Behav. Nutr. Phys. Act. 14, 42 (2017).
Gow, M. L., Garnett, S. P., Baur, L. A. & Lister, N. B. The effectiveness of different diet strategies to reduce type 2 diabetes risk in youth. Nutrients 8, 486 (2016).
Díaz, R. G., Esparza-Romero, J., Moya-Camarena, S. Y., Robles-Sardín, A. E. & Valencia, M. E. Lifestyle intervention in primary care settings improves obesity parameters among Mexican youth. J. Am. Diet Assoc. 110, 285–290 (2010).
Epstein, L. H., Wing, R. R., Koeske, R. & Valoski, A. Effects of diet plus exercise on weight change in parents and children. J. Consult. Clin. Psychol. 52, 429 (1984).
Jiang, J. X., Xia, X., Greiner, T., Lian, G. & Rosenqvist, U. A two year family based behaviour treatment for obese children. Arch. Dis. Child. 90, 1235–1238 (2005).
Gow, M. L. et al. Impact of dietary macronutrient distribution on BMI and cardiometabolic outcomes in overweight and obese children and adolescents: a systematic review. Nutr. Rev. 72, 453–470 (2014).
Demol, S. et al. Low-carbohydrate (low and high-fat) versus high-carbohydrate low-fat diets in the treatment of obesity in adolescents. Acta Paediatr. 98, 346–351 (2009).
Kirk, S. et al. Role of carbohydrate modification in weight management among obese children: a randomized clinical trial. J. Pediatr. 161, 320–327 (2012).
Westerterp-Plantenga, M. S., Nieuwenhuizen, A., Tome, D., Soenen, S. & Westerterp, K. R. Dietary protein, weight loss, and weight maintenance. Annu. Rev. Nutr. 29, 21–41 (2009).
Papadaki, A. et al. The effect of protein and glycemic index on children’s body composition: the DiOGenes randomized study. Pediatrics 126, E1143–E1152 (2010).
Schwingshackl, L., Hobl, L. P. & Hoffmann, G. Effects of low glycaemic index/low glycaemic load versus high glycaemic index/ high glycaemic load diets on overweight/obesity and associated risk factors in children and adolescents: a systematic review and meta-analysis. Nutr. J. 14, 87 (2015).
Seimon, R. V. et al. Do intermittent diets provide physiological benefits over continuous diets for weight loss? a systematic review of clinical trials. Mol. Cell. Endocrinol. 418, 153–172 (2015).
Headland, M., Clifton, P. M., Carter, S. & Keogh, J. B. Weight-loss outcomes: a systematic review and meta-analysis of intermittent energy restriction trials lasting a minimum of 6 months. Nutrients 8, 354 (2016).
Lister, N. et al. Nutritional adequacy of diets for adolescents with overweight and obesity: considerations for dietetic practice. Eur. J. Clin. Nutr. 71, 646–651 (2017).
Mulholland, Y., Nicokavoura, E., Broom, J. & Rolland, C. Very-low-energy diets and morbidity: a systematic review of longer-term evidence. Br. J. Nutr. 108, 832–851 (2012).
Berkowitz, R. I. et al. Meal replacements in the treatment of adolescent obesity: a randomized controlled trial. Obesity (Silver Spring) 19, 1193–1199 (2011).
Gow, M. L., Baur, L. A., Johnson, N. A., Cowell, C. T. & Garnett, S. P. Reversal of type 2 diabetes in youth who adhere to a very-low-energy diet: a pilot study. Diabetologia 60, 406–415 (2016).
Willi, S. M., Martin, K., Datko, F. M. & Brant, B. P. Treatment of type 2 diabetes in childhood using a very-low-calorie diet. Diabetes Care 27, 348–353 (2004).
Moldovan, A. R. & David, D. Effect of obesity treatments on eating behavior: psychosocial interventions versus surgical interventions. a systematic review. Eat Behav. 12, 161–167 (2011).
Webber, L., Hill, C., Saxton, J., Van Jaarsveld, C. & Wardle, J. Eating behaviour and weight in children. Int. J. Obes. 33, 21 (2009).
Ho, M. et al. Effect of a prescriptive dietary intervention on psychological dimensions of eating behavior in obese adolescents. Int. J. Behav. Nutr. Phys. Act 10, 119 (2013).
O´Malley, G. et al. Physical activity and physical fitness in pediatric obesity: what are the first steps for clinicians? Expert conclusion from the 2016 ECOG workshop. Int. J. Exerc. Sci. 10, 487–496 (2017).
Ekelund, U. et al. Independent associations of physical activity and cardiorespiratory fitness with metabolic risk factors in children: the European youth heart study. Diabetologia 50, 1832–1840 (2007).
Janssen, I. & LeBlanc, A. G. Systematic review of the health benefits of physical activity and fitness in school-aged children and youth. Int. J. Behav. Nutr. Phys. Act. 7, 40 (2010).
Lubans, D. et al. Physical activity for cognitive and mental health in youth: a systematic review of mechanisms. Pediatrics 33, e20161642 (2016).
Raitakan, O. T. et al. Effects of persistent physical activity and inactivity on coronary risk factors in children and young adults the cardiovascular risk in young Finns study. Am. J. Epidemiol. 140, 195–205 (1994).
Centers for Disease Control and Prevention. The association between school-based physical activity, including physical education, and academic performance. CDC. https://www.cdc.gov/healthyyouth/health_and_academics/pdf/pa-pe_paper.pdf (2010).
Paes, S. T., Marins, J. C. B. & Andreazzi, A. E. Metabolic effects of exercise on childhood obesity: a current view. Rev. Paul Pediatr. 33, 122–129 (2015).
Gow, M. L. et al. Sustained improvements in fitness and exercise tolerance in obese adolescents after a 12 week exercise intervention. Obes. Res. Clin. Pract. 10, 178–188 (2016).
Australian Government Department of Health. Australia’s physical activity and sedentary behaviour guidelines. Australian Government Department of Health. http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines (2014).
Department of Health (UK). UK physical activity guidelines. GOV.UK https://www.gov.uk/government/publications/uk-physical-activity-guidelines (2011).
The Public Health Agency of Canada. 24 h movement guidelines for children and youth: an integration of physical activity, sedentary behaviour, and sleep. Government of Canada. https://www.canada.ca/en/public-health/services/health-promotion/healthy-living/physical-activity/24-hour-movement-guidelines-children-youth.html (2016).
Office of Disease Prevention and Health Promotion. Physical Activity Guidelines for Americans. health.gov https://health.gov/paguidelines/guidelines/ (2008).
Stearns, J. A., Carson, V., Spence, J. C., Faulkner, G. & Leatherdale, S. T. The role of peer victimization in the physical activity and screen time of adolescents: a cross-sectional study. BMC Pediatr. 17, 170 (2017).
Tsiros, M. et al. Day-to-day physical functioning and disability in obese 10-to 13-year-olds. Pediatr. Obes. 8, 31–41 (2013).
Tsiros, M. D., Coates, A. M., Howe, P., Grimshaw, P. & Buckley, J. D. Obesity: the new childhood disability? Obes. Rev. 12, 26–36 (2011).
Fedele, D. A., Cushing, C. C., Fritz, A., Amaro, C. M. & Ortega, A. Mobile health interventions for improving health outcomes in youth: a meta-analysis. JAMA Pediatr. 171, 461–469 (2017).
Cappuccio, F. P. et al. Meta-analysis of short sleep duration and obesity in children and adults. Sleep 31, 619–626 (2008).
Fatima, Y. & Mamun, A. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obes. Rev. 16, 137–149 (2015).
Thomson, C. A. et al. Relationship between sleep quality and quantity and weight loss in women participating in a weight-loss intervention trial. Obesity 20, 1419–1425 (2012).
Chaput, J.-P. & Tremblay, A. Sleeping habits predict the magnitude of fat loss in adults exposed to moderate caloric restriction. Obes. Facts 5, 561–566 (2012).
Capers, P. L., Fobian, A. D., Kaiser, K. A., Borah, R. & Allison, D. B. A systematic review and meta-analysis of randomized controlled trials of the impact of sleep duration on adiposity and components of energy balance. Obes. Rev. 16, 771–782 (2015).
Yoong, S. L. et al. Systematic review and meta-analysis of interventions targeting sleep and their impact on child body mass index, diet, and physical activity. Obesity 24, 1140–1147 (2016).
Chaput, J.-P. & Dutil, C. Lack of sleep as a contributor to obesity in adolescents: impacts on eating and activity behaviors. Int. J. Behav. Nutr. Phys. Act 13, 103 (2016).
Carroll, J. K. et al. Who uses mobile phone health apps and does use matter? a secondary data analytics approach. J. Med. Internet Res. 19, e125 (2017).
Jakicic, J. M. et al. Effect of wearable technology combined with a lifestyle intervention on long-term weight loss: the IDEA randomized clinical trial. JAMA 316, 1161–1171 (2016).
van der Zanden, R., Kramer, J., Gerrits, R. & Cuijpers, P. Effectiveness of an online group course for depression in adolescents and young adults: a randomized trial. J. Med. Internet Res. 14, e86 (2012).
Mead, E. et al. Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database Syst. Rev. 6, CD012651 (2017).
Wiegand, S. et al. Predicting weight loss and maintenance in overweight/obese pediatric patients. Horm. Res. Paediatr. 82, 380–387 (2014).
Gow, M. L. et al. Can early weight loss, eating behaviors and socioeconomic factors predict successful weight loss at 12- and 24-months in adolescents with obesity and insulin resistance participating in a randomised controlled trial? Int. J. Behav. Nutr. Phys. Act. 13, 1–11 (2016).
Mead, E. et al. Drug interventions for the treatment of obesity in children and adolescents. Cochrane Database Syst. Res. 11, CD012436 (2016).
Van Gaal, L. & Scheen, A. Weight management in type 2 diabetes: current and emerging approaches to treatment. Diabetes Care 38, 1161–1172 (2015).
Paravattil, B., Wilby, K. J. & Turgeon, R. Topiramate monotherapy for weight reduction in patients with type 2 diabetes mellitus: a systematic review and meta-analysis. Diabetes Res. Clin. Pract. 114, 9–14 (2016).
Fox, C. K. et al. Meal replacements followed by topiramate for the treatment of adolescent severe obesity: a pilot randomized controlled trial. Obesity 24, 2553–2561 (2016).
Joao, A., Reis, F. & Fernandes, R. The incretin system ABCs in obesity and diabetes–novel therapeutic strategies for weight loss and beyond. Obes. Rev. 17, 553–572 (2016).
Tong, J. & Sandoval, D. A. Is the GLP-1 system a viable therapeutic target for weight reduction? Rev. Endocr. Metab. Disord. 12, 187–195 (2011).
Davies, M. et al. Effect of oral semaglutide compared with placebo and subcutaneous semaglutide on glycemic control in patients with type 2 diabetes: a randomized clinical trial. JAMA 318, 1460–1470 (2017).
Kelly, A. S. et al. The effect of glucagon-like peptide-1 receptor agonist therapy on body mass index in adolescents with severe obesity: a randomized, placebo-controlled, clinical trial. JAMA Pediatr. 167, 355–360 (2013).
Vidal, J., Corcelles, R., Jiménez, A., Flores, L. & Lacy, A. M. Metabolic and bariatric surgery for obesity. Gastroenterology 152, 1780–1790 (2017).
O’Brien, P. E. et al. Laparoscopic adjustable gastric banding in severely obese adolescents: a randomized trial. JAMA 303, 519–526 (2010).
Ells, L. J. et al. Surgery for the treatment of obesity in children and adolescents. Cochrane Database Syst. Res. 6, CD011740 (2015).
Paulus, G. F. et al. Bariatric surgery in morbidly obese adolescents: a systematic review and meta-analysis. Obes. Surg. 25, 860–878 (2015).
Inge, T. H. et al. Weight loss and health status 3 years after bariatric surgery in adolescents. N. Engl. J. Med. 374, 113–123 (2016).
Beamish, A. J. & Reinehr, T. Should bariatric surgery be performed in adolescents? Eur. J. Endocrinol. 176, D1–D15 (2017).
Inge, T. H. et al. Bariatric surgery for severely overweight adolescents: concerns and recommendations. Pediatrics 114, 217–223 (2004).
International Pediatric Endosurgery Group. IPEG guidelines for surgical treatment of extremely obese adolescents. J Laparoendosc. Adv. Surg. Tech. 19 (Suppl. 1), xiv–xvi (2009).
Baur, L. A. & Fitzgerald, D. A. Recommendations for bariatric surgery in adolescents in Australia and New Zealand. J. Paediatr. Child Health 46, 704–707 (2010).
Michalsky, M., Reichard, K., Inge, T., Pratt, J. & Lenders, C. ASMBS pediatric committee best practice guidelines. Surg. Obes. Relat. Dis. 8, 1–7 (2012).
Pulgarón, E. R. Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clin. Ther. 35, A18–A32 (2013).
Agirbasli, M., Tanrikulu, A. M. & Berenson, G. S. Metabolic syndrome: bridging the gap from childhood to adulthood. Cardiovasc. Ther. 34, 30–36 (2016).
Cook, S., Weitzman, M., Auinger, P., Nguyen, M. & Dietz, W. H. Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third national health and nutrition examination survey, 1988–1994. Arch. Pediatr. Adolesc. Med. 157, 821–827 (2003).
Ford, E. S. & Li, C. Defining the metabolic syndrome in children and adolescents: will the real definition please stand up? J. Pediatr. 152, 160–164 (2008).
Reinehr, T. Metabolic syndrome in children and adolescents: a critical approach considering the interaction between pubertal stage and insulin resistance. Curr. Diab. Rep. 16, 8 (2016).
Zimmet, P. et al. The metabolic syndrome in children and adolescents–an IDF consensus report. Pediatr. Diabetes 8, 299–306 (2007).
Pernia, S. & DeMaagd, G. The new pregnancy and lactation labeling rule. P. T. 41, 713 (2016).
European Medicines Agency. Good pharmacovigilance practices. EMA http://www.ema.europa.eu/ema/index.jsp?curl=pages/regulation/document_listing/document_listing_000345.jsp&mid=WC0b01ac058058f32c (2017).
Therapeutic Goods Administration (Australia). Prescribing medicines in pregnancy database. TGA https://www.tga.gov.au/australian-categorisation-system-prescribing-medicines-pregnancy (2017).
Andersen, I. G., Holm, J. C. & Homøe, P. Obstructive sleep apnea in obese children and adolescents, treatment methods and outcome of treatment–a systematic review. Int. J. Pediatr. Otorhinolaryngol. 87, 190–197 (2016).
Doycheva, I., Watt, K. D. & Alkhouri, N. Nonalcoholic fatty liver disease in adolescents and young adults: the next frontier in the epidemic. Hepatology 65, 2100–2109 (2017).
Bitersohl, B., Hosalkar, H. S., Zilkens, C. & Krauspe, R. Current concepts in management of slipped capital femoral epiphysis. Hip. Int. 25, 104–114 (2015).
Lewandowski, R. E. et al. Evidence for the management of adolescent depression. Pediatrics 132, e996–e1009 (2013).
Wehry, A. M., Beesdo-Baum, K., Hennelly, M. M., Connolly, S. D. & Strawn, J. R. Assessment and treatment of anxiety disorders in children and adolescents. Curr. Psychiatry Rep. 17, 52 (2015).
Zeitler, P. et al. Type 2 diabetes in the child and adolescent. Pediatr. Diabetes 15, 26–46 (2014).
International Society for Pediatric and Adolescent Diabetes. ISPAD clinical practice consensus guidelines 2014. ISPAD http://www.ispad.org/?page=ISPADClinicalPract (2014).
Caprio, S., Perry, R. & Kursawe, R. Adolescent obesity and insulin resistance: roles of ectopic fat accumulation and adipose inflammation. Gastroenterology 152, 1638–1646 (2017).
van Vliet, M. et al. Overweight is highly prevalent in children with type 1 diabetes and associates with cardiometabolic risk. J. Pediatr. 156, 923–929 (2010).
Kit, B. K. et al. Prevalence of and trends in dyslipidemia and blood pressure among US children and adolescents, 1999–2012. JAMA Pediatr. 169, 272–279 (2015).
Bays, H. E., Jones, P. H., Orringer, C. E., Brown, W. V. & Jacobson, T. A. National lipid association annual summary of clinical lipidology 2016. J. Clin. Lipidol. 10, S1–S43 (2016).
Oh, R. C. & Lanier, J. B. Management of hypertriglyceridemia. Am. Fam. Physician. 75, 1365–1371 (2007).
Flynn, J. T. et al. Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics 140, e20171904 (2017).
Legro, R. S. et al. Diagnosis and treatment of polycystic ovary syndrome: an endocrine society clinical practice guideline. J. Clin. Endocrinol. Metab. 98, 4565–4592 (2013).
Glintborg, D. et al. Body composition is improved during 12 months’ treatment with metformin alone or combined with oral contraceptives compared with treatment with oral contraceptives in polycystic ovary syndrome. J. Clin. Endocrinol. Metab. 99, 2584–2591 (2014).
World Health Organization. Report of the commission on ending childhood obesity. WHO http://www.who.int/end-childhood-obesity/publications/echo-report/en/ (2016).
Steinbeck, K., Towns, S. & Bennett, D. Adolescent and young adult medicine is a special and specific area of medical practice. J. Paediatr. Child Health 50, 427–431 (2014).
Shrewsbury, V., Baur, L., Nguyen, B. & Steinbeck, K. Transition to adult care in adolescent obesity: a systematic review and why it is a neglected topic. Int. J. Obes. 38, 475 (2014).
Chapman, L., Darling, A. & Brown, J. Association between metformin and vitamin B 12 deficiency in patients with type 2 diabetes: a systematic review and meta-analysis. Diabetes Metab. 42, 316–327 (2016).
Gallo, M. F. et al. Combination contraceptives: effects on weight. Cochrane Database Syst. Rev. 25, CD003987 (2014).
Romo, A. & Benavides, S. Treatment options in insulin resistance obesity–related acanthosis nigricans. Ann. Pharmacother. 42, 1090–1094 (2008).
McDonagh, M. S., Selph, S., Ozpinar, A. & Foley, C. Systematic review of the benefits and risks of metformin in treating obesity in children aged 18 years and younger. JAMA Pediatr. 168, 178–184 (2014).
Marcus, C. L. et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics 130, e714–e755 (2012).
National Institute for Health Care and Excellence. Depression in children and young people: identification and management: clinical guideline [CG28]. NICE. https://www.nice.org.uk/guidance/cg28 (2017).
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This narrative review is based upon data from systematic reviews, review papers and individual studies known to the authors. Other studies were identified by a MEDLINE search of English language papers published up to 2017 using the search terms “obesity” and “adolescent” and then further refined using such terms as “bariatric surgery”, “behaviour therapy”, “drug therapy”, “diet”, “exercise”, “physical activity”, “weight maintenance” or “sleep”. Where appropriate, reviews or studies of obesity treatment involving children or adults were included in the Review. Reference lists of key papers were also checked to identify additional papers of interest. We also searched for clinical guidelines on the management of adolescent obesity. For the latter to be considered, the guidelines had to be developed or endorsed by a national or international health professional body or government agency and available in English.
Australian Government Department of Health: https://www.tga.gov.au/australian-categorisation-system-prescribing-medicines-pregnancy
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Steinbeck, K.S., Lister, N.B., Gow, M.L. et al. Treatment of adolescent obesity. Nat Rev Endocrinol 14, 331–344 (2018). https://doi.org/10.1038/s41574-018-0002-8
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