The Medical and Non-medical Interventions in Obesity Amongst School Going Children Review of the Literature

This review will have two major parts, the first part is identifying the complex interventions in the prevention of obesity and analyzing them into different components. The second part will include reviewing the evidence of various intervention strategies, both medical and non-medical. Due to the volume of studies in this field, the aim is to classify the relevant literature and the guidelines on school-age obese children’s intervention methods. The National Institute of Health and Research (NIHR), MEDLINE, and the Cochrane research databases will be used for the primary data. The following websites were also used; National Institute for Health and Clinical Excellence and the Scottish Intercollege Guidelines. Forty applicable materials were found useful to this topic, comprising 70 studies.

When children have a body mass index (MBI) that is more than or equal to the 95th percentile of sex and age, they are obese. If one is obese at the age of 12, studies show that the chances of remaining obese till adulthood are at 98%. According to Fruh (2017), obesity in children is a problem that needs to be given urgent clinical attention due to the effects it has on their daily lives. The current literature on pediatric obesity management explains that there are diverse management concepts that are specific to the intervention in children. First, the interventions need to be family-centered by involving all the family members. Second, it must be suitable for the child’s developmental needs, and third, it should be understood that the loss of weight is a complicated process in growing children. Ruban et al. (2019) state that a child’s nutrition needs must be addressed during the treatment process to maintain normal linear health, growth, and development. The health complications of obesity are physical, psychological, and medical; therefore, the most appropriate strategy should be employed to reduce the risks.

Several factors influence the growth and development of obesity in children, and all the intervention techniques used should be anchored on the predisposing and causal factors. Since there are various causes of obesity, the treatments also need to vary. The major treatment options include behavior modifications, changes in diet, and exercise. The literature available shows that the diet interventions need to be strictly supervised by a health professional because the children are growing and have nutritional requirements (Ruban, 2019). Whether a child has genes that make them gain weight or is obese because of eating unhealthy food, a combination of lifestyle and medication if the conditions worsen is necessary.

Most of the scholarly journal articles on this topic elucidate that little had been achieved despite rigorous lifestyle changes and other supportive practices within the environment to manage obesity in children. Children continue to struggle with excess weight and other associated health complications. Due to the failure of intensive lifestyle modifications, the Endocrine Society issued guidelines that there should be a combination of lifestyle modifications and pharmacotherapy strategies to manage obesity. The guidelines stipulated when the conditions can be managed through non-medical and medical methods. They explained that pharmacotherapy should be preferred for children from families with a history of type 2 diabetes (Mendy et al., 2019). Therefore, the intervention used depends on a variety of factors.

Currently, the Drug and Food Administration (FDA) has approved and recommended the drugs that can be Orlistat as the first-line drug in the treatment of obesity. However, some other drugs, such as metformin, have demonstrated promising results in treating obesity amongst adolescents. Lifestyle interventions can reduce the rates at which children gain weight and the deposition of fats. They can also defer type 2 diabetes risk factors; however, they need to be intensive to be effective. Mendy et al. (2017) argue that exercises and eating dietary food are difficult to maintain amongst children and adolescents because they require supervision by the parents’ caregivers or teachers, which may not happen all the time. Although adult literature has shown that lifestyle changes reduce the lipid profiles, the pediatric literature does not demonstrate the same results.

The latest literature on interventions confirms that doctors may prescribe medication if they realize that other intervention strategies might not be effective. The children who have been unable to lose weight through lifestyle methods should undergo weight loss surgery. One of those types of operation is Bariatric, which is usually recommended by the primary doctor or pediatrician. This type of incision is mostly administered to children who have severe obesity, and the intervention is urgently needed. Studies have shown that the method is effective for children who have conditions associated with high blood pressure, sleep apnea, and diabetes (Kenney et al., 2017). The goal of this intervention is to reduce weight and the effects associated with it as well as produce the minimum risks possible.

Therefore, the surgery is the choice of treatment after the other management options failed. Irrespective of the type of Bariatric surgery used, studies have shown that it is superior to other non-medical and medical interventions (Mendy et al., 2019). The Swedish Studies on Obesity, which is one of the largest researches ever conducted, provides observable data on the surgery’s effects (Mendy et al., 2019). The study showed a high degree of weight loss among the group that underwent the control group’s surgery. Improvement of morbidities associated with obesity was also observed and there was a reduction. The investigations were done on children aged 5 and 16 from different social demographics. Additionally, the inquiries demonstrate that the surgery has long-term effects on weight loss and diabetes resolution compared with other medical and non-medical methods (Hruby & Hu, 2015). Therefore, this treatment option has proved to be the most effective management strategy for diabetes and associate morbidities.

The American Academy of Pediatrics (AAP) latest guidelines elucidates that the adverse effects of obesity shorten children’s lifespan. While doctors can help mitigate the effects of obesity in youngsters through lifestyle methods, the adjustments do not usually make significant changes to their lives for overweight young ones, especially those who are above 100 pounds. Therefore, there is a need to use other medical interventions with low risks and produce results quickly. The surgery is supposed to be done by surgeons highly experienced and working in a high-quality patient facility. This surgery’s complications are rare and insignificant, and they include the deficiency of micronutrients more, especially iron (Westman, 2016). This problem can be easily alleviated by getting supplements to restore the body to its normal condition. Therefore, surgery is one of the most effective ways of treating obesity in children.

The available literature shows that obesity in children has continued to be an ever-growing epidemic in developed and developing countries. However, the effect is mostly felt in developed countries such as the United States. The economic and health implications are dire in society in the nation. Therefore, the right mitigation methods must be designed so that the problem can be minimized. A combination of lifestyle and pharmacotherapy strategies has proved effective through the available latest literature. However, medical methods such as surgery have attested successfully because lifestyle modifications require thorough monitoring of children, which sometimes is difficult. For a specific method to be recommended, an analysis of the condition, predisposing factors, and the causal reasons should be considered.

References

Fruh, S. M. (2017). Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. Journal of the American Association of Nurse Practitioners, 29(S1), S3–S14. Web.

Hruby, A., & Hu, F. B. (2015). The epidemiology of obesity: A big picture. Pharmaco Economics, 33(7), 673–689. Web.

Kenney, E. L., Wintner, S., Lee, R. M., & Austin, S. B. (2017). Obesity prevention interventions in us public schools: Are schools using programs that promote weight stigma? Preventing Chronic Disease, 14, E142. Web.

Mendy, V. L., Vargas, R., Cannon-Smith, G., & Payton, M. (2017). Overweight, obesity, and extreme obesity among Mississippi adults, 2001-2010 and 2011-2015. Preventing Chronic Disease, 14, E49. Web.

Ruban, A., Stoenchev, K., Ashrafian, H., & Teare, J. (2019). Current treatments for obesity. Clinical Medicine, 19(3), 205–212. Web.

Westman, E. C. (2016). Medical treatment of pediatric overweight and obesity. Obesity, 195-203. Web.

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