• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.23 no.1
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• pp.15-25
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• 2020

Prevalence of pediatric obesity has increased worldwide in the last 20 years. Obese children suffer not only physical complications but also mental health problems such as depression, attention deficit hyperactivity disorder (ADHD), and eating disorders, as well as psychosocial impairments, such as school adjustment problems, bullying, and low self-esteem. Recently, there have been some studies on the association of mental health problems and pediatric obesity. In the treatment of pediatric obesity, many previous studies suggest multidisciplinary treatment. However, cognitive behavioral therapy (CBT) has attracted attention because obese children are accompanied by body image distortion, emotion dysregulation, and difficulties in stimulus control. This review is a narrative summary of the recent studies on mental health problems and CBT in pediatric obesity. The relationship between depression/anxiety and pediatric obesity is still inconsistent but recent studies have revealed a bidirectional relation between depression and obesity. Additionally, some studies suggest that obese children may have eating disorder symptoms, like loss of control eating, and require therapeutic intervention for pediatric obesity treatment. Furthermore, impulsivity and inattention of ADHD symptom is thought to increase the risk of obesity. It has also been suggested that CBT can be very effective for mental health problems such as depression, impulsivity, and body image distortion, that may coexist with pediatric obesity, and use of multimedia and application can be useful in CBT.

• Clinical and Experimental Pediatrics
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• v.64 no.5
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• pp.196-207
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• 2021

Over the last few decades, the rates of pediatric obesity have more than doubled regardless of sociodemographic categorization, and despite these rates plateauing in recent years there continues to be an increase in the severity of obesity in children and adolescents. This review will discuss the pediatric obesity mediated cardiovascular disease (CVD) risk factors such as attenuated levels of satiety and energy metabolism hormones, insulin resistance, vascular endothelial dysfunction, and arterial stiffness. Additionally, early intervention to combat pediatric obesity is critical as obesity has been suggested to track into adulthood, and these obese children and adolescents are at an increased risk of early mortality. Current suggested strategies to combat pediatric obesity are modifying diet, limiting sedentary behavior, and increasing physical activity. The effects of exercise intervention on metabolic hormones such as leptin and adiponectin, insulin sensitivity/resistance, and body fat in obese children and adolescents will be discussed along with the exercise modality, intensity, and duration. Specifically, this review will focus on the differential effects of aerobic exercise, resistance training, and combined exercise on the cardiovascular risks in pediatric obesity. This review outlines the evidence that exercise intervention is a beneficial therapeutic strategy to reduce the risk factors for CVD and the ideal exercise prescription to combat pediatric obesity should contain both muscle strengthening and aerobic components with an emphasis on fat mass reduction and long-term adherence.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.22 no.1
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• pp.1-27
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• 2019

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.

• Clinical and Experimental Pediatrics
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• v.62 no.1
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• pp.3-21
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• 2019

The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: (1) definition and diagnosis of overweight and obesity in children and adolescents; (2) principles of treatment of pediatric obesity; (3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; (4) pharmacotherapy; and (5) bariatric surgery.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.20 no.2
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• pp.71-78
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• 2017

Child obesity has become a significant health issue in Korea. Prevalence of obesity in school-age children in Korea has been alarmingly rising since 2008. Prevalence of obesity among infants and preschool-age children in Korea has doubled since 2008. Obese children may develop serious health complications. Before nutritional counseling is pursued, several points should be initially considered. The points are modifiable risk factors, assessment for child obesity, and principles of treatment. Motivational interviewing and a multidisciplinary team approach are key principles to consider in managing child obesity effectively in the short-term as well as long-term. Nutritional counseling begins with maintaining a daily log of food and drink intake, which could possibly be causing obesity in a child. Several effective tools for nutritional counseling in practice are the Traffic Light Diet plan, MyPlate, Food Balance Wheel, and 'Food Exchange Table'. Detailed nutritional counseling supported by a qualified dietitian is an art of medicine enabling insulin therapy and hypoglycemic agents to effectively manage diabetes mellitus in obese children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.sup1
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• pp.118-126
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• 2009

The incidence of childhood obesity has increased dramatically. Childhood obesity is an increasing health problem because of its strong associations with chronic health problems in children and adults. These health problems significantly contribute to the development of common chronic diseases in later life, including hypertension, type2 diabetes, hyperinsulinemia, coronary heart disease, and other psychological disorders. So it is an important issue to prevent and treat obesity during childhood and adolescent. Diet and exercise are the cornerstones of treatment for obesity and related complications. For obese children, some clinical trials have shown improvement with diet, exercise, and /or behavioral interventions. Promising interventions for high-risk individuals, such as bariatric surgery and novel pharmacological agents, also require rigorous assessment with attention to long-term patient important outcomes. There are various pharmacological approaches to the treatment of obesity in the adolescent population some of which have FDA approval. In the article we discuss pharmacological approaches to guide the treatment of obesity in the pediatric population, including risks of treatment, monitoring of potential side effects.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.12 no.sup1
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• pp.62-71
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• 2009

Non-alcoholic fatty liver disease (NAFLD) is the most common cause of pediatric liver disease. Similar to NAFLD in adults, NAFLD in children is associated with obesity and insulin resistance and requires liver histology for diagnosis and staging. However, significant histological differences exist between adult and pediatric NAFLD. The rise in childhood obesity has been accompanied by an increase in pediatric NAFLD. Age, gender and race/ethnicity are significant determinants of risk, and sex hormones, insulin sensitivity and adipocytokines are implicated in the pathogenesis of pediatric NAFLD. There is no consensus for treatment of NAFLD, however, data suggest that diet, exercise and some pharmacological therapies may be of benefit. To evaluate and effectively treat pediatric NAFLD, the pathophysiology and natural history of the disease should be clarified and non-invasive methods for screening, diagnosis, and longitudinal assessment developed.

• Clinical and Experimental Pediatrics
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• v.64 no.12
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• pp.619-627
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• 2021

Pediatric obesity has become a serious public health issue. The prevalence of obesity in children and adolescents has increased worldwide and in Korea over several decades. Obese children are more likely to be obese adults with an increased cardiovascular risk. Therefore, maintaining a healthy weight and preventing obesity during childhood are of critical importance. Moreover, obese children and adolescents often have endocrine comorbidities such as prediabetes, type 2 diabetes, dyslipidemia, metabolic syndrome, polycystic ovary syndrome, and central precocious puberty. Hence, the early implementation of obesity management using a multidisciplinary team approach and screening for these comorbidities in obese children and adolescents are required with the appropriate management of each comorbidity and/or specialist referral.

• Journal of Korean Medicine for Obesity Research
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• v.9 no.1
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• pp.45-51
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• 2009

Objectives The purpose of this study was to investigate the effect of oriental treatment on pediatric overweight and obesity. Methods From the December 2006 to the May 2008, 19 children were treated of obesity control in J Korean Hospital, electrolipolysis, auricular acupuncture was done 2 times per week for 4 weeks with the consulting of diet and exercise. Nine children were treated for 9 weeks. We checked the change of weight at treatment time and the body composition measured by bioelectrical impedance analysis(BIA) per 2 weeks. Results After 4 weeks treatment, the weight loss was 2.67${\pm}$1.75kg. And after 9 weeks treatment, the weight loss of 9 children was 5.91${\pm}$2.73kg. Total fat mass measured by BIA significantly decreased 2.38${\pm}$1.19kg after 4 weeks. BMI and the weight loss of children were significantly correlated. After 4 weeks treatment the BMI significantly decreased 1.43${\pm}$0.89kg/m$^2$. After 8 weeks treatment the BMI of 9 children significantly decreased 3.31${\pm}$1.47kg/m$^2$. Conclusions The pediatric obesity could be effective treated by herdal medicine and electroacupuncture.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.1
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• pp.62-69
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• 2006

Objective : This study was conducted to investigate as to whether obesity have any effects on conscious sedation outcomes. Methods : Forty children (mean age 30.5 months, mean height and weight were 91.3cm, 14.3kg respectively) were sedated with chloral hydrate (60 mg/kg) and hydroxyzine (25mg). The relative obesity rate of the patients was obtained by the proportion of height to weight and the tonsil size of the patients was classified by Brodsky's scale. The overall sedation outcomes were evaluated by Houpt's scale. The pulse and respiratory rates during sedation were also evaluated. Results: The obesity of the patients had no statistically significant effects on movement, crying during sedation. However, an increase in obesity had negative effects on the overall conscious sedation outcomes. Conclusion: This investigation demonstrated that increased obesity may cause detrimental effects on pediatric conscious sedation outcomes.