Weight loss effect of Sibutramine is also modest and side effects are significant.
Two Bariatric procedures are being tried in children. The first is the Gastric Bypass as shown in this slide and the other is the Adjustable Gastric Band as shown in the next slide. Data is being accumulated to determine efficacy and safety for both of these procedures in children.
This shows the adjustable gastric band.
The only recommended weight loss therapy in children is diet, exercise, and behavior modification.
Behavioral therapy is more effective in children than adults as shown by Len Epstein.
OFFICE-BASED MANAGMENT OF PEDIATRIC OBESITY William J. Klish, M.D. Professor of Pediatrics Baylor College of Medicine
Most logical approach to controlling the obesity epidemic Prevention
However for the average practicing pediatrician treatment and prevention must go together
Treatment Options available to the Pediatrician
Weight Loss Drugs
OBESITY TREATMENT Generic Name Trade Name Dexfenfluramine* Redux Diethylpropion Tenuate Fenfluramine* Podimin Mazindol Sanorex, Mazanor Phendimetrazine Bontul, Plagine, Prelu-2,X-Trozine lonamin, Adipex-2 Phentermine* Fastin, Oby-trim Sibutramine Meridia *Recalled by the FDA Lipase Inhibitor Orlistat Xenacal Appetite Suppressants
Roux-en-Y GBP Current Status of Medical and Surgical Therapy for Obesity Gastroenterology Vol.120, No.3 Restrictive bariatric procedures
Adjustable gastric banding Current Status of Medical and Surgical Therapy for Obesity Gastroenterology Vol.120, No.3 Restrictive bariatric procedures
ONLY ACCEPTED WEIGHT LOSS THERAPY FOR CHILDREN
Behavioral treatment is more effective in children than in adults Epstein, et.al., JAMA, 1995 Kids are not just “little” adults!
Medical Treatment of Obesity Success limited !!
A WEIGH OF LIFE Total number of patients 468 Number completing info packet 83 (18%) Number completing interview only 53 (11%) Number starting program 332 (71%) Number finishing program 92 (20%) OUTCOME (ONE YEAR STUDY)
A WEIGH OF LIFE Change in % IBW (all completers) -23.5+16.1 (average sessions - 18.3) Success rate for completers 98% Change in % IBW (all starters) -11.2+16 (average sessions - 9.34) OUTCOME (ONE YEAR STUDY)