Child and Adolescent Obesity: Causes and Consequences, Prevention and Management

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On April 28, 1783, the following conversation took place between Dr. Samuel Johnson and his biographer James Boswell: "Speaking of a man who was grown very fat, so as to be incommoded with corpulency, he [Johnson] said 'He eats too much, Sir.' BOSWELL, 'I don't know, Sir; you will see one man fat, who eats moderately, and another lean, who eats a great deal.' JOHNSON, 'Nay, Sir, whatever may be the quantity that a man eats, it is plain that if he is too fat, he has eaten more than he should have done. One man may have a digestion that consumes food better than common; but it is certain that solidity is encreased by putting something too it'" (Life of Samuel Johnson. New York: Heritage Press, 1965). Are we any wiser today? Although we are indeed more knowledgeable, the argument still goes on. Boswell's point of view is reflected in much of today's literature on obesity, whereas others are convinced, and rightly so, that overweight people do eat too much. Second only to dental caries, obesity is the most common nutritional disease in the developed world. We in the United States are in the midst of an epidemic, although the Europeans are doing their best to catch up. Indeed, most of the authors of Child and Adolescent Obesity are from Europe or the United Kingdom. They discuss all aspects of the obese state, from demographics to metabolic features, including the recently described leptin. Family therapy, bariatric surgery, appetite suppressants, the Prader-Willi syndrome, exercise therapy, and the relation between adolescent and adult obesity are included, and each chapter is heavily referenced. Modern technology has largely done away with the classic nutritional ailments, and today's society has done its best to promote and ensure a superabundance of nutrients. One can hardly think of a set of circumstances better designed to promote obesity in our society: the ubiquitous automobile contributing to reduced physical activity; the abund

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Editorial Reviews

From the Publisher
"[A] stepping stone for the reader to begin understanding and more effectively managing obesity. I highly recommend it as a resource for all practicing physicians who require the skills necessary for management of severely overweight and obese children and adolescents." Archives of Pediatric and Adolescent Medicine

"This book covers a complex topic taking into consideration a wide variety of determinants of obesity. The synopsis of the material is very useful to health professionals as it provides updated information and raises many questions for future research." Doody's Notes

"It is helpful to have the evidence on the epidemiological data and the outcomes of obesity presented clearly." Journal of the Royal Society of Medicine

"It is noteworthy that the authors portray the obese person as a human being, not merely as a metabolic machine ... one can applaud the authors." New England Journal of Medicine

"I would highly recommend this textbook to any practicing clinician, including gastroenterologists, primary care physicians, and pediatricians. It also can serve as an invaluable reference for other members of the weight loss management team including dieticians, nurses, psychologists and exercise physiologists." Practical Gastroenterology

"The book is well organized and a pleasure to read." Annals of Human Biology

Doody's Review Service
Reviewer: Roula Tzianetas, RDN, BASc (University of British Columbia)
Description: This overview of childhood obesity includes literature from various studies that look at the causes, consequences, and prevention and treatment of childhood obesity.
Purpose: The purpose is to increase awareness of childhood obesity and the complexity of this health concern among health professionals and society. In addition, the authors intend to provide some practical expertise. The objectives are very worthy and this collaboration is greatly needed to disseminate a collection of research on childhood obesity. Although the book provides information on the causes, consequences, and treatment options for childhood obesity, there is limited information on the outcomes of some of the treatment strategies (i.e., how do things work in practice? What strategies work and do not work with children).
Audience: According to the authors, the book is primarily written for health and research workers. It is also suggested that the book will reach a wider group of individuals that the authors have not specified. In my opinion, the book is written at a level for health professionals and I do not believe it is user-friendly for the general population. The majority of the authors have a wide variety of experience in certain areas of childhood obesity.
Features: The book addresses a variety of topics that relate to childhood obesity. It begins with a description of the pathology, epidemiology, and sociological issues surrounding obesity. It provides a synopsis of the possible clinical outcomes of childhood obesity and an overview of the prevention strategies such as diet, activity, and drug therapies. Most interesting is the concluding chapter that focuses on future issues and research opportunities in this area. While the authors' intentions may have been good, I question the use of the drawing on the cover. As health practitioners working with children, we need to have empathy, but I found that the drawing may be interpreted in a negative manner by individuals who live with obesity. I think it continues to perpetuate the stigma associated with obesity and would prefer a comprehensive picture of body images on the cover. Realizing that the book cannot cover every topic extensively, I would like to have seen a review of how some of the practical applications work with children living with obesity. Specifically, reviewing the current research on behavior modification (i.e., why do some children change; what influences their change; what are their experiences; what works and doesn't work with regards to behavior modification and the outcomes of these strategies). Lastly, the use of the term "slimming" is an important issue. The authors need to present their interpretation and use of this term, since it can be misinterpreted. It may conjure up an image of needing to be "thinner" where our goal as health professionals is to encourage healthy weights for children so that they can live healthy lives.
Assessment: This book covers a complex topic taking into consideration a wide variety of determinants of obesity. The synopsis of the material is very useful to health professionals as it provides updated information and raises many questions for future research.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780521026642
  • Publisher: Cambridge University Press
  • Publication date: 3/31/2006
  • Edition description: First Edition
  • Pages: 440
  • Product dimensions: 6.85 (w) x 9.72 (h) x 0.91 (d)

Meet the Author

Post-Graduate in Pediatrics 1979, Free University of Brussels with 'highest distinction' - in French 'la plus grande distinction' (19/20). Full career in the Pediatric Department of the University Hospital St Pierre, Brugmann and HUDERF. Assistant head of clinics from 1982. Outpatient clinic of pediatrics, outpatient clinic for obesity (from 1986), outpatient clinic for adolescents (from 1997). Medical manager of the Hospital 1993–1995. Active member of the International Physicians against the Nuclear War (Education Reward UNESCO 1984, Nobel Peace Prize 1985). Formed in 1990 the European Childhoood Obesity Group (ECOG) (with Dr E. M. E. Poskitt). Secretary 1990–1994, President 1994–1997, Board Member. The ECOG this year became the official Task Force for Childhood Obesity of the European Association for the Study of Obesity (EASO). Links exist also with the International Obesity Task Force (WHO). Member of the Belgian Academy of Pediatrics, the European and International Association for the Study on Obesity, the European Childhood Obesity Group. Papers, mainly on obesity in children, in Sleep, Pediatric & Adolescent Medicine, Nutrition Research, Risk and Safety Medicine, Acta Paediatrica, International Journal of Obesity. Book edited in 1995 with support of Regional Ministry of Health - Brussels: l'Enfant Obèse. Pp 1-120. Bruxelles, Traces de Doigts, W. Burniat Ed. Invited as lecturer to International Meetings: The Obese Child, Ancona 1990, 5th International Congress on Pediatric Nutrition, Naples 1992; Post-Graduate Course on Childhood Obesity, Pécs,Hungary 1994; 6th Workshop of the ECOG, Ulm, 1996; ECOG Satellite 8th European Congress on Obesity, Dublin 1997. Organiser 1st ECOG Workshop, Brussels 1991; 1st ECOG Satellite to EASO Congress, Dublin 1997; ECOG Satellite to 10Th EASO Congress, Antwerp 2000.

Medical statistician with a long term research interest in child growth and nutrition. Previously worked at MRC Pneumoconiosis Research Unit in South Wales, then MRC Dunn Nutrition Unit in Cambridge for 23 years. Now professor of medical statistics at Institute of Child Health. Developed statistical methods for constructing growth charts, and applied them to produce national charts for 8 countries. Has designed several novel forms of growth chart. Invented the Cole Calculator, a slide rule to assess child height, weight and body mass index. Joint editor of Body Composition Techniques in Health and Disease, CUP 1995. 300+ publications in statistical, medical, nutritional and auxological journals. Developed International Obesity Task Force cutoffs to define child obesity. Helped develop Baby Check, booklet to help parents identify seriously ill infants. Member, steering committee, WHO Multicenter Growth Reference. Editorial board member of Annals of Human Biology, European Journal of Clinical Nutrition, Statistics in Medicine and Public Health Nutrition, also statistical adviser to BMJ. Won 1976 Frances Wood Memorial Prize, Royal Statistical Society.

Chaired the Committee on Nutrition and Physical Activity in the Danish Government's 10 year Programme on Health Promotion and Prevention. Chair of the Congress Organising Committee of the 5th International Congress on Behavioral Medicine (Copenhagen 1998). Former Secretary (3 years), now board member of the European Childhood Obesity Group (ECOG). Published several papers on childhood obesity. For instance Lancet 1994 about the strong effect of parental neglect on developing obesity in young adulthood. From 2001 Danish member of European Association for the Study of Obesity's (EASO) Pediatric Task Force Group Founder member and former Scientific Secretary of The Danish Society of Psychosocial Medicine (6 years). Member of editorial board of International Journal of Behavioral Medicine

Medical doctor qualified 1963, specialising in paediatrics since 1967. Worked with malnutrition with MRC (Medical Research Council of UK) in Uganda 1968-71. Then paediatric posts in Birmingham and University of Liverpool UK. Running obesity clinic for children from 1971–76 in Birmingham and 1977–93 in Liverpool. Research in Birmingham with MRC on later outcome for fat babies 1974-76. 1993–98 Head of MRC Dunn Nutritional Group Field Station in Keneba, The Gambia. Since 1998 attached to International Nutrition Group in the Public Health Nutrition Unit at London School of Hygiene and Tropical Medicine. Co founder (with Walter Burniat) of European Childhood Obesity Group in late 1980s. Author Practical Paediatric Nutrition (Butterworths, 1988) and around 100 other articles and book chapters on paediatric nutrition: obesity, malnutrition; feeding problems; nutritional problems in children with heart disease; fetal alcohol syndrome etc. Past commitments include Chair of British Paediatric Association (now Royal College of Paediatrics & Child Health) Nutrition Subcommittee; member of Panel on Child Nutrition of Department of Health Committee on Medical Aspects of Food Policy; member of Vitamin Working Party for Department of Health Panel on Dietary Reference Values; member Department of Health Advisory Committee on Drugs; Gambian Department of Health Vitamin A working party; Gambian Department of Health Breast Feeding working party; member and then Chair of Gambian Food and Nutrition Association; member Joint MRC/Gambian Ministry of Health Ethical Committee. First President European Childhood Obesity Group. Also long-standing involvement with International Federation of University Women (IFUW: an NGO of about 180,000 women in 70+ countries dedicated to development of women and international friendship and peace) – President IFUW 1995-98. Awarded OBE for services to medical research and the IFUW in the Birthday Honours 1998.

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Table of Contents

List of contributors; Foreword William H. Dietz; Preface; Part I. Causes: 1. Measurement and definition Tim J. Cole and Marie Françoise Rolland-Cachera; 2. Epidemiology Michèle Guillaume and Inge Lissau; 3. Molecular and biological factors with emphasis on adipose tissue development Martin Wabitsch; 4. Nutrition Marie Françoise Rolland-Cachera and France Bellisle; 5. Physical activity Yves Schutz and Claudio Maffeis; 6. Psychosocial factors Andrew J. Hill and Inge Lissau; Part II. Consequences: 7. Clinical features, adverse effects and outcome Karl F. M. Zwiauer, Margherita Caroli, Ewa Malecka-Tendera and Elizabeth M. E. Poskitt; 8. The obese adolescent Marie-Laure Frelut and Carl-Erik Flodmark; 9. Prader-Willi and other syndromes Giuseppe Chiumello and Elizabeth M. E. Poskitt; 10. Hormonal and metabolic changes Ewa Malecka-Tendera and Dénes Molnár; 11. Risk of cardiovascular complications David S. Freedman, Sathanur R. Srinivasan and Gerald S. Berenson; Part III. Prevention and Management: 12. Prevention Inge Lissau, Walter Burniat, Elizabeth M. E. Poskitt and Tim J. Cole; 13. Home-based management Elizabeth M. E. Poskitt; 14. Dietary management Margherita Caroli and Walter Burniat; 15. Management through activity Jana Parizkova, Claudio Maffeis and Elizabeth M. E. Poskitt; 16. Psychotherapy Carl-Erik Flodmark and Inge Lissau; 17. Drug therapy Dénes Molnár and Ewa Malecka-Tendera; 18. Surgical treatment Alessandro Salvatoni; 19. Interdisciplinary outpatient management Beatrice Bauer and Claudio Maffeis; 20. Interdiscplinary residential management Marie-Laure Frelut; 21. The future W. Philip T. James; Index.

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